SlideShare uma empresa Scribd logo
1 de 56
Poliomyelitis and Post Polio Syndrome Orla Hardiman Beaumont Hospital Dublin
Poliovirus
Poliomyelitis ,[object Object],[object Object],[object Object],[object Object]
POLIOMYELITIS ,[object Object],[object Object],[object Object],[object Object]
Poliomyelitis:Epidemiology ,[object Object],[object Object]
Epidemiology of Polio in US
LIFE CYCLE OF POLIO VIRUS
Clinical Pattern of Polio
POLIO ATTACKS MOTOR NEURONES
Poliomyelitis:Clinical Features ,[object Object],[object Object],[object Object]
Poliomyelitis: Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Measures to Prevent Infection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pointers for Parents:    (USA 1951)
Poliomyelitis: Treatment ,[object Object],[object Object],[object Object],[object Object]
Poliomyelitis: Treatment ,[object Object],[object Object],[object Object]
Poliovirus: Eradication ,[object Object],[object Object],[object Object],[object Object],[object Object]
Inactivated Vaccine ,[object Object],[object Object],[object Object],[object Object],[object Object],Jonas Salk
Live Vaccine ,[object Object],[object Object],[object Object],[object Object]
Poliomyelitis in USA Since Vaccinations
Poliomyelitis:Current Status ,[object Object],[object Object],[object Object],[object Object]
Polio Eradication: Status in 1988
Polio Eradication:  Status in 1998
 
Polio Revisited ,[object Object],[object Object],[object Object],[object Object]
THE POST POLIO SYNDROME: EXPERIENCE FROM A TERTIARY NEUROLOGY REFERRAL CENTRE IN IRELAND  Dr. Grainne Gorman,Catherine Lynch R.N.,Dr. Orla Hardiman Department of Neurology, Beaumont Hospital.
Details Collated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
New Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Natural History of Polio (Halstead)
Criteria For Diagnosis of Post Polio Syndrome ,[object Object],[object Object],[object Object]
Criteria for Diagnosis of Post Polio Syndrome (cont’d) ,[object Object],[object Object],[object Object]
Pathophysiology ,[object Object],[object Object],[object Object],[object Object]
Theories (contd.) ,[object Object],[object Object],[object Object]
Possible Causes of Late Complications of Polio
Main Clinical Features of PPS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fatigue ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Weakness ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Muscle Pain ,[object Object],[object Object],[object Object],[object Object]
Swallowing Problems ,[object Object],[object Object],[object Object]
Cold Intolerance ,[object Object],[object Object],[object Object]
Sleep Apnoea ,[object Object],[object Object],[object Object],[object Object]
Risk Factors for Sleep Apnoea ,[object Object],[object Object],[object Object]
Management of Post Polio  Syndrome in Ireland ,[object Object],[object Object],[object Object],[object Object]
Post Polio Syndrome  Multidisciplinary Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Post Polio Syndrome in Ireland ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Post Polio Syndrome in Ireland ,[object Object],[object Object],[object Object]
Management of Post Polio Syndrome in Ireland ,[object Object],[object Object],[object Object]
Measuring Progression ,[object Object],[object Object],[object Object]
SERIAL QMAs IN 16 MUSCLES
CHANGES IN STRENGTH OVER TIME USING QMA
Research ,[object Object],[object Object],[object Object],[object Object]
ELECTROMYOGRAPHY ,[object Object],[object Object]
Treatment /Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CONCLUSIONS ,[object Object],[object Object],[object Object],[object Object],[object Object]

Mais conteúdo relacionado

Mais procurados

Poliomyelitis uploaded by Samrat Gurung
Poliomyelitis uploaded by Samrat GurungPoliomyelitis uploaded by Samrat Gurung
Poliomyelitis uploaded by Samrat GurungSamrat Gurung
 
Communicable disease - intestinal infections
Communicable disease - intestinal infectionsCommunicable disease - intestinal infections
Communicable disease - intestinal infectionsAnju T.N
 
