SlideShare a Scribd company logo
Acute Renal Failure and Sepsis Michael Fernando M.D. PGY-3 Cleveland Clinic July 18, 2007
Clinical Definition of Sepsis
RIFLE classification of Acute Renal Failure ,[object Object],[object Object],[object Object],[object Object],[object Object]
Occurrence of Acute Renal Failure in Sepsis
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hemodynamics and Hormones ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology
Pathophysiology II ,[object Object],[object Object],[object Object],[object Object]
Importance of Vasopressin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vasopressin and GFR ,[object Object],[object Object],[object Object],[object Object]
Effects of Systemic Arterial Vasodilation on Starling forces ,[object Object],[object Object],[object Object]
Effects of systemic arterial vasodilatation (cont.’d) ,[object Object],[object Object],[object Object]
Excessive fluid administration in the setting of Sepsis and ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Experimental models of Sepsis induced ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Benefits of Early Fluid Resuscitation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Glucose Control ,[object Object],[object Object]
Benefits Glucorticoids ,[object Object],[object Object],[object Object]
 
Renal Replacement Therapy ,[object Object],[object Object]
Peak Concentration Hypothesis
Renal Replacement Therapy ,[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]

More Related Content

What's hot

SIRS
SIRSSIRS
SIRS
Aswin Rm
 
The Science of Sepsis
The Science of SepsisThe Science of Sepsis
The Science of Sepsis
Brian Wells, MD, MS, MPH
 
Systemic Inflammatory Response Syndrome SIRS and Septicemia
Systemic Inflammatory Response Syndrome SIRS and SepticemiaSystemic Inflammatory Response Syndrome SIRS and Septicemia
Systemic Inflammatory Response Syndrome SIRS and Septicemia
Chetan Ganteppanavar
 
Septic shock Pathophysiology
Septic shock Pathophysiology Septic shock Pathophysiology
Septic shock Pathophysiology
Society for Microbiology and Infection care
 
09 Nouri Acute Renal Failure
09 Nouri   Acute Renal Failure09 Nouri   Acute Renal Failure
09 Nouri Acute Renal Failureguest2379201
 
Sepsis and septic shock
Sepsis and septic shockSepsis and septic shock
Sepsis and septic shockBabak Jebelli
 
Sepsis syndrome
Sepsis syndromeSepsis syndrome
Sepsis syndrome
Efosa Aimien
 
Sepsis
SepsisSepsis
SURVIVING SEPSIS CAMPAIGN- 2012 to 2016
SURVIVING SEPSIS CAMPAIGN- 2012 to 2016SURVIVING SEPSIS CAMPAIGN- 2012 to 2016
SURVIVING SEPSIS CAMPAIGN- 2012 to 2016
Rahul Goel
 
Perioperative acute kidney injury
Perioperative acute kidney injuryPerioperative acute kidney injury
Perioperative acute kidney injuryAndrew Ferguson
 
Aki Rhabdomyolysis
Aki RhabdomyolysisAki Rhabdomyolysis
Aki Rhabdomyolysis
Adrianne Gabucan
 
Perioperative acute kidney injury case presentation
Perioperative acute kidney injury case presentationPerioperative acute kidney injury case presentation
Perioperative acute kidney injury case presentation
Shen-Chih Wang
 
Sepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac DysfunctionSepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac Dysfunctionshivabirdi
 
Approach to sepsis- a primary physician perspective
Approach to sepsis- a primary physician perspectiveApproach to sepsis- a primary physician perspective
Approach to sepsis- a primary physician perspective
Naveen Kumar
 
AKI pathophysiology chaken maniyan
AKI  pathophysiology chaken maniyanAKI  pathophysiology chaken maniyan
AKI pathophysiology chaken maniyan
CHAKEN MANIYAN
 
Acute Sepsis - Emergency Management
Acute Sepsis - Emergency ManagementAcute Sepsis - Emergency Management
Acute Sepsis - Emergency Management
Dr Varun Patel
 
Aki
AkiAki
Sickle cell nephropathy SCN
Sickle cell nephropathy SCNSickle cell nephropathy SCN
Sickle cell nephropathy SCN
mohamed hassan abbass
 

What's hot (20)

SIRS
SIRSSIRS
SIRS
 
Sepsis And Septic Shock
Sepsis And Septic ShockSepsis And Septic Shock
Sepsis And Septic Shock
 
