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Based thereon diabetes insipidus diuretics discount 500mg actoplus met amex, the Arbitrator concluded that the Petitioner engaged in a personal deviation diabetes type 1 financial help purchase discount actoplus met, as the petitioner had yet to return to his regular route home diabetes quotes buy actoplus met 500 mg otc. The its decision would not be disturbed on appeal unless against petitioner testifed that he left his normal path of travel on the manifest weight of the evidence blood sugar 280 order actoplus met master card. The appellate court Route 12 when he traveled several hundred feet on Hartigan accepted that the petitioner was not engaged in a business Road and entered the bank parking lot. At the time related activity at the time of the occurrence, but rather, had of the injury, the petitioner was pulling back onto Route 12 deviated from his course of employment based upon the from Hartigan Road. In Robinson, the Supreme Court addressed the compen As a result of decisions such as Robinson and Cox, coun sability of a case where a traveling employee departed from sel must engage in a multi step analysis in order to evaluate the normal and customary route to a job site. First, it is incumbent upon counsel that they could go Christmas shopping following his visit to a to determine whether evidence will be introduced by the job site. The court pointed out petitioner that would create a dual purpose for the deviation. Larson provides: if he had been injured on Hartigan Road while still traveling to the bank that the case would be non-compensable Larson plain reading of the Cox decision certainly suggests that the WorkersCompensation Section 19. A petition for from the most direct route, he was then on a personal side rehearing has been denied. In Cox, the court could have concluded that the petitioner had returned to his normal route at the time of the injury since he was in the act of turning onto Route 12 at the time of the accident. This approach has worked well in Illinois and elsewhere with very few measurable com plaints. The approach relies upon licensed professionals who are trained to respect the confdentiality of others and who By: James E. Swansea the Perceived Problem with Privacy Common law did not recognize a physician-patient privi lege. Attorneys have asserted that privacy that results from disclosure to an outside party. Courts have specifcally grappled with two issues: About the Authors (1) what medical records might be relevant or reasonably calculated to lead to admissible evidence in a particular case; James E. DeFranco, president of DeFranco & Bradley, and (2) who should review those records to determine which P. An analysis of case personal injury claims for brain damage, multiple spine law from Illinois and other jurisdictions reveals that decisions operations, complex regional pain syndrome, and medical concerning the scope of relevancy are reasonably consistent malpractice, and claims involving civil arson, insurance fraud, premises liability, retaliatory discharge, employment but decisions relating to who will evaluate medical records discrimination, and commercial breach of contract. Such an analysis reveals that the scope of relevancy can be rather broad and the effort required to distinguish relevant information from irrelevant in Darrell J. Attempts to place that injury defense, property damage claims, premises liability, burden on health care providers are untenable and attempts to products liability, and wrongful discharge cases. Louis University place that burden on trial judges is a time-consuming waste of and his J. The information was no longer required to pertain in which the recipient introduces his mental condi to enumerated illnesses or conditions to receive confdential tion or any aspect of his services received for such status. Instead, confdentiality applied to past, present, and condition as an element of his claim or defense, if future physical or mental health information. Health Insurance and only to the extent the court in which the proceed Portability and Accountability Act: Standards for Privacy of ings have been brought. Health Privacy Stories, to have consented, by virtue of fling a personal injury action, (March 5, 2007). First, formation of a personal injury plaintiff by deeming a personal the lawyers collecting medical records are licensed profes injury plaintiff to have waived his or her right to privacy and sionals who could lose their license to practice law if they confdentiality with regard to medical records upon fling suit. Second, the lawyers At the same time, however, Section 2-1003 instituted cer collecting the records are part of a profession that considers tain safeguards to prevent the disclosure of a personal injury confdentiality sacrosanct. Section 2-1003 as an unconstitutional violation of the sepa Regardless of the lack of interest defense lawyers have ration of powers clause of the Illinois Constitution. In Missouri, as in Illinois, the scope of discovery is (Civil 2009)); dictated by the scope of damages averred in the petition.
