SlideShare ist ein Scribd-Unternehmen logo
1 von 9
Formulas –
Part 2
Unwell Surgical Patient
Oxygen delivery
How to manipulate O2 delivery?
• DO2 = CO x Hb x SO2 x constant
• CO = SV x HR
• BP = CO x SVR
• DO2 = SV x HR x Hb x SO2 x constant
How to manipulate O2 delivery?
• DO2 = SV x HR x Hb x SO2 x constant
• SV ~ Preload (CVP) – Contractility – Afterload (SVR)
• HR ~ Slow – Irregular – Fast
• Hb ~ Blood loss – Chronic anaemia
• SaO2 ~ Ventilation – Perfusion
• Ventilation ~ FiO2 – RR – TV – Consolidation – Atelectasis
• Perfusion ~ PE – Hypovolemia
Oxygen–
hemoglobin
dissociation
curve
Ventilation
SaO2 vs PaO2 vs FiO2
• ALI the PaO2 (eg 10 kPa) /FiO2 (eg 0.2) ratio is <40 kPa (300 mmHg)
• Oxygen–hemoglobin dissociation curve (PaO2 vs SaO2)
Circulatory System
• Pump
• Vessels
• Blood
Shock
• Shock is the state of not enough blood flow to the tissues of the body
as a result of problems with the circulatory system (wikipedia)
Shock
• Cardiogenic (Pump)
• Hypovolemic (Blood)
• Distributive (Vessels)
• Obstructive (Vessels)

Weitere ähnliche Inhalte

Was ist angesagt?

Bedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenationBedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenationDr. Tushar Patil
 
Physical principles of gas exchange
Physical principles of gas exchangePhysical principles of gas exchange
Physical principles of gas exchangeDr Sara Sadiq
 
Chapter 40 transport of oxygen and carbon
Chapter 40 transport of oxygen and carbonChapter 40 transport of oxygen and carbon
Chapter 40 transport of oxygen and carbonDon Alerta
 
Arterial blood gas analysis
Arterial  blood  gas  analysisArterial  blood  gas  analysis
Arterial blood gas analysisAnkit Jain
 
Oxygen delivery-systems
Oxygen delivery-systemsOxygen delivery-systems
Oxygen delivery-systemsSarwesh Kumar
 
TRANSPORT OF CARBON DIOXIDE
TRANSPORT OF CARBON DIOXIDETRANSPORT OF CARBON DIOXIDE
TRANSPORT OF CARBON DIOXIDEDr Nilesh Kate
 
Immediate physical response at altitude
Immediate physical response at altitudeImmediate physical response at altitude
Immediate physical response at altitudeDr Usha (Physio)
 
Transport of gases for dental students
Transport of gases for dental studentsTransport of gases for dental students
Transport of gases for dental studentsDr Kiran Kumar
 
11.17.08(b): Alveolar Ventilation II
11.17.08(b): Alveolar Ventilation II11.17.08(b): Alveolar Ventilation II
11.17.08(b): Alveolar Ventilation IIOpen.Michigan
 
Blood gas exchange 2
Blood gas exchange 2Blood gas exchange 2
Blood gas exchange 2Girmay Fitiwi
 
Oxygenation and ventilation monitoring
Oxygenation and ventilation monitoringOxygenation and ventilation monitoring
Oxygenation and ventilation monitoringDr Subodh Chaturvedi
 
Electrolyte balance in critically ill patients
Electrolyte balance in critically ill patientsElectrolyte balance in critically ill patients
Electrolyte balance in critically ill patientssamirelansary
 
O2 and co2-transport
O2 and co2-transportO2 and co2-transport
O2 and co2-transportRavi Kumar
 

Was ist angesagt? (20)

Perfusion parameter
Perfusion parameterPerfusion parameter
Perfusion parameter
 
Transport of gases
Transport of gasesTransport of gases
Transport of gases
 
Bedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenationBedside monitoring of tissue perfusion and oxygenation
Bedside monitoring of tissue perfusion and oxygenation
 
Physical principles of gas exchange
Physical principles of gas exchangePhysical principles of gas exchange
Physical principles of gas exchange
 
