SlideShare a Scribd company logo
1 of 13
Pulmonary emphysema

by Anna Savchuk
Emphysema is a chronic respiratory disease due to
over inflation or abnormal increase in the size of the air
sacs (alveoli) in the lungs function, breathlessness.
CAUSES

Smoking
Occupational exposure to chemical fumes
Heredity (deficiency of AAT)
HIV infection
Severe respiratory efforts
Use of intravenous drugs
MECHANISM
Symptoms

Suffocation
Shortness of breath
Whooping cough
Loss of appetite and weight loss
Fatigue
Chest enlargement
Diagnosis

Chest X-Ray
Arterial
blood
analysis (the blood tests

gases

measures
how well your lungs transfer oxygen to
your bloodstream)

Pulmonary

function

tests

(measure how much air you lungs can
hold and the flow of)

Sputum examination

(analysis
of cells in sputum can help determine the
cause of some lung problems)

Spirometry

(a procedure that
measures the forced expiratory volume in
one second)
Treatment are:
Non pharmacological
Pharmacological
Non pharmacological
General Treatment
By Quit smoking (first step for smokers is to quit smoking. If He/She is a smoker)
By Oxygen therapy (home oxygen therapy.)
By Taking Precautions
•Avoid dust.
•Avoid extremes of temperature & humidity.
•Avoid high altitude.
•Improved nutrition, hygiene and exercise.
•Special breathing patterns and positions.
Pharmacological

Medicinal Treatment
Bronchodilators :Albuterol (Proventil or Ventoline)
a “rescue" medication.

Ipratropium bromide (Atrovent)
provide greater relief, and long lasts.

'Both available as Metered-Dose Inhaler (MDI).

Methylxanthines (Theophylline)
is the bronchodialating medicine available in tablet form.

Corticosteroids
help to decrease the inflammation of the airway walls.

Antibiotics
Surgical treatment

Lung volume reduction surgery (most diseases
parts of the lung are removed)
Lung transplantation (it is a risky and
expensive procedure)
Classification
The end…

More Related Content

What's hot

Reactive airway diseases_2018_pmm
Reactive airway diseases_2018_pmmReactive airway diseases_2018_pmm
Reactive airway diseases_2018_pmmParthiv Mehta
 
Copd introduction and pft
Copd introduction  and pftCopd introduction  and pft
Copd introduction and pftprash258
 
Aspergillosis Patients Support Meeting June 2011 - Nigel Clayton
Aspergillosis Patients Support Meeting June 2011 - Nigel ClaytonAspergillosis Patients Support Meeting June 2011 - Nigel Clayton
Aspergillosis Patients Support Meeting June 2011 - Nigel ClaytonGraham Atherton
 
Oxygen therapy in acutely ill patients
Oxygen therapy in acutely ill patientsOxygen therapy in acutely ill patients
Oxygen therapy in acutely ill patientsAdel Hamada
 
Chronic obstructive pulmonary disease (COPD)- Preeti sharma
Chronic obstructive pulmonary disease (COPD)- Preeti sharmaChronic obstructive pulmonary disease (COPD)- Preeti sharma
Chronic obstructive pulmonary disease (COPD)- Preeti sharmaEducate with smile
 
Respiratory
RespiratoryRespiratory
Respiratorywashinca
 
Anaesthesia for COPD 15-09-14
Anaesthesia for COPD 15-09-14Anaesthesia for COPD 15-09-14
Anaesthesia for COPD 15-09-14Aftab Hussain
 
Asthma presentetion
Asthma presentetionAsthma presentetion
Asthma presentetionakshayniraj
 
chronic obstructive pulmonary disease in equine
chronic obstructive pulmonary disease in equinechronic obstructive pulmonary disease in equine
chronic obstructive pulmonary disease in equineDr-Mohamed Ghanem
 
Reactive airway obstruction in children detection management_2018_pmm
Reactive airway obstruction  in children detection management_2018_pmmReactive airway obstruction  in children detection management_2018_pmm
Reactive airway obstruction in children detection management_2018_pmmParthiv Mehta
 