The Science of Sepsis
The Science of SepsisThe Science of Sepsis
The Science of Sepsis
 
Systemic Inflammatory Response Syndrome SIRS and Septicemia
Systemic Inflammatory Response Syndrome SIRS and SepticemiaSystemic Inflammatory Response Syndrome SIRS and Septicemia
Systemic Inflammatory Response Syndrome SIRS and Septicemia
 
Septic shock Pathophysiology
Septic shock Pathophysiology Septic shock Pathophysiology
Septic shock Pathophysiology
 
Hepatic Failure
Hepatic FailureHepatic Failure
Hepatic Failure
 
09 Nouri Acute Renal Failure
09 Nouri   Acute Renal Failure09 Nouri   Acute Renal Failure
09 Nouri Acute Renal Failure
 
Sepsis and septic shock
Sepsis and septic shockSepsis and septic shock
Sepsis and septic shock
 
Sepsis syndrome
Sepsis syndromeSepsis syndrome
Sepsis syndrome
 
Sepsis
SepsisSepsis
Sepsis
 
SURVIVING SEPSIS CAMPAIGN- 2012 to 2016
SURVIVING SEPSIS CAMPAIGN- 2012 to 2016SURVIVING SEPSIS CAMPAIGN- 2012 to 2016
SURVIVING SEPSIS CAMPAIGN- 2012 to 2016
 
Perioperative acute kidney injury
Perioperative acute kidney injuryPerioperative acute kidney injury
Perioperative acute kidney injury
 
Aki Rhabdomyolysis
Aki RhabdomyolysisAki Rhabdomyolysis
Aki Rhabdomyolysis
 
Perioperative acute kidney injury case presentation
Perioperative acute kidney injury case presentationPerioperative acute kidney injury case presentation
Perioperative acute kidney injury case presentation
 
Sepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac DysfunctionSepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac Dysfunction
 
Approach to sepsis- a primary physician perspective
Approach to sepsis- a primary physician perspectiveApproach to sepsis- a primary physician perspective
Approach to sepsis- a primary physician perspective
 
AKI pathophysiology chaken maniyan
AKI  pathophysiology chaken maniyanAKI  pathophysiology chaken maniyan
AKI pathophysiology chaken maniyan
 
Acute Sepsis - Emergency Management
Acute Sepsis - Emergency ManagementAcute Sepsis - Emergency Management
Acute Sepsis - Emergency Management
 
Aki
AkiAki
Aki
 
Sickle cell nephropathy SCN
Sickle cell nephropathy SCNSickle cell nephropathy SCN
Sickle cell nephropathy SCN
 

Viewers also liked

District 9465 Vocational Manual 2014 15
District 9465 Vocational Manual 2014 15District 9465 Vocational Manual 2014 15
District 9465 Vocational Manual 2014 15
Kero O'Shea
 
Septic shock; latest update
Septic shock; latest updateSeptic shock; latest update
Septic shock; latest update
Ramadan Arafa
 
DENGUE HEMORRHAGIC FEVER
DENGUE HEMORRHAGIC FEVERDENGUE HEMORRHAGIC FEVER
DENGUE HEMORRHAGIC FEVER
Jack Frost
 
Think kidneys primary care and commissions workshop 240315 master slide deck ...
Think kidneys primary care and commissions workshop 240315 master slide deck ...Think kidneys primary care and commissions workshop 240315 master slide deck ...
Think kidneys primary care and commissions workshop 240315 master slide deck ...Renal Association
 
Acute renal failure in icu .....
Acute renal failure in icu .....Acute renal failure in icu .....
Acute renal failure in icu .....Mahmoud El-saharty
 
Injuria renal aguda
Injuria renal agudaInjuria renal aguda
Injuria renal aguda
evidenciaterapeutica.com
 
Severe Sepsis & Septic Shock
Severe Sepsis & Septic ShockSevere Sepsis & Septic Shock
Severe Sepsis & Septic ShockAndrew Ferguson
 
Acute Kidney Injury 2013
Acute Kidney Injury 2013Acute Kidney Injury 2013
Acute Kidney Injury 2013
Joel Topf
 
Sepsis Care in 2015
Sepsis Care in 2015Sepsis Care in 2015
Sepsis Care in 2015
Salim Rezaie
 
Acute Kidney Injury
Acute Kidney InjuryAcute Kidney Injury
Acute Kidney Injury
Dr.Mahmoud Abbas
 