Oxygen transport
Oxygen transport Oxygen transport
Oxygen transport
 
Chapter 40 transport of oxygen and carbon
Chapter 40 transport of oxygen and carbonChapter 40 transport of oxygen and carbon
Chapter 40 transport of oxygen and carbon
 
Physiology part1
Physiology part1Physiology part1
Physiology part1
 
Arterial blood gas analysis
Arterial  blood  gas  analysisArterial  blood  gas  analysis
Arterial blood gas analysis
 
Hemodynamics and bp
Hemodynamics and bpHemodynamics and bp
Hemodynamics and bp
 
Oxygen delivery-systems
Oxygen delivery-systemsOxygen delivery-systems
Oxygen delivery-systems
 
Capnography
CapnographyCapnography
Capnography
 
TRANSPORT OF CARBON DIOXIDE
TRANSPORT OF CARBON DIOXIDETRANSPORT OF CARBON DIOXIDE
TRANSPORT OF CARBON DIOXIDE
 
Immediate physical response at altitude
Immediate physical response at altitudeImmediate physical response at altitude
Immediate physical response at altitude
 
Transport of gases for dental students
Transport of gases for dental studentsTransport of gases for dental students
Transport of gases for dental students
 
11.17.08(b): Alveolar Ventilation II
11.17.08(b): Alveolar Ventilation II11.17.08(b): Alveolar Ventilation II
11.17.08(b): Alveolar Ventilation II
 
Blood gas exchange 2
Blood gas exchange 2Blood gas exchange 2
Blood gas exchange 2
 
Oxygen cascade & therapy
Oxygen cascade & therapyOxygen cascade & therapy
Oxygen cascade & therapy
 
Oxygenation and ventilation monitoring
Oxygenation and ventilation monitoringOxygenation and ventilation monitoring
Oxygenation and ventilation monitoring
 
Electrolyte balance in critically ill patients
Electrolyte balance in critically ill patientsElectrolyte balance in critically ill patients
Electrolyte balance in critically ill patients
 
O2 and co2-transport
O2 and co2-transportO2 and co2-transport
O2 and co2-transport
 

Ähnlich wie Formulas - Physiology and Surgery

oxygen and carbon di oxide transport O2_AND_CO2.pptx
oxygen and carbon di oxide transport O2_AND_CO2.pptxoxygen and carbon di oxide transport O2_AND_CO2.pptx
oxygen and carbon di oxide transport O2_AND_CO2.pptxDrratnakumari
 
O2 and CO2 transport by M. Pandian
O2 and CO2 transport by M. PandianO2 and CO2 transport by M. Pandian
O2 and CO2 transport by M. PandianPandian M
 
Respiratory #2, Gas Transport - Physiology
Respiratory #2, Gas Transport - PhysiologyRespiratory #2, Gas Transport - Physiology
Respiratory #2, Gas Transport - PhysiologyCU Dentistry 2019
 
Cardiac output & monitoring
Cardiac output &  monitoringCardiac output &  monitoring
Cardiac output & monitoringArundev P Nair
 
Invasive Hemodynamics: Assessment and interpretation
Invasive Hemodynamics: Assessment and interpretationInvasive Hemodynamics: Assessment and interpretation
Invasive Hemodynamics: Assessment and interpretationKerolus Shehata
 
Transport of oxygen and carbon dioxide
Transport of oxygen and carbon dioxideTransport of oxygen and carbon dioxide
Transport of oxygen and carbon dioxideRaju Jadhav
 
ANPS 020 Cornbrooks 04-11-14.ppt
ANPS 020 Cornbrooks 04-11-14.pptANPS 020 Cornbrooks 04-11-14.ppt
ANPS 020 Cornbrooks 04-11-14.pptSabariKreeshan
 
Arterial and Venous Blood Gas Analysis Edward Omron MD, MPH
Arterial and Venous Blood Gas Analysis   Edward Omron MD, MPHArterial and Venous Blood Gas Analysis   Edward Omron MD, MPH
Arterial and Venous Blood Gas Analysis Edward Omron MD, MPHEdward M. Omron MD, MPH, FCCP
 
6@gas exchange and transport
6@gas exchange and transport6@gas exchange and transport
6@gas exchange and transportMohanad Mohanad
 