Oxygen insufficiency
Oxygen insufficiencyOxygen insufficiency
Oxygen insufficiencykaminisao
 
nursing - oxygenation
nursing - oxygenationnursing - oxygenation
nursing - oxygenationtwiggypiggy
 

What's hot (20)

Reactive airway diseases_2018_pmm
Reactive airway diseases_2018_pmmReactive airway diseases_2018_pmm
Reactive airway diseases_2018_pmm
 
Emphysema
Emphysema Emphysema
Emphysema
 
Copd introduction and pft
Copd introduction  and pftCopd introduction  and pft
Copd introduction and pft
 
Aspergillosis Patients Support Meeting June 2011 - Nigel Clayton
Aspergillosis Patients Support Meeting June 2011 - Nigel ClaytonAspergillosis Patients Support Meeting June 2011 - Nigel Clayton
Aspergillosis Patients Support Meeting June 2011 - Nigel Clayton
 
Oxygen therapy in acutely ill patients
Oxygen therapy in acutely ill patientsOxygen therapy in acutely ill patients
Oxygen therapy in acutely ill patients
 
Emphysema PPT
Emphysema PPTEmphysema PPT
Emphysema PPT
 
Bronchitis
BronchitisBronchitis
Bronchitis
 
Chronic obstructive pulmonary disease (COPD)- Preeti sharma
Chronic obstructive pulmonary disease (COPD)- Preeti sharmaChronic obstructive pulmonary disease (COPD)- Preeti sharma
Chronic obstructive pulmonary disease (COPD)- Preeti sharma
 
Respiratory
RespiratoryRespiratory
Respiratory
 
Anaesthesia for COPD 15-09-14
Anaesthesia for COPD 15-09-14Anaesthesia for COPD 15-09-14
Anaesthesia for COPD 15-09-14
 
Emphysema
EmphysemaEmphysema
Emphysema
 
Oxygenation
OxygenationOxygenation
Oxygenation
 
Asthma presentetion
Asthma presentetionAsthma presentetion
Asthma presentetion
 
chronic obstructive pulmonary disease in equine
chronic obstructive pulmonary disease in equinechronic obstructive pulmonary disease in equine
chronic obstructive pulmonary disease in equine
 
Ae in copd
Ae in copdAe in copd
Ae in copd
 
Reactive airway obstruction in children detection management_2018_pmm
Reactive airway obstruction  in children detection management_2018_pmmReactive airway obstruction  in children detection management_2018_pmm
Reactive airway obstruction in children detection management_2018_pmm
 
Copd ppt
Copd pptCopd ppt
Copd ppt
 
Oxygen insufficiency
Oxygen insufficiencyOxygen insufficiency
Oxygen insufficiency
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
 
nursing - oxygenation
nursing - oxygenationnursing - oxygenation
nursing - oxygenation
 

Viewers also liked

An Introduction to the McKenzie Method
An Introduction to the McKenzie MethodAn Introduction to the McKenzie Method
An Introduction to the McKenzie MethodDeborah Currier
 
pulmonary rehabilitation
pulmonary rehabilitationpulmonary rehabilitation
pulmonary rehabilitationmrinal joshi
 
Pulmonary Rehabilitation
Pulmonary RehabilitationPulmonary Rehabilitation
Pulmonary Rehabilitationrehabroger
 
Pulmonary rehabilitation
Pulmonary rehabilitationPulmonary rehabilitation
Pulmonary rehabilitationkhushali52
 
Rheumatic Disorders Part I
Rheumatic Disorders Part IRheumatic Disorders Part I
Rheumatic Disorders Part ICarmela Domocmat
 
Motar Relearning Program
Motar Relearning ProgramMotar Relearning Program
Motar Relearning ProgramReenu Purohit
 
Pulmonary Rehabilitation pptx
Pulmonary Rehabilitation  pptxPulmonary Rehabilitation  pptx
Pulmonary Rehabilitation pptxDr Subin Ahmed
 
Facilitatory and inhibitory techniques new
Facilitatory and inhibitory techniques newFacilitatory and inhibitory techniques new
Facilitatory and inhibitory techniques newShilpa Prajapati
 
