SlideShare a Scribd company logo
1 of 55
Sexually Transmitted Diseases Capital Conference, June 2007 Gregory Perron, MD
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Useful Resources ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Genital Ulcer Diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Herpes Simplex Virus ,[object Object],[object Object],[object Object],[object Object],[object Object]
HSV, Primary Infection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Primary HSV, female patient Primary infection in pregnancy: highest risk of fetal transmission
Medical Treatment   First Clinical Episode   ,[object Object]
HSV – Recurrent Episodes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HSV Suppression ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Syphilis -  Treponema pallidum ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary syphilis-chancre Hallmark: PAINLESS!
Secondary syphilis -skin rash; mucocutaneous lesions, regional lymphadenopathy characteristic
Secondary syphilis - condyloma lata
Syphilis Stages cont ,[object Object],[object Object],[object Object],[object Object],[object Object]
Syphilis- Diagnostic Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nontreponemal Tests ,[object Object],[object Object],[object Object],[object Object]
Treponemal Tests ,[object Object],[object Object],[object Object],[object Object],[object Object]
Syphilis Diagnosis ,[object Object],[object Object]
Syphilis Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Syphilis Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary & Secondary cont ,[object Object],[object Object],[object Object]
Primary & Secondary cont ,[object Object],[object Object]
Neurosyphilis ,[object Object],[object Object],[object Object]
Neurosyphilis cont ,[object Object],[object Object],[object Object]
Chancroid ulcers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Granuloma inguinale, male ,[object Object],[object Object],[object Object],[object Object]
Urethritis/Cervicitis Diseases ,[object Object],[object Object],[object Object],[object Object]
Chlamydia ,[object Object],[object Object],[object Object],[object Object]
Chlamydia Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chlamydia Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chlamydia in Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chlamydia Followup ,[object Object],[object Object],[object Object]
Gonorrhea ,[object Object],[object Object],[object Object],[object Object],ick
Gonococcal cervicitis ,[object Object],[object Object],[object Object]
Gonorrhea - gram stain of urethral discharge Diagnosis by gram stain– MEN only
Gonorrhea Infection in the Eye Diagnosis is by clinical suspicion and culture- need selective media in CO2-enriched environment Treatment: ceftriazone 1gm IM; consider saline lavage
GC Treatment ,[object Object],[object Object],[object Object]
MPC, NGU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diseases Characterized by Vaginal Discharge ,[object Object],[object Object],[object Object],[object Object]
Vulvovaginal Candidiasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VVC, Cont’d ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of VVC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Trichomonas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Bacterial Vaginosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vagin osis  – not Vagin itis
Bacterial Vaginosis Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Human Papilloma Virus ,[object Object],[object Object],[object Object],[object Object]
HPV Factoids ,[object Object],[object Object],[object Object],[object Object],[object Object]
HPV Counselling ,[object Object],[object Object],[object Object]
HPV- Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HPV Vaccine - Gardisil ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Vaccines for STDs ,[object Object],[object Object]
HPV, HSV Vaccines ,[object Object],[object Object],[object Object],[object Object],[object Object]
Questions?

More Related Content

What's hot

What's hot (20)

Sexually transmitted infections
Sexually transmitted infectionsSexually transmitted infections
Sexually transmitted infections
 
Sexually Transmitted Diseases (STDs)
Sexually Transmitted Diseases (STDs)Sexually Transmitted Diseases (STDs)
Sexually Transmitted Diseases (STDs)
 
Overview of STI
Overview of STIOverview of STI
Overview of STI
 
Sexually transmitted diseases
Sexually transmitted diseasesSexually transmitted diseases
Sexually transmitted diseases
 
STI'S
STI'SSTI'S
STI'S
 
Syndromic approach
Syndromic approachSyndromic approach
Syndromic approach
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted Infections
 
19.Infection Of Vaginal
19.Infection Of Vaginal19.Infection Of Vaginal
19.Infection Of Vaginal
 
STD's
STD'sSTD's
STD's
 
Sexually transmitted diseases management
Sexually transmitted diseases managementSexually transmitted diseases management
Sexually transmitted diseases management
 
Sexually Transmitted Infections Sexually Transmitted Infections
Sexually Transmitted Infections 	 Sexually Transmitted InfectionsSexually Transmitted Infections 	 Sexually Transmitted Infections
Sexually Transmitted Infections Sexually Transmitted Infections
 