Acute Kidney Injury
Acute Kidney InjuryAcute Kidney Injury
Acute Kidney Injury
Hayelom Michael Deyo
 
Guidelines Sepsis(Power Point)
Guidelines Sepsis(Power Point)Guidelines Sepsis(Power Point)
Guidelines Sepsis(Power Point)gatotaji
 
Sepsis updates 2016
Sepsis updates 2016Sepsis updates 2016
Sepsis updates 2016
Ashraf Nadim
 
Fisiopatologia lesion renal aguda en sepsis
Fisiopatologia lesion renal aguda en sepsisFisiopatologia lesion renal aguda en sepsis
Fisiopatologia lesion renal aguda en sepsis
Alejandro Granada Valderrama
 
Dengue Fever Power Point
Dengue Fever Power PointDengue Fever Power Point
Dengue Fever Power Point
orlandito12
 

Viewers also liked (17)

District 9465 Vocational Manual 2014 15
District 9465 Vocational Manual 2014 15District 9465 Vocational Manual 2014 15
District 9465 Vocational Manual 2014 15
 
Septic shock; latest update
Septic shock; latest updateSeptic shock; latest update
Septic shock; latest update
 
Fracaso Renal Agudo
Fracaso Renal AgudoFracaso Renal Agudo
Fracaso Renal Agudo
 
DENGUE HEMORRHAGIC FEVER
DENGUE HEMORRHAGIC FEVERDENGUE HEMORRHAGIC FEVER
DENGUE HEMORRHAGIC FEVER
 
Think kidneys primary care and commissions workshop 240315 master slide deck ...
Think kidneys primary care and commissions workshop 240315 master slide deck ...Think kidneys primary care and commissions workshop 240315 master slide deck ...
Think kidneys primary care and commissions workshop 240315 master slide deck ...
 
Acute renal failure in icu .....
Acute renal failure in icu .....Acute renal failure in icu .....
Acute renal failure in icu .....
 
Injuria renal aguda
Injuria renal agudaInjuria renal aguda
Injuria renal aguda
 
Shock pathophysiology
Shock pathophysiologyShock pathophysiology
Shock pathophysiology
 
Severe Sepsis & Septic Shock
Severe Sepsis & Septic ShockSevere Sepsis & Septic Shock
Severe Sepsis & Septic Shock
 
Acute Kidney Injury 2013
Acute Kidney Injury 2013Acute Kidney Injury 2013
Acute Kidney Injury 2013
 
Sepsis Care in 2015
Sepsis Care in 2015Sepsis Care in 2015
Sepsis Care in 2015
 
Acute Kidney Injury
Acute Kidney InjuryAcute Kidney Injury
Acute Kidney Injury
 
Acute Kidney Injury
Acute Kidney InjuryAcute Kidney Injury
Acute Kidney Injury
 
Guidelines Sepsis(Power Point)
Guidelines Sepsis(Power Point)Guidelines Sepsis(Power Point)
Guidelines Sepsis(Power Point)
 
Sepsis updates 2016
Sepsis updates 2016Sepsis updates 2016
Sepsis updates 2016
 
Fisiopatologia lesion renal aguda en sepsis
Fisiopatologia lesion renal aguda en sepsisFisiopatologia lesion renal aguda en sepsis
Fisiopatologia lesion renal aguda en sepsis
 
Dengue Fever Power Point
Dengue Fever Power PointDengue Fever Power Point
Dengue Fever Power Point
 

Similar to Acute Renal Failure And Sepsis

Hepatorenal Syndrome
Hepatorenal SyndromeHepatorenal Syndrome
Hepatorenal Syndrome
edwinchowyw
 
shock marker
shock markershock marker
shock markerEM OMSB
 
Prevention of AKI
Prevention of AKIPrevention of AKI
Prevention of AKI
DrAnkitPurohit
 
Acute kidney injury and urine output in ICU
Acute kidney injury and urine output in ICUAcute kidney injury and urine output in ICU
Acute kidney injury and urine output in ICUgagsol
 
Ira en sepsis
Ira en sepsisIra en sepsis
The Critically Ill PAH Patient
The Critically Ill PAH PatientThe Critically Ill PAH Patient
The Critically Ill PAH Patient
Duke Heart
 
