SlideShare une entreprise Scribd logo
1  sur  28
LIVER CIRRHOSIS
BY
DINU GEORGE,
1ST YR MSC NURSING,

ZNC
GASTROINTESTINAL SYSTEM
Definition
Liver

cirrhosis is a chronic
progressive disease of the liver
characterised by diffused
damage to cell with fibrosis and
nodular regeneration.

Medical dictionary.
Wikipedia:
Cirrhosis

is a consequence of
chronic liver disease,
characterised by replacement of
liver tissue by fibrosis, scar tissue
and regenerative nodules leading
to loss of liver function.
Mayo clinic staff
Cirrosis

is scaring of liver caused
by many forms of liver disease
and conditions, such as hepatitis
and chronic alcohol abuse.
ASCITIS
BRUSING AND BLEEDING
ITCHING AND PRURITIS
JAUNDICE
SPIDER NAEVI / SPIDER ANGIOMAS
GALL STONE
PALMAR ERYTHEMIAS
GYANAECOMASTIA
CAPUT MEDUSA
VARICES
MENTAL DISTURBENCES
MANAGEMENT
GENERAL MANAGEMENT


PROMOTION OF REST



IMPROVE NUTRITION; Dietary restructyion of protein, salt,
water.



SKIN CARE



REDUCE RISK FOR INJURY



MONITERING AND MANAGING POTENTIAL
COMPLICATIONS



HEPATIC ENCEPHALOPATHY



FLUID VOL EXCESS
MEDICAL MANAGEMENT


TREATMENT OF UNDERLYING CAUSE



PREVENT INFECTION: ANTIBIOTICS . eg;
cephalosporine



ASITIS; FRUSAMIDE(40-80 mg/day)



HEPATO RENAL SYNDROME; DIEURITICS



HEPATIC ENCEPHALOPATHY; NEOMYCINE (1 mg
6th hrly), METRONIDAZOLE(250mg 8th hrly)
SURGICAL MANAGEMENT


TRANS JUGULAR INTRAHEPATIC PROTOSYSTEMIC
SHUNT (TIPS)



DISTAL SPLENORENAL SHUNT (DSR)



ENDOSCOPIC SCLEROTHERAPY



BANDING OR LIGATION



SCLEROTHERAPY AND BANDING



BALLOON TAMPONADE



LIVER TRANSPLANTATION
COMPLICATION


PORTAL HYPERTENSION



ESOPHAGEAL VERISES



GASTRIC VARICIES



PEREPHERAL EDEMA



ASCITIS



HEPATIC ENCEPHALOPATHY/ COMA



HEPATORENAL SYNDROME



PERITONITIS
THANKYOU

Contenu connexe

Tendances (20)

Liver Failure
Liver FailureLiver Failure
Liver Failure
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Inflammatory bowel disease
Inflammatory bowel diseaseInflammatory bowel disease
Inflammatory bowel disease
 
Esophageal varices
Esophageal varicesEsophageal varices
Esophageal varices
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Chronic Pancreatitis
Chronic PancreatitisChronic Pancreatitis
Chronic Pancreatitis
 
Ulcerative Colitis
Ulcerative Colitis Ulcerative Colitis
Ulcerative Colitis
 
Crohn’s disease
Crohn’s diseaseCrohn’s disease
Crohn’s disease
 
Colitis
ColitisColitis
Colitis
 
liver Cirrhosis
liver Cirrhosis liver Cirrhosis
liver Cirrhosis
 
GASTRITIS.pptx
GASTRITIS.pptxGASTRITIS.pptx
GASTRITIS.pptx
 
Glomerulonephritis
GlomerulonephritisGlomerulonephritis
Glomerulonephritis
 
Hepatic Failure.pptx
Hepatic Failure.pptxHepatic Failure.pptx
Hepatic Failure.pptx
 
Cirrhosis of liver ppt
Cirrhosis of liver pptCirrhosis of liver ppt
Cirrhosis of liver ppt
 
Ulcerative Colitis (UC)
Ulcerative Colitis (UC) Ulcerative Colitis (UC)
Ulcerative Colitis (UC)
 
Hepatic failure
Hepatic failureHepatic failure
Hepatic failure
 
Cholecystitis
CholecystitisCholecystitis
Cholecystitis
 
Intestinal obstruction
Intestinal obstructionIntestinal obstruction
Intestinal obstruction
 
Liver Cirrhosis
Liver CirrhosisLiver Cirrhosis
Liver Cirrhosis
 

Similaire à Liver cirrhosis ppt

Cirrhosis of liver .pptx
Cirrhosis of liver .pptxCirrhosis of liver .pptx
Cirrhosis of liver .pptxsaranapr87
 
Liver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshh
Liver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshhLiver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshh
Liver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshhssusere3aa49
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosisNgk Sharma
 
Livercirrhosisl 090306011045-phpapp01
Livercirrhosisl 090306011045-phpapp01Livercirrhosisl 090306011045-phpapp01
Livercirrhosisl 090306011045-phpapp01Michael Peter
 
Approach to obstructive jaundice
Approach to obstructive jaundiceApproach to obstructive jaundice
Approach to obstructive jaundicesk harish
 