Sexually Transmitted Infection (STI)
Sexually Transmitted Infection (STI)Sexually Transmitted Infection (STI)
Sexually Transmitted Infection (STI)
 
Chlamydia
ChlamydiaChlamydia
Chlamydia
 
Syndromic approach
Syndromic approachSyndromic approach
Syndromic approach
 
Genital infections in gynecology
Genital infections in gynecologyGenital infections in gynecology
Genital infections in gynecology
 
STI PowerPoint
STI PowerPointSTI PowerPoint
STI PowerPoint
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted Infections
 
Pelvic Inflammatory Disease
Pelvic Inflammatory DiseasePelvic Inflammatory Disease
Pelvic Inflammatory Disease
 
Pelvic Inflammatory Disease
Pelvic Inflammatory DiseasePelvic Inflammatory Disease
Pelvic Inflammatory Disease
 
Moniliasis
Moniliasis Moniliasis
Moniliasis
 

Viewers also liked

Sexually transmitted diseases (pictures)
Sexually transmitted diseases (pictures)Sexually transmitted diseases (pictures)
Sexually transmitted diseases (pictures)Reynel Dan
 
Sexually Transmitted Diseases
Sexually Transmitted DiseasesSexually Transmitted Diseases
Sexually Transmitted Diseasesshenell delfin
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted InfectionsKarl Daniel, M.D.
 
An std powerpoint
An std powerpointAn std powerpoint
An std powerpointcarolee430
 
Sexually transmitted diseases
Sexually transmitted diseasesSexually transmitted diseases
Sexually transmitted diseasesMissKuebler
 
Sexually transmitted diseases (STDS) with nursing responsibilty
Sexually transmitted diseases (STDS) with nursing responsibiltySexually transmitted diseases (STDS) with nursing responsibilty
Sexually transmitted diseases (STDS) with nursing responsibiltyeducation4227
 
Sexually Transmitted Infection (Malaysian STI Guidelines 2015)
Sexually Transmitted Infection (Malaysian STI Guidelines 2015)Sexually Transmitted Infection (Malaysian STI Guidelines 2015)
Sexually Transmitted Infection (Malaysian STI Guidelines 2015)Shalini mas
 
RTIs-STIs Dr. Suraj Chawla
RTIs-STIs Dr. Suraj ChawlaRTIs-STIs Dr. Suraj Chawla
RTIs-STIs Dr. Suraj ChawlaSuraj Chawla
 
Gyn Infections
Gyn  InfectionsGyn  Infections
Gyn InfectionsMiami Dade
 
Surgical Options In The Management Of Hernia Repair
Surgical Options In The Management Of Hernia RepairSurgical Options In The Management Of Hernia Repair
Surgical Options In The Management Of Hernia Repairsafarmas
 
Common Skin Disorders Of The Penis
Common Skin Disorders Of The PenisCommon Skin Disorders Of The Penis
Common Skin Disorders Of The PenisAhmad Kharrouby
 
Adolescent health
Adolescent healthAdolescent health
Adolescent healthAbino David
 

Viewers also liked (20)

Sexually transmitted diseases (pictures)
Sexually transmitted diseases (pictures)Sexually transmitted diseases (pictures)
Sexually transmitted diseases (pictures)
 
Sexually Transmitted Diseases
Sexually Transmitted DiseasesSexually Transmitted Diseases
Sexually Transmitted Diseases
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted Infections
 
An std powerpoint
An std powerpointAn std powerpoint
An std powerpoint
 
Sexually transmitted disease
Sexually transmitted diseaseSexually transmitted disease
Sexually transmitted disease
 
Sexually transmitted diseases
Sexually transmitted diseasesSexually transmitted diseases
Sexually transmitted diseases
 
Sexually transmitted disease
Sexually transmitted diseaseSexually transmitted disease
Sexually transmitted disease
 
STD's
STD'sSTD's
STD's
 
Sexually transmitted diseases (STDS) with nursing responsibilty
Sexually transmitted diseases (STDS) with nursing responsibiltySexually transmitted diseases (STDS) with nursing responsibilty
Sexually transmitted diseases (STDS) with nursing responsibilty
 
Sexually Transmitted Infection (Malaysian STI Guidelines 2015)
Sexually Transmitted Infection (Malaysian STI Guidelines 2015)Sexually Transmitted Infection (Malaysian STI Guidelines 2015)
Sexually Transmitted Infection (Malaysian STI Guidelines 2015)
 