Hrs ashraf omar
Hrs ashraf omarHrs ashraf omar
Hrs ashraf omar
FAARRAG
 
Monsoon Illnesses affecting Lungs (Part 1 of 2)
Monsoon Illnesses affecting Lungs (Part 1 of 2)Monsoon Illnesses affecting Lungs (Part 1 of 2)
Monsoon Illnesses affecting Lungs (Part 1 of 2)
Manjit Tendolkar
 
Renal transplant: anaesthetic implications & considerations
Renal transplant: anaesthetic implications & considerationsRenal transplant: anaesthetic implications & considerations
Renal transplant: anaesthetic implications & considerations
drsandeepbmore
 
Fibrosis[1]
Fibrosis[1]Fibrosis[1]
Fibrosis[1]
specialclass
 
How Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failureHow Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failurechandra talur
 
Sudden onset shortness of breath in patient with chronic renal failure
Sudden onset shortness of breath in patient with chronic renal failureSudden onset shortness of breath in patient with chronic renal failure
Sudden onset shortness of breath in patient with chronic renal failureAR Muhamad Na'im
 
SLED .pptx
SLED .pptxSLED .pptx
SLED .pptx
THEJASWIMARLA1
 
Autosomal dominant polycystic kidney disease (adpkd)
Autosomal dominant polycystic kidney disease (adpkd)Autosomal dominant polycystic kidney disease (adpkd)
Autosomal dominant polycystic kidney disease (adpkd)Rupin Kumar
 
00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf
00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf
00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf
aldy669826
 
Intensive care nephrology
Intensive care nephrologyIntensive care nephrology
Intensive care nephrology
FarragBahbah
 
Chapter 11
Chapter 11Chapter 11
Chapter 11
Trường Sơn
 
Liver disease
Liver diseaseLiver disease
Liver disease
Eman Rasmy
 

Similar to Acute Renal Failure And Sepsis (20)

Hepatorenal Syndrome
Hepatorenal SyndromeHepatorenal Syndrome
Hepatorenal Syndrome
 
shock marker
shock markershock marker
shock marker
 
Prevention of AKI
Prevention of AKIPrevention of AKI
Prevention of AKI
 
Acute kidney injury and urine output in ICU
Acute kidney injury and urine output in ICUAcute kidney injury and urine output in ICU
Acute kidney injury and urine output in ICU
 
Ira en sepsis
Ira en sepsisIra en sepsis
Ira en sepsis
 
The Critically Ill PAH Patient
The Critically Ill PAH PatientThe Critically Ill PAH Patient
The Critically Ill PAH Patient
 
Hrs ashraf omar
Hrs ashraf omarHrs ashraf omar
Hrs ashraf omar
 
Monsoon Illnesses affecting Lungs (Part 1 of 2)
Monsoon Illnesses affecting Lungs (Part 1 of 2)Monsoon Illnesses affecting Lungs (Part 1 of 2)
Monsoon Illnesses affecting Lungs (Part 1 of 2)
 
Renal transplant: anaesthetic implications & considerations
Renal transplant: anaesthetic implications & considerationsRenal transplant: anaesthetic implications & considerations
Renal transplant: anaesthetic implications & considerations
 
Fibrosis[1]
Fibrosis[1]Fibrosis[1]
Fibrosis[1]
 
How Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failureHow Best To Prevent & Manage Acute Renal failure
How Best To Prevent & Manage Acute Renal failure
 
Sudden onset shortness of breath in patient with chronic renal failure
Sudden onset shortness of breath in patient with chronic renal failureSudden onset shortness of breath in patient with chronic renal failure
Sudden onset shortness of breath in patient with chronic renal failure
 
SLED .pptx
SLED .pptxSLED .pptx
SLED .pptx
 
Autosomal dominant polycystic kidney disease (adpkd)
Autosomal dominant polycystic kidney disease (adpkd)Autosomal dominant polycystic kidney disease (adpkd)
Autosomal dominant polycystic kidney disease (adpkd)
 
00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf
00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf
00. Non Renal Indication Hemodialysis in ICU dr rulli.pdf
 
hep27679
hep27679hep27679
hep27679
 
Intensive care nephrology
Intensive care nephrologyIntensive care nephrology
Intensive care nephrology
 