Preference in awarding the Frank Garvey Scholarship will be made for students from Suffolk County managing diabetes through diet and exercise buy generic actoplus met 500mg online, N diabete games order actoplus met overnight delivery. The new field metabolic disease dogs cheap generic actoplus met uk, which will cost approx imately $2 million to construct diabetes insipidus left untreated buy actoplus met canada, will affect the varsity teamsability to recruit high-caliber players. Guilfoile, who attends every football game, home and away, then made an additional gift of $10,000 to be used for the creation of a counseling program for student athletes. In recognition and out of gratitude, the College has named the 2002, and the news is very good. Holy Cross recorded its highest faculty lounge in the Department of Religion level of total voluntary support ever, with after him. This eclipsed the previous record after graduation from Holy Cross, and spent of $19 million set in 1998. Giving from parents accounted children, two of whom, George and Constance, graduated from Holy Cross. Weiss, Director Grants, Foundations & Corporate Giving mong Holy CrossA recent grant awards have been two from the foundations of major corporations. This is a continuation of an Avon grant that has already provided eight scholarships of this type. It will be a focal point on campus for innovative cur riculum development whereby selected intermediate and advanced courses will add laboratory components in order to address these research questions and to extend studentslearn ing. The event raised $140,000 to support 15 summer interns working in leading businesses and not-for-profits in the metropolitan New York area. The goal of the Summer Internship Program is to offer 250 paid summer internships nationwide by 2005. Professors typically participate twice in a 10-year period although there are a few excep tions. The first class is followed by lunch, with classes resuming promptly for the final two ses sions. Classes success and his 10th year serving as Former students repeatedly mention included: Visiting Assistant Professor chairman, Onofrey Jr. He has served as president and newsletters earned him the Perotta class reunion chairman in 1977, class director of the Holy Cross Club of St. As president of the Class of reunion gift committee chair in 1982 Louis and the Holy Cross Club of the 1964 Charitable Foundation, he has led and co-chair in 1987. Trudel co-developed served on the board of the New York passionate supporter of the 1843 and administers the Class Networking Regional Club and as president of the Society. He and his wife, Maureen, reside Florida, Missouri, Colorado and the in Haddam, Conn. They will also nominate 15 to 20 ments made in connection with his or her own involve directors, 10 of whom will come from a specific class, ment beginning with one nominee from each third preceding any other outstanding service or contribution to the class as follows: 2003, 2000, 1997, 1994, 1991, 1988, College 1985, 1982, 1979, 1976. Fall Homecoming 2002 Elda Driscoll is presented with the Crusader of the Year Award by Holy Cross Club of Rhode Island treasurer, Ann Sept. In addition, he worked as theall Oindividual champion on the 1984 cross the 47th Hall of Fame dinner Holy Cross purchasing director. In track and field, T and induction ceremony held Bellerose currently serves as the associate she was a three-time All-New England Saturday, May 4, at the Hogan Campus director of athletics and as business selection in indoor track (1982, 1984, Center. He his playing days, he has served as both National Catholic College was a three-year starter at forward for Holy Cross Magazine Summer 2002 54 Announces Yearly Awards Lauren M. Rinaldi is a two-time Patriot Of Fteam which defeated nationally ranked Swords was also a member of the UnitedameLeague Champion in both the 1 and 3 St.
Common practice is to maintain precautions until the patient no longer harbors the organism or is discharged from the health care facility diabetes symptoms excessive sweating purchase cheap actoplus met line. For these patients diabetes type 1 markers cheap actoplus met master card, early instruction in proper diet; oral health diabetes tipo 1 purchase genuine actoplus met on-line, including use of dental sealants and adequate fuoride intake; and prevention or cessation of smoking will aid in prevention of dental carries and poten tially lower their risk of recurrent endocarditis blood glucose non fasting discount 500 mg actoplus met with visa. Hospitals should develop institution specifc guidelines for the proper use of vancomycin. When symptoms occur, they are most often related to larval skin invasion, tissue migration, and/or the presence of adult worms in the intestine. Infective (flariform) l arvae are acquired from skin contact with contaminated soil, producing transient pru ritic papules at the site of penetration. Larvae migrate to the lungs and can cause a tran sient pneumonitis or Loeffer-like syndrome. After ascending the tracheobronchial tree, larvae are swallowed and mature into adults within the gastrointestinal tract. Symptoms of intestinal infection include nonspecifc abdominal pain, malabsorption, vomiting, and diarrhea. This condition, which frequently is fatal, is characterized by fever, abdominal pain, diffuse pulmonary infltrates, and septicemia or meningitis caused by enteric gram-negative bacilli. Humans are the principal hosts, but dogs, cats, and other animals can serve as reservoirs. Transmission involves penetration of skin by infective (flariform) larvae from contact with infected soil. Infections rarely can be acquired from intimate skin contact or from inadvertent coprophagy, such as from ingestion of contaminated food or within institutional settings. Adult females release eggs in the small intestine, where they hatch as frst-stage (rhabditiform) larvae that are excreted in feces. A small percentage of larvae molt to the infective (flariform) stage during intestinal transit, at which point they can penetrate the bowel mucosa or perianal skin, thus maintaining the life cycle within a single person (autoinfection). Because of this capacity for autoinfection, people can remain infected for decades after leaving a geographic area with endemic infection. At least 3 consecutive stool specimens should be examined microscopically for character istic larvae (not eggs), but stool concentration techniques may be