RTIs-STIs Dr. Suraj Chawla
RTIs-STIs Dr. Suraj ChawlaRTIs-STIs Dr. Suraj Chawla
RTIs-STIs Dr. Suraj Chawla
 
VENTRAL HERNIA
VENTRAL HERNIAVENTRAL HERNIA
VENTRAL HERNIA
 
Gyn Infections
Gyn  InfectionsGyn  Infections
Gyn Infections
 
Hernia & abd wall lecture
Hernia & abd wall lectureHernia & abd wall lecture
Hernia & abd wall lecture
 
Inguinal Hernia- Groin Swellings
Inguinal Hernia- Groin SwellingsInguinal Hernia- Groin Swellings
Inguinal Hernia- Groin Swellings
 
Surgical Options In The Management Of Hernia Repair
Surgical Options In The Management Of Hernia RepairSurgical Options In The Management Of Hernia Repair
Surgical Options In The Management Of Hernia Repair
 
Common Skin Disorders Of The Penis
Common Skin Disorders Of The PenisCommon Skin Disorders Of The Penis
Common Skin Disorders Of The Penis
 
Hernia
Hernia Hernia
Hernia
 
Adolescent health
Adolescent healthAdolescent health
Adolescent health
 
Inguinal hernia
Inguinal herniaInguinal hernia
Inguinal hernia
 

Similar to Sexually Transmitted Diseases

Management of acute pid
Management of acute pidManagement of acute pid
Management of acute pidPratyush1693
 
KHMH Obs gyn infections PID ulcers STDs vaginitis.ppt
KHMH Obs gyn infections PID ulcers STDs vaginitis.pptKHMH Obs gyn infections PID ulcers STDs vaginitis.ppt
KHMH Obs gyn infections PID ulcers STDs vaginitis.pptrigomontejo
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted InfectionsEric Meininger
 
Febrile neutropenia ankur
Febrile neutropenia ankurFebrile neutropenia ankur
Febrile neutropenia ankurAnkur Varshney
 
Pelvic Inflammatory Disease with YouTube Video
Pelvic Inflammatory Disease with YouTube VideoPelvic Inflammatory Disease with YouTube Video
Pelvic Inflammatory Disease with YouTube VideoKarthikeyan Pethusamy
 
G Y N E C O L O G I C N U R S I N G
G Y N E C O L O G I C  N U R S I N GG Y N E C O L O G I C  N U R S I N G
G Y N E C O L O G I C N U R S I N Gdiane_dona
 
infections during pregnancy-Renjini.R....pptx
infections during pregnancy-Renjini.R....pptxinfections during pregnancy-Renjini.R....pptx
infections during pregnancy-Renjini.R....pptxRenjini R
 
Pelvic inflammatory disease
Pelvic inflammatory diseasePelvic inflammatory disease
Pelvic inflammatory diseaseraj kumar
 
sexual transmitted diseases and the emergency room
sexual transmitted diseases and the emergency room sexual transmitted diseases and the emergency room
sexual transmitted diseases and the emergency room Rashid Abuelhassan
 
modified syndromic approach for sexaully transmitted disease
modified syndromic approach for sexaully transmitted diseasemodified syndromic approach for sexaully transmitted disease
modified syndromic approach for sexaully transmitted diseaseseethagovin
 

Similar to Sexually Transmitted Diseases (20)

STI.ppt
STI.pptSTI.ppt
STI.ppt
 
pid.pptx
pid.pptxpid.pptx
pid.pptx
 
Management of acute pid
Management of acute pidManagement of acute pid
Management of acute pid
 
Std
StdStd
Std
 
KHMH Obs gyn infections PID ulcers STDs vaginitis.ppt
KHMH Obs gyn infections PID ulcers STDs vaginitis.pptKHMH Obs gyn infections PID ulcers STDs vaginitis.ppt
KHMH Obs gyn infections PID ulcers STDs vaginitis.ppt
 
L46 Pelvic Inflammatory Disease (PID)
L46 Pelvic Inflammatory Disease (PID)L46 Pelvic Inflammatory Disease (PID)
L46 Pelvic Inflammatory Disease (PID)
 
Diagnosis and management of PID
Diagnosis and management of PIDDiagnosis and management of PID
Diagnosis and management of PID
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted Infections
 