Chapter 11
Chapter 11Chapter 11
Chapter 11
 
Liver disease
Liver diseaseLiver disease
Liver disease
 
Rifle=mgm
Rifle=mgmRifle=mgm
Rifle=mgm
 

More from shivabirdi

Expanded Donor Criteria forLiver Transplantation
Expanded Donor Criteria forLiver TransplantationExpanded Donor Criteria forLiver Transplantation
Expanded Donor Criteria forLiver Transplantationshivabirdi
 
Renal Function in ICU
Renal Function in ICURenal Function in ICU
Renal Function in ICUshivabirdi
 
An Update on Procedural Sedation
An Update on Procedural SedationAn Update on Procedural Sedation
An Update on Procedural Sedationshivabirdi
 
Nice Sugar Study - Glycemic control in the ICU
Nice Sugar Study - Glycemic control in the ICUNice Sugar Study - Glycemic control in the ICU
Nice Sugar Study - Glycemic control in the ICUshivabirdi
 
Early Goal-Directed Therapy in Septic Shock
Early Goal-Directed Therapy in Septic ShockEarly Goal-Directed Therapy in Septic Shock
Early Goal-Directed Therapy in Septic Shockshivabirdi
 
Pulmonary Artery Catheter Questionnaire
Pulmonary Artery Catheter QuestionnairePulmonary Artery Catheter Questionnaire
Pulmonary Artery Catheter Questionnaireshivabirdi
 
When Is Critical Care Medicine Cost-Effective?
When Is Critical Care Medicine Cost-Effective?When Is Critical Care Medicine Cost-Effective?
When Is Critical Care Medicine Cost-Effective?shivabirdi
 
Basic Trauma And Burn Management
Basic Trauma And Burn ManagementBasic Trauma And Burn Management
Basic Trauma And Burn Managementshivabirdi
 
Therapy Misalignment
Therapy MisalignmentTherapy Misalignment
Therapy Misalignmentshivabirdi
 
Renal Function Iin ICU
Renal Function Iin ICURenal Function Iin ICU
Renal Function Iin ICUshivabirdi
 
SICU Critical Care Safety Study
SICU Critical Care Safety StudySICU Critical Care Safety Study
SICU Critical Care Safety Studyshivabirdi
 
Sicu Intro Bioethics
Sicu Intro BioethicsSicu Intro Bioethics
Sicu Intro Bioethicsshivabirdi
 

More from shivabirdi (12)

Expanded Donor Criteria forLiver Transplantation
Expanded Donor Criteria forLiver TransplantationExpanded Donor Criteria forLiver Transplantation
Expanded Donor Criteria forLiver Transplantation
 
Renal Function in ICU
Renal Function in ICURenal Function in ICU
Renal Function in ICU
 
An Update on Procedural Sedation
An Update on Procedural SedationAn Update on Procedural Sedation
An Update on Procedural Sedation
 
Nice Sugar Study - Glycemic control in the ICU
Nice Sugar Study - Glycemic control in the ICUNice Sugar Study - Glycemic control in the ICU
Nice Sugar Study - Glycemic control in the ICU
 
Early Goal-Directed Therapy in Septic Shock
Early Goal-Directed Therapy in Septic ShockEarly Goal-Directed Therapy in Septic Shock
Early Goal-Directed Therapy in Septic Shock
 
Pulmonary Artery Catheter Questionnaire
Pulmonary Artery Catheter QuestionnairePulmonary Artery Catheter Questionnaire
Pulmonary Artery Catheter Questionnaire
 
When Is Critical Care Medicine Cost-Effective?
When Is Critical Care Medicine Cost-Effective?When Is Critical Care Medicine Cost-Effective?
When Is Critical Care Medicine Cost-Effective?
 
Basic Trauma And Burn Management
Basic Trauma And Burn ManagementBasic Trauma And Burn Management
Basic Trauma And Burn Management
 
Therapy Misalignment
Therapy MisalignmentTherapy Misalignment
Therapy Misalignment
 
Renal Function Iin ICU
Renal Function Iin ICURenal Function Iin ICU
Renal Function Iin ICU
 
SICU Critical Care Safety Study
SICU Critical Care Safety StudySICU Critical Care Safety Study
SICU Critical Care Safety Study
 
Sicu Intro Bioethics
Sicu Intro BioethicsSicu Intro Bioethics
Sicu Intro Bioethics
 

Recently uploaded

Webinar Exploring DORA for Fintechs - Simont Braun
Webinar Exploring DORA for Fintechs - Simont BraunWebinar Exploring DORA for Fintechs - Simont Braun
Webinar Exploring DORA for Fintechs - Simont Braun
FinTech Belgium
 
innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...
innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...
innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...
Falcon Invoice Discounting
 