Small pox and chicken pox
Small pox and chicken poxSmall pox and chicken pox
Small pox and chicken poxRizwan S A
 
Chest wall deformities
Chest wall deformitiesChest wall deformities
Chest wall deformitiesdegnarog
 
Poliomyelitis ortho pt
Poliomyelitis ortho ptPoliomyelitis ortho pt
Poliomyelitis ortho ptRajani Cartor
 
Polio myelitis - DISEASE CONDITION IN DETAIL
Polio myelitis - DISEASE CONDITION IN DETAILPolio myelitis - DISEASE CONDITION IN DETAIL
Polio myelitis - DISEASE CONDITION IN DETAILShebs Alumoottil
 
Hospital acquired pneumonia
Hospital acquired pneumoniaHospital acquired pneumonia
Hospital acquired pneumoniaMEEQAT HOSPITAL
 
Presentation on lymphatic filariasis
Presentation on lymphatic filariasisPresentation on lymphatic filariasis
Presentation on lymphatic filariasisDrRezwanulHasan
 
Previous year question on polio based on neet pg, usmle, plab and fmge or mci...
Previous year question on polio based on neet pg, usmle, plab and fmge or mci...Previous year question on polio based on neet pg, usmle, plab and fmge or mci...
Previous year question on polio based on neet pg, usmle, plab and fmge or mci...Abhishek Gupta
 
Epidemiology of Malaria
Epidemiology of MalariaEpidemiology of Malaria
Epidemiology of MalariaNikhil Bansal
 

Mais procurados (20)

Poliomyelitis uploaded by Samrat Gurung
Poliomyelitis uploaded by Samrat GurungPoliomyelitis uploaded by Samrat Gurung
Poliomyelitis uploaded by Samrat Gurung
 
Mumps
MumpsMumps
Mumps
 
Communicable disease - intestinal infections
Communicable disease - intestinal infectionsCommunicable disease - intestinal infections
Communicable disease - intestinal infections
 
Small pox and chicken pox
Small pox and chicken poxSmall pox and chicken pox
Small pox and chicken pox
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Measles
MeaslesMeasles
Measles
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Rabies
Rabies Rabies
Rabies
 
Chest wall deformities
Chest wall deformitiesChest wall deformities
Chest wall deformities
 
Poliomyelitis ortho pt
Poliomyelitis ortho ptPoliomyelitis ortho pt
Poliomyelitis ortho pt
 
Polio myelitis - DISEASE CONDITION IN DETAIL
Polio myelitis - DISEASE CONDITION IN DETAILPolio myelitis - DISEASE CONDITION IN DETAIL
Polio myelitis - DISEASE CONDITION IN DETAIL
 
Hospital acquired pneumonia
Hospital acquired pneumoniaHospital acquired pneumonia
Hospital acquired pneumonia
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Empyema
EmpyemaEmpyema
Empyema
 
German measles
German measlesGerman measles
German measles
 
Presentation on lymphatic filariasis
Presentation on lymphatic filariasisPresentation on lymphatic filariasis
Presentation on lymphatic filariasis
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Previous year question on polio based on neet pg, usmle, plab and fmge or mci...
Previous year question on polio based on neet pg, usmle, plab and fmge or mci...Previous year question on polio based on neet pg, usmle, plab and fmge or mci...
Previous year question on polio based on neet pg, usmle, plab and fmge or mci...
 