Bone and joint infections: Osteomyelitis, Septic Arthritis
Bone and joint infections: Osteomyelitis, Septic ArthritisBone and joint infections: Osteomyelitis, Septic Arthritis
Bone and joint infections: Osteomyelitis, Septic ArthritisCarmela Domocmat
 
14. pulmonary-function-tests
14. pulmonary-function-tests14. pulmonary-function-tests
14. pulmonary-function-testsSuhail Khan
 

Viewers also liked (16)

Pulmonary Rehabilitation
Pulmonary RehabilitationPulmonary Rehabilitation
Pulmonary Rehabilitation
 
An Introduction to the McKenzie Method
An Introduction to the McKenzie MethodAn Introduction to the McKenzie Method
An Introduction to the McKenzie Method
 
pulmonary rehabilitation
pulmonary rehabilitationpulmonary rehabilitation
pulmonary rehabilitation
 
Pulmonary Rehabilitation
Pulmonary RehabilitationPulmonary Rehabilitation
Pulmonary Rehabilitation
 
Pulmonary rehabilitation
Pulmonary rehabilitationPulmonary rehabilitation
Pulmonary rehabilitation
 
Rheumatic Disorders Part I
Rheumatic Disorders Part IRheumatic Disorders Part I
Rheumatic Disorders Part I
 
Motar Relearning Program
Motar Relearning ProgramMotar Relearning Program
Motar Relearning Program
 
Emphysema
EmphysemaEmphysema
Emphysema
 
Pulmonary Rehabilitation pptx
Pulmonary Rehabilitation  pptxPulmonary Rehabilitation  pptx
Pulmonary Rehabilitation pptx
 
Brunnstrom
BrunnstromBrunnstrom
Brunnstrom
 
Facilitatory and inhibitory techniques new
Facilitatory and inhibitory techniques newFacilitatory and inhibitory techniques new
Facilitatory and inhibitory techniques new
 
Bone and joint infections: Osteomyelitis, Septic Arthritis
Bone and joint infections: Osteomyelitis, Septic ArthritisBone and joint infections: Osteomyelitis, Septic Arthritis
Bone and joint infections: Osteomyelitis, Septic Arthritis
 
Principles of mulligan
Principles of mulliganPrinciples of mulligan
Principles of mulligan
 
14. pulmonary-function-tests
14. pulmonary-function-tests14. pulmonary-function-tests
14. pulmonary-function-tests
 
Emphysema
EmphysemaEmphysema
Emphysema
 
Rheumatology
RheumatologyRheumatology
Rheumatology
 

Similar to Emphisema

Asthma and copd overlap syndrome (acos) tst edited ramathibodi
Asthma and copd overlap syndrome (acos) tst edited ramathibodiAsthma and copd overlap syndrome (acos) tst edited ramathibodi
Asthma and copd overlap syndrome (acos) tst edited ramathibodiTheerasuk Kawamatawong
 
172-Careers-Resp-system postural drainage.ppt
172-Careers-Resp-system postural drainage.ppt172-Careers-Resp-system postural drainage.ppt
172-Careers-Resp-system postural drainage.pptsiddhimeena3
 
bronchialasthmamanagement-181207213555 (1).pptx
bronchialasthmamanagement-181207213555 (1).pptxbronchialasthmamanagement-181207213555 (1).pptx
bronchialasthmamanagement-181207213555 (1).pptxRajveer71
 
Asthma .pptx
 Asthma .pptx Asthma .pptx
Asthma .pptxUVAS
 
Respiratory disorders.pptx
Respiratory disorders.pptxRespiratory disorders.pptx
Respiratory disorders.pptxRuchiPal10
 
ASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASE
ASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASEASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASE
ASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASEblessyjannu21
 

Similar to Emphisema (20)

Asthma and copd overlap syndrome (acos) tst edited ramathibodi
Asthma and copd overlap syndrome (acos) tst edited ramathibodiAsthma and copd overlap syndrome (acos) tst edited ramathibodi
Asthma and copd overlap syndrome (acos) tst edited ramathibodi
 