Cirrhosis of Liver
Cirrhosis of LiverCirrhosis of Liver
Cirrhosis of Liverowshidha
 
Cirrhosis of liver.2003 all
Cirrhosis of liver.2003 allCirrhosis of liver.2003 all
Cirrhosis of liver.2003 alltareq chowdhury
 
indian childhood cirrosis
indian childhood cirrosisindian childhood cirrosis
indian childhood cirrosisNidhiDwivedi29
 
Hepatic disorder ! Cirrhosis, Jaundice
Hepatic disorder ! Cirrhosis, Jaundice Hepatic disorder ! Cirrhosis, Jaundice
Hepatic disorder ! Cirrhosis, Jaundice Rahul Ranjan
 
08 cirrhosis of liver and its causes.pptx
08 cirrhosis of liver and its causes.pptx08 cirrhosis of liver and its causes.pptx
08 cirrhosis of liver and its causes.pptxLankeSuneetha
 
Liver Cirrhosis
Liver CirrhosisLiver Cirrhosis
Liver CirrhosisJack Frost
 
Interventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disordersInterventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disordershr77
 
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACT
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACTDISORDERS OF LIVER, PANCREAS AND BILIARY TRACT
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACTAndhrapradesh
 
Liver Cirrhosis (CLI 602).ppt
Liver Cirrhosis (CLI 602).pptLiver Cirrhosis (CLI 602).ppt
Liver Cirrhosis (CLI 602).pptLivoJoe1
 
Lecture 24 diseases of alimentary system
Lecture 24 diseases of alimentary systemLecture 24 diseases of alimentary system
Lecture 24 diseases of alimentary systemGreen-book
 

Similaire à Liver cirrhosis ppt (20)

Cirrhosis of liver .pptx
Cirrhosis of liver .pptxCirrhosis of liver .pptx
Cirrhosis of liver .pptx
 
Liver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshh
Liver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshhLiver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshh
Liver Cirrhosis.pptxgsuhsbshhshhsjjsjbbshshh
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Cirrhosis of Liver
Cirrhosis of LiverCirrhosis of Liver
Cirrhosis of Liver
 
Liver cirrhosis
Liver cirrhosisLiver cirrhosis
Liver cirrhosis
 
Livercirrhosisl 090306011045-phpapp01
Livercirrhosisl 090306011045-phpapp01Livercirrhosisl 090306011045-phpapp01
Livercirrhosisl 090306011045-phpapp01
 
Cirrhosis of liver
Cirrhosis of liverCirrhosis of liver
Cirrhosis of liver
 
Approach to obstructive jaundice
Approach to obstructive jaundiceApproach to obstructive jaundice
Approach to obstructive jaundice
 
Cirrhosis of Liver
Cirrhosis of LiverCirrhosis of Liver
Cirrhosis of Liver
 
Liver pathology.pptx
Liver pathology.pptxLiver pathology.pptx
Liver pathology.pptx
 
Cirrhosis of liver.2003 all
Cirrhosis of liver.2003 allCirrhosis of liver.2003 all
Cirrhosis of liver.2003 all
 
indian childhood cirrosis
indian childhood cirrosisindian childhood cirrosis
indian childhood cirrosis
 
Hepatic disorder ! Cirrhosis, Jaundice
Hepatic disorder ! Cirrhosis, Jaundice Hepatic disorder ! Cirrhosis, Jaundice
Hepatic disorder ! Cirrhosis, Jaundice
 
08 cirrhosis of liver and its causes.pptx
08 cirrhosis of liver and its causes.pptx08 cirrhosis of liver and its causes.pptx
08 cirrhosis of liver and its causes.pptx
 
Liver Cirrhosis
Liver CirrhosisLiver Cirrhosis
Liver Cirrhosis
 
Interventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disordersInterventions for clients with liver, gallbladder and pancreas disorders
Interventions for clients with liver, gallbladder and pancreas disorders
 
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACT
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACTDISORDERS OF LIVER, PANCREAS AND BILIARY TRACT
DISORDERS OF LIVER, PANCREAS AND BILIARY TRACT
 
Liver Cirrhosis (CLI 602).ppt
Liver Cirrhosis (CLI 602).pptLiver Cirrhosis (CLI 602).ppt
Liver Cirrhosis (CLI 602).ppt
 
Cld seminar 2
Cld seminar 2Cld seminar 2
Cld seminar 2
 
Lecture 24 diseases of alimentary system
Lecture 24 diseases of alimentary systemLecture 24 diseases of alimentary system
Lecture 24 diseases of alimentary system
 

Dernier

Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana GuptaLifecare Centre
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationMedicoseAcademics
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Availablesoniyagrag336
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryJyoti singh
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableSteve Davis
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxSwetaba Besh
 
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
 
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...dilbirsingh0889
 
💰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
 
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
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
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
 
(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
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxSwetaba Besh
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Janvi Singh
 
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...Rashmi Entertainment
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...dishamehta3332
 
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Janvi Singh
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 

Dernier (20)

Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
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
 
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
💞 Safe And Secure Call Girls Coimbatore🧿 6378878445 🧿 High Class Coimbatore C...
 
💰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...
 
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...
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
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...
 
(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 ...
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
 
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
 

Liver cirrhosis ppt