Epidemiology of Malaria
Epidemiology of MalariaEpidemiology of Malaria
Epidemiology of Malaria
 
23. polio andinfluenza
23. polio andinfluenza23. polio andinfluenza
23. polio andinfluenza
 

Destaque

Polio Final Presentation
Polio Final PresentationPolio Final Presentation
Polio Final PresentationAnkush Ankush
 
Occupational Therapy management for Post polio syndrome
Occupational Therapy management for Post polio syndromeOccupational Therapy management for Post polio syndrome
Occupational Therapy management for Post polio syndromePhinoj K Abraham
 
Polio power point
Polio power pointPolio power point
Polio power pointjasono5
 
Acute flaccid paralysis (AFP)
Acute flaccid paralysis (AFP)Acute flaccid paralysis (AFP)
Acute flaccid paralysis (AFP)Azad Haleem
 
Orthotic treatment of polio myelitis
Orthotic treatment of polio myelitisOrthotic treatment of polio myelitis
Orthotic treatment of polio myelitisAinaa Khan
 
Acute flaccid paralysis (polio&tm)
Acute flaccid paralysis (polio&tm)Acute flaccid paralysis (polio&tm)
Acute flaccid paralysis (polio&tm)Dr.Jatheesh Mohan
 
Post polio residual paralysis PPT
Post polio residual paralysis PPTPost polio residual paralysis PPT
Post polio residual paralysis PPTSAI KRISHNA
 
Post polio residual paralysis of foot and ankle
Post polio residual paralysis of foot and anklePost polio residual paralysis of foot and ankle
Post polio residual paralysis of foot and ankleGIRIDHAR BOYAPATI
 
Polio lower limb deformity
Polio lower limb deformityPolio lower limb deformity
Polio lower limb deformityNaveed Jumani
 
PICORNA VIRUS POLIO dr. someshwaran may 2015
PICORNA VIRUS POLIO dr. someshwaran may 2015 PICORNA VIRUS POLIO dr. someshwaran may 2015
PICORNA VIRUS POLIO dr. someshwaran may 2015 SOMESHWARAN R
 

Destaque (20)

Polio project
Polio projectPolio project
Polio project
 
late effect of polio
late effect of poliolate effect of polio
late effect of polio
 
Polio
PolioPolio
Polio
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Polio Final Presentation
Polio Final PresentationPolio Final Presentation
Polio Final Presentation
 
Occupational Therapy management for Post polio syndrome
Occupational Therapy management for Post polio syndromeOccupational Therapy management for Post polio syndrome
Occupational Therapy management for Post polio syndrome
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Polio
PolioPolio
Polio
 
Poliomyelitis
PoliomyelitisPoliomyelitis
Poliomyelitis
 
Polio
PolioPolio
Polio
 
Polio power point
Polio power pointPolio power point
Polio power point
 
Acute flaccid paralysis (AFP)
Acute flaccid paralysis (AFP)Acute flaccid paralysis (AFP)
Acute flaccid paralysis (AFP)
 
Orthotic treatment of polio myelitis
Orthotic treatment of polio myelitisOrthotic treatment of polio myelitis
Orthotic treatment of polio myelitis
 
Polio
PolioPolio
Polio
 
Acute flaccid paralysis (polio&tm)
Acute flaccid paralysis (polio&tm)Acute flaccid paralysis (polio&tm)
Acute flaccid paralysis (polio&tm)
 
Post polio residual paralysis PPT
Post polio residual paralysis PPTPost polio residual paralysis PPT
Post polio residual paralysis PPT
 
Post polio residual paralysis of foot and ankle
Post polio residual paralysis of foot and anklePost polio residual paralysis of foot and ankle
Post polio residual paralysis of foot and ankle
 
Surviellance
SurviellanceSurviellance
Surviellance
 
Polio lower limb deformity
Polio lower limb deformityPolio lower limb deformity
Polio lower limb deformity
 
PICORNA VIRUS POLIO dr. someshwaran may 2015
PICORNA VIRUS POLIO dr. someshwaran may 2015 PICORNA VIRUS POLIO dr. someshwaran may 2015
PICORNA VIRUS POLIO dr. someshwaran may 2015
 

Semelhante a Dr Orlapresentation8

ACUTE FLACCID PARALYSIS MBBS Lecture
ACUTE FLACCID PARALYSIS MBBS Lecture ACUTE FLACCID PARALYSIS MBBS Lecture
ACUTE FLACCID PARALYSIS MBBS Lecture Sajjad Sabir
 