172-Careers-Resp-system postural drainage.ppt
172-Careers-Resp-system postural drainage.ppt172-Careers-Resp-system postural drainage.ppt
172-Careers-Resp-system postural drainage.ppt
 
Emphysema
EmphysemaEmphysema
Emphysema
 
bronchialasthmamanagement-181207213555 (1).pptx
bronchialasthmamanagement-181207213555 (1).pptxbronchialasthmamanagement-181207213555 (1).pptx
bronchialasthmamanagement-181207213555 (1).pptx
 
Bronchial asthma
Bronchial asthmaBronchial asthma
Bronchial asthma
 
Asthma .pptx
 Asthma .pptx Asthma .pptx
Asthma .pptx
 
Bronchial asthama
Bronchial asthamaBronchial asthama
Bronchial asthama
 
Respiratory system
Respiratory systemRespiratory system
Respiratory system
 
Asthma
Asthma Asthma
Asthma
 
Asthma ppt
Asthma pptAsthma ppt
Asthma ppt
 
Copd imp د. جيهان
Copd imp د. جيهانCopd imp د. جيهان
Copd imp د. جيهان
 
Respiratory disorders.pptx
Respiratory disorders.pptxRespiratory disorders.pptx
Respiratory disorders.pptx
 
Emphysema ppt
Emphysema pptEmphysema ppt
Emphysema ppt
 
ASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASE
ASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASEASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASE
ASTHMA- ONE OF THE MOST COMMON RESPIRATORY DISEASE
 
Env and asthma
Env and asthmaEnv and asthma
Env and asthma
 
Austin Journal of Asthma
Austin Journal of AsthmaAustin Journal of Asthma
Austin Journal of Asthma
 
Austin Journal of Asthma: Open Access
Austin Journal of Asthma: Open AccessAustin Journal of Asthma: Open Access
Austin Journal of Asthma: Open Access
 
Austin Journal of Asthma: Open Access
Austin Journal of Asthma: Open AccessAustin Journal of Asthma: Open Access
Austin Journal of Asthma: Open Access
 
Austin Journal of Asthma: Open Access
Austin Journal of Asthma: Open AccessAustin Journal of Asthma: Open Access
Austin Journal of Asthma: Open Access
 
Austin Journal of Asthma: Open Access
Austin Journal of Asthma: Open AccessAustin Journal of Asthma: Open Access
Austin Journal of Asthma: Open Access
 

More from National Medical Univercity (Kiev, Ukraine) (9)

Флегмона
ФлегмонаФлегмона
Флегмона
 
Пріони і пріонні захворювання
Пріони і пріонні захворюванняПріони і пріонні захворювання
Пріони і пріонні захворювання
 
Diphtheria
DiphtheriaDiphtheria
Diphtheria
 
Проблема туберкульозу в Україні
Проблема туберкульозу в УкраїніПроблема туберкульозу в Україні
Проблема туберкульозу в Україні
 
Renal transplantation
Renal transplantationRenal transplantation
Renal transplantation
 
Urinary system
Urinary systemUrinary system
Urinary system
 
Asthma
AsthmaAsthma
Asthma
 
Невідкладні хірургічні стани
Невідкладні хірургічні стани Невідкладні хірургічні стани
Невідкладні хірургічні стани
 
Способи тимчасової і остаточної зупинки кровотеч
Способи тимчасової і остаточної зупинки кровотечСпособи тимчасової і остаточної зупинки кровотеч
Способи тимчасової і остаточної зупинки кровотеч
 

Recently uploaded

Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...parulsinha
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...narwatsonia7
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
(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
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
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
 
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
 
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
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
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
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
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
 
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
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...narwatsonia7
 
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
 

Recently uploaded (20)

Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur  Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Guntur  Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Guntur Just Call 8250077686 Top Class Call Girl Service Available
 
(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...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
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
 
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...
 
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 ...
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Ooty Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
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
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
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...
 
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 ...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
 
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
 

Emphisema