一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理
一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理
一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理
betoozp
 
how to swap pi coins to foreign currency withdrawable.
how to swap pi coins to foreign currency withdrawable.how to swap pi coins to foreign currency withdrawable.
how to swap pi coins to foreign currency withdrawable.
DOT TECH
 
The European Unemployment Puzzle: implications from population aging
The European Unemployment Puzzle: implications from population agingThe European Unemployment Puzzle: implications from population aging
The European Unemployment Puzzle: implications from population aging
GRAPE
 
Proposer Builder Separation Problem in Ethereum
Proposer Builder Separation Problem in EthereumProposer Builder Separation Problem in Ethereum
Proposer Builder Separation Problem in Ethereum
RasoulRamezanian1
 
how can I sell my pi coins for cash in a pi APP
how can I sell my pi coins for cash in a pi APPhow can I sell my pi coins for cash in a pi APP
how can I sell my pi coins for cash in a pi APP
DOT TECH
 
The secret way to sell pi coins effortlessly.
The secret way to sell pi coins effortlessly.The secret way to sell pi coins effortlessly.
The secret way to sell pi coins effortlessly.
DOT TECH
 
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad, Mandi Bah...
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad,  Mandi Bah...NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad,  Mandi Bah...
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad, Mandi Bah...
Amil Baba Dawood bangali
 
Isios-2024-Professional-Independent-Trustee-Survey.pdf
Isios-2024-Professional-Independent-Trustee-Survey.pdfIsios-2024-Professional-Independent-Trustee-Survey.pdf
Isios-2024-Professional-Independent-Trustee-Survey.pdf
Henry Tapper
 
MERCHANTBANKING-PDF complete picture.pdf
MERCHANTBANKING-PDF complete picture.pdfMERCHANTBANKING-PDF complete picture.pdf
MERCHANTBANKING-PDF complete picture.pdf
Sudarshan Dakuru
 
Greek trade a pillar of dynamic economic growth - European Business Review
Greek trade a pillar of dynamic economic growth - European Business ReviewGreek trade a pillar of dynamic economic growth - European Business Review
Greek trade a pillar of dynamic economic growth - European Business Review
Antonis Zairis
 
what is a pi whale and how to access one.
what is a pi whale and how to access one.what is a pi whale and how to access one.
what is a pi whale and how to access one.
DOT TECH
 
Which Crypto to Buy Today for Short-Term in May-June 2024.pdf
Which Crypto to Buy Today for Short-Term in May-June 2024.pdfWhich Crypto to Buy Today for Short-Term in May-June 2024.pdf
Which Crypto to Buy Today for Short-Term in May-June 2024.pdf
Kezex (KZX)
 
一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理
一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理
一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理
ydubwyt
 
Commercial Bank Economic Capsule - May 2024
Commercial Bank Economic Capsule - May 2024Commercial Bank Economic Capsule - May 2024
Commercial Bank Economic Capsule - May 2024
Commercial Bank of Ceylon PLC
 
Turin Startup Ecosystem 2024 - Ricerca sulle Startup e il Sistema dell'Innov...
Turin Startup Ecosystem 2024  - Ricerca sulle Startup e il Sistema dell'Innov...Turin Startup Ecosystem 2024  - Ricerca sulle Startup e il Sistema dell'Innov...
Turin Startup Ecosystem 2024 - Ricerca sulle Startup e il Sistema dell'Innov...
Quotidiano Piemontese
 
how can I sell pi coins after successfully completing KYC
how can I sell pi coins after successfully completing KYChow can I sell pi coins after successfully completing KYC
how can I sell pi coins after successfully completing KYC
DOT TECH
 
how to sell pi coins in all Africa Countries.
how to sell pi coins in all Africa Countries.how to sell pi coins in all Africa Countries.
how to sell pi coins in all Africa Countries.
DOT TECH
 
Falcon Invoice Discounting: Optimizing Returns with Minimal Risk
Falcon Invoice Discounting: Optimizing Returns with Minimal RiskFalcon Invoice Discounting: Optimizing Returns with Minimal Risk
Falcon Invoice Discounting: Optimizing Returns with Minimal Risk
Falcon Invoice Discounting
 

Recently uploaded (20)

Webinar Exploring DORA for Fintechs - Simont Braun
Webinar Exploring DORA for Fintechs - Simont BraunWebinar Exploring DORA for Fintechs - Simont Braun
Webinar Exploring DORA for Fintechs - Simont Braun
 
innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...
innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...
innovative-invoice-discounting-platforms-in-india-empowering-retail-investors...
 