Acute Flaccid Paralysis Lecture MBBS
Acute Flaccid Paralysis Lecture MBBSAcute Flaccid Paralysis Lecture MBBS
Acute Flaccid Paralysis Lecture MBBSSajjad Sabir
 
Acute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptx
Acute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptxAcute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptx
Acute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptxnowrin05273815
 
Acute poliomyelitis
Acute poliomyelitisAcute poliomyelitis
Acute poliomyelitiskiranmct
 
Guillain-Barre syndrome; the murderer enemy
Guillain-Barre syndrome; the murderer enemyGuillain-Barre syndrome; the murderer enemy
Guillain-Barre syndrome; the murderer enemySamir Mounir
 
ANNUAHREE's presentation.pptx
ANNUAHREE's presentation.pptxANNUAHREE's presentation.pptx
ANNUAHREE's presentation.pptxannushree9
 
Poliomyelitis 15-04-2023.ppt
Poliomyelitis 15-04-2023.pptPoliomyelitis 15-04-2023.ppt
Poliomyelitis 15-04-2023.pptSardarAwais4
 
Polio myelitis
Polio myelitisPolio myelitis
Polio myelitisGAMANDEEP
 
Guillain barre syndrome (gbs)
Guillain barre syndrome (gbs) Guillain barre syndrome (gbs)
Guillain barre syndrome (gbs) Mohamed Abunada
 
Guillain-Barré syndrome with Physiotherapeautic managements
Guillain-Barré syndrome with Physiotherapeautic managementsGuillain-Barré syndrome with Physiotherapeautic managements
Guillain-Barré syndrome with Physiotherapeautic managementsSAGAR KUMAR GOUDA
 
Acute flaccid paralysis afp ‫‬
Acute flaccid paralysis afp ‫‬Acute flaccid paralysis afp ‫‬
Acute flaccid paralysis afp ‫‬Mohamed Abunada
 
دمحمد ابوندىAcute flaccid paralysis afp ‫‬
دمحمد ابوندىAcute flaccid paralysis afp ‫‬دمحمد ابوندىAcute flaccid paralysis afp ‫‬
دمحمد ابوندىAcute flaccid paralysis afp ‫‬Mohamed Abunada
 
poliomyelitis مجد الدين.pptx
poliomyelitis مجد الدين.pptxpoliomyelitis مجد الدين.pptx
poliomyelitis مجد الدين.pptxhtmii
 

Semelhante a Dr Orlapresentation8 (20)

ACUTE FLACCID PARALYSIS MBBS Lecture
ACUTE FLACCID PARALYSIS MBBS Lecture ACUTE FLACCID PARALYSIS MBBS Lecture
ACUTE FLACCID PARALYSIS MBBS Lecture
 
Acute Flaccid Paralysis Lecture MBBS
Acute Flaccid Paralysis Lecture MBBSAcute Flaccid Paralysis Lecture MBBS
Acute Flaccid Paralysis Lecture MBBS
 
Acute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptx
Acute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptxAcute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptx
Acute flaccid paralysis (GBS, TM, Polio, Traumatic Neuritis).pptx
 
Poliomyelitis1
Poliomyelitis1Poliomyelitis1
Poliomyelitis1
 
Acute poliomyelitis
Acute poliomyelitisAcute poliomyelitis
Acute poliomyelitis
 
Poliomyelitis1
Poliomyelitis1Poliomyelitis1
Poliomyelitis1
 
Guillain-Barre syndrome; the murderer enemy
Guillain-Barre syndrome; the murderer enemyGuillain-Barre syndrome; the murderer enemy
Guillain-Barre syndrome; the murderer enemy
 