Febrile neutropenia ankur
Febrile neutropenia ankurFebrile neutropenia ankur
Febrile neutropenia ankur
 
Adolescent sti ucaya
Adolescent sti ucayaAdolescent sti ucaya
Adolescent sti ucaya
 
Pelvic Inflammatory Disease with YouTube Video
Pelvic Inflammatory Disease with YouTube VideoPelvic Inflammatory Disease with YouTube Video
Pelvic Inflammatory Disease with YouTube Video
 
G Y N E C O L O G I C N U R S I N G
G Y N E C O L O G I C  N U R S I N GG Y N E C O L O G I C  N U R S I N G
G Y N E C O L O G I C N U R S I N G
 
infections during pregnancy-Renjini.R....pptx
infections during pregnancy-Renjini.R....pptxinfections during pregnancy-Renjini.R....pptx
infections during pregnancy-Renjini.R....pptx
 
Gonorrhea
GonorrheaGonorrhea
Gonorrhea
 
Infections.pptx
Infections.pptxInfections.pptx
Infections.pptx
 
Std
StdStd
Std
 
Pelvic inflammatory disease
Pelvic inflammatory diseasePelvic inflammatory disease
Pelvic inflammatory disease
 
sexual transmitted diseases and the emergency room
sexual transmitted diseases and the emergency room sexual transmitted diseases and the emergency room
sexual transmitted diseases and the emergency room
 
Std noon conf 2019
Std  noon conf 2019Std  noon conf 2019
Std noon conf 2019
 
modified syndromic approach for sexaully transmitted disease
modified syndromic approach for sexaully transmitted diseasemodified syndromic approach for sexaully transmitted disease
modified syndromic approach for sexaully transmitted disease
 

More from MedicineAndHealth

Medical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.LaszloMedical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.LaszloMedicineAndHealth
 
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET 	 HO...HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET 	 HO...
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...MedicineAndHealth
 
Accounting I: Introduction to University Accounting Accounting I: Introduct...
Accounting I: Introduction to University Accounting 	 Accounting I: Introduct...Accounting I: Introduction to University Accounting 	 Accounting I: Introduct...
Accounting I: Introduction to University Accounting Accounting I: Introduct...MedicineAndHealth
 
Personalized Medicine: Current and Future Perspectives Personalized Medicin...
Personalized Medicine: Current and Future Perspectives 	 Personalized Medicin...Personalized Medicine: Current and Future Perspectives 	 Personalized Medicin...
Personalized Medicine: Current and Future Perspectives Personalized Medicin...MedicineAndHealth
 
Victim Compensation Without Litigation - the Lexington Experience Victim Co...
Victim Compensation Without Litigation - the Lexington Experience 	 Victim Co...Victim Compensation Without Litigation - the Lexington Experience 	 Victim Co...
Victim Compensation Without Litigation - the Lexington Experience Victim Co...MedicineAndHealth
 
Long term Care in Developed Countries and Recommendations for Slovak Republic...
Long term Care in Developed Countries and Recommendations for Slovak Republic...Long term Care in Developed Countries and Recommendations for Slovak Republic...
Long term Care in Developed Countries and Recommendations for Slovak Republic...MedicineAndHealth
 
Compensation Larger Practices
Compensation Larger PracticesCompensation Larger Practices
Compensation Larger PracticesMedicineAndHealth
 
Defending Medical Malpractice
Defending Medical MalpracticeDefending Medical Malpractice
Defending Medical MalpracticeMedicineAndHealth
 
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...
Personalized Medicine: Balancing the Promise and Peril of ... 	 Personalized ...Personalized Medicine: Balancing the Promise and Peril of ... 	 Personalized ...
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...MedicineAndHealth
 
Negotiating For The Ideal Job
Negotiating For The Ideal JobNegotiating For The Ideal Job
Negotiating For The Ideal JobMedicineAndHealth
 
Medical errors, negligence, and litigation
Medical errors, negligence, and litigationMedical errors, negligence, and litigation
Medical errors, negligence, and litigationMedicineAndHealth
 
What to Run Before Your Business Plan Course What to Run Before Your Busine...
What to Run Before Your Business Plan Course 	 What to Run Before Your Busine...What to Run Before Your Business Plan Course 	 What to Run Before Your Busine...
What to Run Before Your Business Plan Course What to Run Before Your Busine...MedicineAndHealth
 

More from MedicineAndHealth (20)

Medical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.LaszloMedical.Profession Kalabay.Laszlo
Medical.Profession Kalabay.Laszlo
 
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET 	 HO...HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET 	 HO...
HOW TO DO PATENT LANDSCAPING(USING FREE DATABASEs e.g. USPTO & ESP@CENET HO...
 