Physiology of hemodynamics & PiCCO parameters in detail
Physiology of hemodynamics & PiCCO parameters in detailPhysiology of hemodynamics & PiCCO parameters in detail
Physiology of hemodynamics & PiCCO parameters in detailmeducationdotnet
 
Arterial Blood Gas Analysis
 Arterial Blood Gas Analysis Arterial Blood Gas Analysis
Arterial Blood Gas Analysisintentdoc
 
Hypoxia in surgical patients1
Hypoxia in surgical patients1Hypoxia in surgical patients1
Hypoxia in surgical patients1Asma' Nayfeh
 
ABG , ARTERIAL BLOOD GAS
ABG , ARTERIAL BLOOD GAS ABG , ARTERIAL BLOOD GAS
ABG , ARTERIAL BLOOD GAS raadqu12345678
 

Ähnlich wie Formulas - Physiology and Surgery (20)

oxygen and carbon di oxide transport O2_AND_CO2.pptx
oxygen and carbon di oxide transport O2_AND_CO2.pptxoxygen and carbon di oxide transport O2_AND_CO2.pptx
oxygen and carbon di oxide transport O2_AND_CO2.pptx
 
O2 and CO2 transport by M. Pandian
O2 and CO2 transport by M. PandianO2 and CO2 transport by M. Pandian
O2 and CO2 transport by M. Pandian
 
Respiratory #2, Gas Transport - Physiology
Respiratory #2, Gas Transport - PhysiologyRespiratory #2, Gas Transport - Physiology
Respiratory #2, Gas Transport - Physiology
 
Chap 40
Chap 40Chap 40
Chap 40
 
Oxygen transport
Oxygen transportOxygen transport
Oxygen transport
 
Cardiac output & monitoring
Cardiac output &  monitoringCardiac output &  monitoring
Cardiac output & monitoring
 
Invasive Hemodynamics: Assessment and interpretation
Invasive Hemodynamics: Assessment and interpretationInvasive Hemodynamics: Assessment and interpretation
Invasive Hemodynamics: Assessment and interpretation
 
ABG interpretation.
ABG  interpretation.ABG  interpretation.
ABG interpretation.
 
Transport of oxygen and carbon dioxide
Transport of oxygen and carbon dioxideTransport of oxygen and carbon dioxide
Transport of oxygen and carbon dioxide
 
ANPS 020 Cornbrooks 04-11-14.ppt
ANPS 020 Cornbrooks 04-11-14.pptANPS 020 Cornbrooks 04-11-14.ppt
ANPS 020 Cornbrooks 04-11-14.ppt
 
Arterial and Venous Blood Gas Analysis Edward Omron MD, MPH
Arterial and Venous Blood Gas Analysis   Edward Omron MD, MPHArterial and Venous Blood Gas Analysis   Edward Omron MD, MPH
Arterial and Venous Blood Gas Analysis Edward Omron MD, MPH
 
6@gas exchange and transport
6@gas exchange and transport6@gas exchange and transport
6@gas exchange and transport
 
Physiology of hemodynamics & PiCCO parameters in detail
Physiology of hemodynamics & PiCCO parameters in detailPhysiology of hemodynamics & PiCCO parameters in detail
Physiology of hemodynamics & PiCCO parameters in detail
 
ABG Analysis in Pediatrics
ABG Analysis in PediatricsABG Analysis in Pediatrics
ABG Analysis in Pediatrics
 
Kottayam apcc2013
Kottayam apcc2013Kottayam apcc2013
Kottayam apcc2013
 
Shock Kuliah Residen.pptx
Shock Kuliah Residen.pptxShock Kuliah Residen.pptx
Shock Kuliah Residen.pptx
 
Arterial Blood Gas Analysis
 Arterial Blood Gas Analysis Arterial Blood Gas Analysis
Arterial Blood Gas Analysis
 
Hypoxia in surgical patients1
Hypoxia in surgical patients1Hypoxia in surgical patients1
Hypoxia in surgical patients1
 
ABG , ARTERIAL BLOOD GAS
ABG , ARTERIAL BLOOD GAS ABG , ARTERIAL BLOOD GAS
ABG , ARTERIAL BLOOD GAS
 
Diffusion
DiffusionDiffusion
Diffusion
 

Mehr von Mohamed Alasmar

Initial assessment of trauma patient
Initial assessment of trauma patientInitial assessment of trauma patient
Initial assessment of trauma patientMohamed Alasmar
 