Afp 30.07.2014
Afp 30.07.2014Afp 30.07.2014
Afp 30.07.2014
 
ANNUAHREE's presentation.pptx
ANNUAHREE's presentation.pptxANNUAHREE's presentation.pptx
ANNUAHREE's presentation.pptx
 
Poliomyelitis 15-04-2023.ppt
Poliomyelitis 15-04-2023.pptPoliomyelitis 15-04-2023.ppt
Poliomyelitis 15-04-2023.ppt
 
Poliomyelitis - Child Health Nursing
Poliomyelitis - Child Health NursingPoliomyelitis - Child Health Nursing
Poliomyelitis - Child Health Nursing
 
Polio myelitis
Polio myelitisPolio myelitis
Polio myelitis
 
Guillain barre syndrome (gbs)
Guillain barre syndrome (gbs) Guillain barre syndrome (gbs)
Guillain barre syndrome (gbs)
 
Poliomyelitis
Poliomyelitis Poliomyelitis
Poliomyelitis
 
Guillain-Barré syndrome with Physiotherapeautic managements
Guillain-Barré syndrome with Physiotherapeautic managementsGuillain-Barré syndrome with Physiotherapeautic managements
Guillain-Barré syndrome with Physiotherapeautic managements
 
Acute Flaccid Paralysis
Acute Flaccid ParalysisAcute Flaccid Paralysis
Acute Flaccid Paralysis
 
Acute flaccid paralysis afp ‫‬
Acute flaccid paralysis afp ‫‬Acute flaccid paralysis afp ‫‬
Acute flaccid paralysis afp ‫‬
 
دمحمد ابوندىAcute flaccid paralysis afp ‫‬
دمحمد ابوندىAcute flaccid paralysis afp ‫‬دمحمد ابوندىAcute flaccid paralysis afp ‫‬
دمحمد ابوندىAcute flaccid paralysis afp ‫‬
 
Back pain
Back painBack pain
Back pain
 
poliomyelitis مجد الدين.pptx
poliomyelitis مجد الدين.pptxpoliomyelitis مجد الدين.pptx
poliomyelitis مجد الدين.pptx
 

Mais de MedicineAndHealth14

Preop Assessment Periop Management
Preop Assessment Periop ManagementPreop Assessment Periop Management
Preop Assessment Periop ManagementMedicineAndHealth14
 
www.triz.hk/icoiappt/icoia010601.ppt www.triz.hk/icoiappt/icoia010601.ppt
www.triz.hk/icoiappt/icoia010601.ppt 	 www.triz.hk/icoiappt/icoia010601.pptwww.triz.hk/icoiappt/icoia010601.ppt 	 www.triz.hk/icoiappt/icoia010601.ppt
www.triz.hk/icoiappt/icoia010601.ppt www.triz.hk/icoiappt/icoia010601.pptMedicineAndHealth14
 
Design of a medical simulator for subcutaneous contraceptive implant insertio...
Design of a medical simulator for subcutaneous contraceptive implant insertio...Design of a medical simulator for subcutaneous contraceptive implant insertio...
Design of a medical simulator for subcutaneous contraceptive implant insertio...MedicineAndHealth14
 
Obesity: The Bariatric Challenge Obesity: The Bariatric Challenge
Obesity: The Bariatric Challenge 	 Obesity: The Bariatric ChallengeObesity: The Bariatric Challenge 	 Obesity: The Bariatric Challenge
Obesity: The Bariatric Challenge Obesity: The Bariatric ChallengeMedicineAndHealth14
 
PEPTIDES AS BIOTHERAPEUTIC TOOLS PEPTIDES AS BIOTHERAPEUTIC TOOLS
PEPTIDES AS BIOTHERAPEUTIC TOOLS 	 PEPTIDES AS BIOTHERAPEUTIC TOOLSPEPTIDES AS BIOTHERAPEUTIC TOOLS 	 PEPTIDES AS BIOTHERAPEUTIC TOOLS
PEPTIDES AS BIOTHERAPEUTIC TOOLS PEPTIDES AS BIOTHERAPEUTIC TOOLSMedicineAndHealth14
 