Accounting I: Introduction to University Accounting Accounting I: Introduct...
Accounting I: Introduction to University Accounting 	 Accounting I: Introduct...Accounting I: Introduction to University Accounting 	 Accounting I: Introduct...
Accounting I: Introduction to University Accounting Accounting I: Introduct...
 
Personalized Medicine: Current and Future Perspectives Personalized Medicin...
Personalized Medicine: Current and Future Perspectives 	 Personalized Medicin...Personalized Medicine: Current and Future Perspectives 	 Personalized Medicin...
Personalized Medicine: Current and Future Perspectives Personalized Medicin...
 
Medicare Basics
Medicare BasicsMedicare Basics
Medicare Basics
 
Victim Compensation Without Litigation - the Lexington Experience Victim Co...
Victim Compensation Without Litigation - the Lexington Experience 	 Victim Co...Victim Compensation Without Litigation - the Lexington Experience 	 Victim Co...
Victim Compensation Without Litigation - the Lexington Experience Victim Co...
 
Long term Care in Developed Countries and Recommendations for Slovak Republic...
Long term Care in Developed Countries and Recommendations for Slovak Republic...Long term Care in Developed Countries and Recommendations for Slovak Republic...
Long term Care in Developed Countries and Recommendations for Slovak Republic...
 
BUSINESS ETHICS
BUSINESS ETHICSBUSINESS ETHICS
BUSINESS ETHICS
 
Sorry Works
Sorry WorksSorry Works
Sorry Works
 
Compensation Larger Practices
Compensation Larger PracticesCompensation Larger Practices
Compensation Larger Practices
 
Defending Medical Malpractice
Defending Medical MalpracticeDefending Medical Malpractice
Defending Medical Malpractice
 
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...
Personalized Medicine: Balancing the Promise and Peril of ... 	 Personalized ...Personalized Medicine: Balancing the Promise and Peril of ... 	 Personalized ...
Personalized Medicine: Balancing the Promise and Peril of ... Personalized ...
 
Seven Basics
Seven BasicsSeven Basics
Seven Basics
 
Negotiating For The Ideal Job
Negotiating For The Ideal JobNegotiating For The Ideal Job
Negotiating For The Ideal Job
 
Medical malpractice
Medical malpracticeMedical malpractice
Medical malpractice
 
2882survey bg
2882survey bg2882survey bg
2882survey bg
 
Medical errors, negligence, and litigation
Medical errors, negligence, and litigationMedical errors, negligence, and litigation
Medical errors, negligence, and litigation
 
The Physician Market Part 2
The Physician Market Part 2The Physician Market Part 2
The Physician Market Part 2
 
What to Run Before Your Business Plan Course What to Run Before Your Busine...
What to Run Before Your Business Plan Course 	 What to Run Before Your Busine...What to Run Before Your Business Plan Course 	 What to Run Before Your Busine...
What to Run Before Your Business Plan Course What to Run Before Your Busine...
 
The physician market Part 1
The physician market Part 1The physician market Part 1
The physician market Part 1
 

Recently uploaded

💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...Sheetaleventcompany
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowtanudubay92
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Sheetaleventcompany
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Sheetaleventcompany
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Sheetaleventcompany
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Sheetaleventcompany
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Sheetaleventcompany
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan 087776558899
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Dipal Arora
 
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Oleg Kshivets
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacyDrMohamed Assadawy
 
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...TanyaAhuja34
 
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...Sheetaleventcompany
 
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...Sheetaleventcompany
 
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...Sheetaleventcompany
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...gragneelam30
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...amritaverma53
 
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Sheetaleventcompany
 
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...Sheetaleventcompany
 

Recently uploaded (20)

💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
💚Reliable Call Girls Chandigarh 💯Niamh 📲🔝8868886958🔝Call Girl In Chandigarh N...
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
 
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
 
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacy
 
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
 
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
Independent Bangalore Call Girls (Adult Only) 💯Call Us 🔝 7304373326 🔝 💃 Escor...
 
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
 
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
 
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
 

Sexually Transmitted Diseases