一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理
一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理
一比一原版Birmingham毕业证伯明翰大学|学院毕业证成绩单如何办理
 
how to swap pi coins to foreign currency withdrawable.
how to swap pi coins to foreign currency withdrawable.how to swap pi coins to foreign currency withdrawable.
how to swap pi coins to foreign currency withdrawable.
 
The European Unemployment Puzzle: implications from population aging
The European Unemployment Puzzle: implications from population agingThe European Unemployment Puzzle: implications from population aging
The European Unemployment Puzzle: implications from population aging
 
Proposer Builder Separation Problem in Ethereum
Proposer Builder Separation Problem in EthereumProposer Builder Separation Problem in Ethereum
Proposer Builder Separation Problem in Ethereum
 
how can I sell my pi coins for cash in a pi APP
how can I sell my pi coins for cash in a pi APPhow can I sell my pi coins for cash in a pi APP
how can I sell my pi coins for cash in a pi APP
 
The secret way to sell pi coins effortlessly.
The secret way to sell pi coins effortlessly.The secret way to sell pi coins effortlessly.
The secret way to sell pi coins effortlessly.
 
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad, Mandi Bah...
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad,  Mandi Bah...NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad,  Mandi Bah...
NO1 Uk Black Magic Specialist Expert In Sahiwal, Okara, Hafizabad, Mandi Bah...
 
Isios-2024-Professional-Independent-Trustee-Survey.pdf
Isios-2024-Professional-Independent-Trustee-Survey.pdfIsios-2024-Professional-Independent-Trustee-Survey.pdf
Isios-2024-Professional-Independent-Trustee-Survey.pdf
 
MERCHANTBANKING-PDF complete picture.pdf
MERCHANTBANKING-PDF complete picture.pdfMERCHANTBANKING-PDF complete picture.pdf
MERCHANTBANKING-PDF complete picture.pdf
 
Greek trade a pillar of dynamic economic growth - European Business Review
Greek trade a pillar of dynamic economic growth - European Business ReviewGreek trade a pillar of dynamic economic growth - European Business Review
Greek trade a pillar of dynamic economic growth - European Business Review
 
what is a pi whale and how to access one.
what is a pi whale and how to access one.what is a pi whale and how to access one.
what is a pi whale and how to access one.
 
Which Crypto to Buy Today for Short-Term in May-June 2024.pdf
Which Crypto to Buy Today for Short-Term in May-June 2024.pdfWhich Crypto to Buy Today for Short-Term in May-June 2024.pdf
Which Crypto to Buy Today for Short-Term in May-June 2024.pdf
 
一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理
一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理
一比一原版UOL毕业证利物浦大学毕业证成绩单如何办理
 
Commercial Bank Economic Capsule - May 2024
Commercial Bank Economic Capsule - May 2024Commercial Bank Economic Capsule - May 2024
Commercial Bank Economic Capsule - May 2024
 
Turin Startup Ecosystem 2024 - Ricerca sulle Startup e il Sistema dell'Innov...
Turin Startup Ecosystem 2024  - Ricerca sulle Startup e il Sistema dell'Innov...Turin Startup Ecosystem 2024  - Ricerca sulle Startup e il Sistema dell'Innov...
Turin Startup Ecosystem 2024 - Ricerca sulle Startup e il Sistema dell'Innov...
 
how can I sell pi coins after successfully completing KYC
how can I sell pi coins after successfully completing KYChow can I sell pi coins after successfully completing KYC
how can I sell pi coins after successfully completing KYC
 
how to sell pi coins in all Africa Countries.
how to sell pi coins in all Africa Countries.how to sell pi coins in all Africa Countries.
how to sell pi coins in all Africa Countries.
 
Falcon Invoice Discounting: Optimizing Returns with Minimal Risk
Falcon Invoice Discounting: Optimizing Returns with Minimal RiskFalcon Invoice Discounting: Optimizing Returns with Minimal Risk
Falcon Invoice Discounting: Optimizing Returns with Minimal Risk
 

Acute Renal Failure And Sepsis