Mais de MedicineAndHealth14 (20)

Diabetic eye disease
Diabetic eye diseaseDiabetic eye disease
Diabetic eye disease
 
Womenseyehealth
WomenseyehealthWomenseyehealth
Womenseyehealth
 
Retinoblastoma
RetinoblastomaRetinoblastoma
Retinoblastoma
 
Glaucoma
GlaucomaGlaucoma
Glaucoma
 
Eye
EyeEye
Eye
 
Radical Neck Dissection
Radical Neck DissectionRadical Neck Dissection
Radical Neck Dissection
 
Entgr Tonsillectomy
Entgr TonsillectomyEntgr Tonsillectomy
Entgr Tonsillectomy
 
Preop Assessment Periop Management
Preop Assessment Periop ManagementPreop Assessment Periop Management
Preop Assessment Periop Management
 
Iodine
IodineIodine
Iodine
 
Deep Neck Infections
Deep Neck InfectionsDeep Neck Infections
Deep Neck Infections
 
Passive Smoking and Health
Passive Smoking and HealthPassive Smoking and Health
Passive Smoking and Health
 
www.triz.hk/icoiappt/icoia010601.ppt www.triz.hk/icoiappt/icoia010601.ppt
www.triz.hk/icoiappt/icoia010601.ppt 	 www.triz.hk/icoiappt/icoia010601.pptwww.triz.hk/icoiappt/icoia010601.ppt 	 www.triz.hk/icoiappt/icoia010601.ppt
www.triz.hk/icoiappt/icoia010601.ppt www.triz.hk/icoiappt/icoia010601.ppt
 
Surgery Block Evaluation
Surgery Block EvaluationSurgery Block Evaluation
Surgery Block Evaluation
 
Cough In The Elderly
Cough In The ElderlyCough In The Elderly
Cough In The Elderly
 
Emergency Contraception
Emergency ContraceptionEmergency Contraception
Emergency Contraception
 
Design of a medical simulator for subcutaneous contraceptive implant insertio...
Design of a medical simulator for subcutaneous contraceptive implant insertio...Design of a medical simulator for subcutaneous contraceptive implant insertio...
Design of a medical simulator for subcutaneous contraceptive implant insertio...
 
Oral Pathology
Oral PathologyOral Pathology
Oral Pathology
 
Obesity: The Bariatric Challenge Obesity: The Bariatric Challenge
Obesity: The Bariatric Challenge 	 Obesity: The Bariatric ChallengeObesity: The Bariatric Challenge 	 Obesity: The Bariatric Challenge
Obesity: The Bariatric Challenge Obesity: The Bariatric Challenge
 
PEPTIDES AS BIOTHERAPEUTIC TOOLS PEPTIDES AS BIOTHERAPEUTIC TOOLS
PEPTIDES AS BIOTHERAPEUTIC TOOLS 	 PEPTIDES AS BIOTHERAPEUTIC TOOLSPEPTIDES AS BIOTHERAPEUTIC TOOLS 	 PEPTIDES AS BIOTHERAPEUTIC TOOLS
PEPTIDES AS BIOTHERAPEUTIC TOOLS PEPTIDES AS BIOTHERAPEUTIC TOOLS
 
Diabetes
DiabetesDiabetes
Diabetes
 

Último

VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Call Girls in Nagpur High Profile
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...narwatsonia7
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...narwatsonia7
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableNehru place Escorts
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service KochiLow Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service KochiSuhani Kapoor
 

Último (20)

VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
Book Paid Powai Call Girls Mumbai 𖠋 9930245274 𖠋Low Budget Full Independent H...
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
VIP Call Girls Tirunelveli Aaradhya 8250192130 Independent Escort Service Tir...
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service KochiLow Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
 

Dr Orlapresentation8