Respiratory conditions in Critically ill Surgical patient
Respiratory conditions in Critically ill Surgical patientRespiratory conditions in Critically ill Surgical patient
Respiratory conditions in Critically ill Surgical patientMohamed Alasmar
 
Thesis discussion: "Evaluation of different modalities of management of penet...
Thesis discussion: "Evaluation of different modalities of management of penet...Thesis discussion: "Evaluation of different modalities of management of penet...
Thesis discussion: "Evaluation of different modalities of management of penet...Mohamed Alasmar
 
Medical Services Chaos and Surgeons Contributions During Arab Spring
Medical Services Chaos and Surgeons Contributions During Arab Spring Medical Services Chaos and Surgeons Contributions During Arab Spring
Medical Services Chaos and Surgeons Contributions During Arab Spring Mohamed Alasmar
 
Antibiotics -simplified-
Antibiotics -simplified-Antibiotics -simplified-
Antibiotics -simplified-Mohamed Alasmar
 
Introduction To 123med.net
Introduction To 123med.netIntroduction To 123med.net
Introduction To 123med.netMohamed Alasmar
 
How To Deal With 123med.net
How To Deal With 123med.netHow To Deal With 123med.net
How To Deal With 123med.netMohamed Alasmar
 

Mehr von Mohamed Alasmar (17)

Initial assessment of trauma patient
Initial assessment of trauma patientInitial assessment of trauma patient
Initial assessment of trauma patient
 
Surgical Nutrition
Surgical NutritionSurgical Nutrition
Surgical Nutrition
 
Respiratory conditions in Critically ill Surgical patient
Respiratory conditions in Critically ill Surgical patientRespiratory conditions in Critically ill Surgical patient
Respiratory conditions in Critically ill Surgical patient
 
Unwell Surgical Patient
Unwell Surgical PatientUnwell Surgical Patient
Unwell Surgical Patient
 
Cardiac Disorders
Cardiac DisordersCardiac Disorders
Cardiac Disorders
 
Colorectal cancer
Colorectal cancerColorectal cancer
Colorectal cancer
 
Palliative surgery
Palliative surgeryPalliative surgery
Palliative surgery
 
Thesis discussion: "Evaluation of different modalities of management of penet...
Thesis discussion: "Evaluation of different modalities of management of penet...Thesis discussion: "Evaluation of different modalities of management of penet...
Thesis discussion: "Evaluation of different modalities of management of penet...
 
Medical Services Chaos and Surgeons Contributions During Arab Spring
Medical Services Chaos and Surgeons Contributions During Arab Spring Medical Services Chaos and Surgeons Contributions During Arab Spring
Medical Services Chaos and Surgeons Contributions During Arab Spring
 
Antibiotics -simplified-
Antibiotics -simplified-Antibiotics -simplified-
Antibiotics -simplified-
 
Surgery profession
Surgery professionSurgery profession
Surgery profession
 
Hk final
Hk finalHk final
Hk final
 
Introduction To 123med.net
Introduction To 123med.netIntroduction To 123med.net
Introduction To 123med.net
 
How To Deal With 123med.net
How To Deal With 123med.netHow To Deal With 123med.net
How To Deal With 123med.net
 
E Learning 2
E Learning 2E Learning 2
E Learning 2
 
MRI physics
MRI physicsMRI physics
MRI physics
 
Basic Computer Course
Basic  Computer CourseBasic  Computer Course
Basic Computer Course
 

Kürzlich hochgeladen

Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...Anamika Rawat
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...parulsinha
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...chennailover
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...khalifaescort01
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Namrata Singh
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...parulsinha
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Vipesco
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Anamika Rawat
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableGENUINE ESCORT AGENCY
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...chetankumar9855
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Anamika Rawat
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426jennyeacort
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...adilkhan87451
 

Kürzlich hochgeladen (20)

Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
Andheri East ^ (Genuine) Escort Service Mumbai ₹7.5k Pick Up & Drop With Cash...
 
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
 
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
Andheri East ) Call Girls in Mumbai Phone No 9004268417 Elite Escort Service ...
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 

Formulas - Physiology and Surgery