required to establish the diagnosis. The use of agar plate culture methods may have greater sensitivity than fecal microscopy, and examination of duodenal contents obtained using the string test (Entero Test), or a direct aspirate through a fexible endoscope also may demonstrate larvae. Eosinophilia (blood eosinophil count greater than 500/L) is common in chronic infec tion but may be absent in hyperinfection syndrome. Serodiagnosis is sensitive and should be considered in all people with unexplained eosinophilia. Gram-negative bacillary meningitis is a common associated fnding in disseminated disease and carries a high mortality rate. Alternative agents include thiabendazole and albendazole, although both drugs are associated with lower cure rates (see Drugs for Parasitic Infections, p 848). Prolonged or repeated treatment may be necessary in people with hyperinfection and disseminated strongyloidiasis, and relapse can occur. Examination of stool for larvae and serum for antibod ies to S stercoralis is recommended in patients with unexplained eosinophilia, especially for those who are immunosuppressed or for whom administration of glucocorticoids is planned. If possible, patients should be treated for strongyloidiasis prior to initiation of immunosuppressive therapy. Intrauterine infection with Treponema pallidum can result in stillbirth, hydrops fetalis, or preterm birth or may be asymptomatic at birth. Infected infants can have hepatosplenomegaly, snuffes (copious nasal secretions), lymphadenopathy, mucocu taneous lesions, pneumonia, osteochondritis and pseudoparalysis, edema, rash, hemolytic anemia, or thrombocytopenia at birth or within the frst 4 to 8 weeks of age. Skin lesions or moist nasal secretions of congenital syphilis are highly infectious. However, organ isms rarely are found in lesions more than 24 hours after treatment has begun. The primary stage appears as one or more painless indurated ulcers (chancres) of the skin or mucous membranes at the site of inoculation. Lesions most commonly appear on the genitalia but may appear elsewhere, depending on the sexual contact responsible for transmission (ie, oral). The secondary stage, beginning 1 to 2 months later, is characterized by rash, mucocutaneous lesions, and lymphadenopathy. The polymorphic maculopapular rash is generalized and typically includes the palms and soles. This stage also resolves spontaneously without treatment in approximately 3 to 12 weeks, leaving the infected person completely asymp tomatic. A variable latent period follows but sometimes is interrupted during the frst few years by recurrences of symptoms of secondary syphilis. Latent syphilis is defned as the period after infection when patients are seroreactive but demonstrate no clinical manifestations of disease. The tertiary stage of infection occurs 15 to 30 years after the initial infection and can include gumma formation, cardiovascular involvement, or neurosyphilis. The incidence of acquired and congenital syphilis increased dramatically in the United States during the late 1980s and early 1990s but decreased subsequently, and in 2000, the incidence was the lowest since reporting began in 1941. Since 2001, however, the rate of primary and secondary syphilis has increased, primarily among men who have sex with men. Among women, the rate of primary and secondary syphilis has increased since 2005, with a concomitant increase in cases of congenital syphilis. Rates of infection remain disproportionately high in large urban areas and in the southern United States. Primary and secondary rates of syphilis are highest in black, non-Hispanic people and in males compared with females. Congenital syphilis is contracted from an infected mother via transplacental trans mission of T pallidum at any time during pregnancy or possibly at birth from contact with maternal lesions. Among women with untreated early syphilis, as many as 40% of pregnancies result in spontaneous abortion, stillbirth, or perinatal death. The rate of transmission is 60% to 100% during primary and secondary syphilis and slowly decreases with later stages of maternal infection (approximately 40% with early latent infection and 8% with late latent infection). The World Health Organization estimates that 1 million pregnancies are affected by syphilis worldwide. Of these, 460 000 will result in stillbirth, hydrops fetalis, abortion, or perinatal death; 270 000 will result in an infant born preterm or with low birth weight; and 270 000 will result in an infant with stigmata of congenital syphilis. Acquired syphilis almost always is contracted through direct sexual contact with ulcer ative lesions of the skin or mucous membranes of infected people. Relapses of secondary syphilis with infectious mucocutaneous lesions can occur up to 4 years after primary infection. In most cases, identi fcation of acquired syphilis in children must be reported to state child protective services agencies. The incubation period for acquired primary syphilis typically is 3 weeks but ranges from 10 to 90 days. Specimens should be scraped from moist mucocutaneous lesions or aspirated from a regional lymph node. Although such testing can provide defnitive diagnosis, in most instances, serologic testing is necessary. Polymerase chain reaction tests and immunoglob ulin (Ig) M immunoblotting have been developed but are not yet available commercially. Presumptive diagnosis is possible using nontreponemal and treponemal serologic tests. Use of only 1 type of test is insuffcient for diagnosis, because false-positive nontrepone mal test results occur with various medical conditions, and treponemal test results remain positive long after syphilis has been treated adequately and can be falsely positive with other spirochetal diseases.
When an action potential travels down the T tubules diabetic diet 1500 calories chart generic actoplus met 500 mg with mastercard, the local depolarization activates the voltage-gated dihydropyridine receptors diabetes prevention breakfast buy 500mg actoplus met fast delivery. Tropomyosin-troponin complex is repositioned; ++ the released Ca binds with troponin C exposing the binding sites on the actin molecule so that they can attach with the myosin cross bridges at their specific sites diabetes insipidus kezelése purchase actoplus met canada. This stiffness of death is a generalized locking in place of skeletal muscle beginning 3-4 hours after death and completed in about 12 hours diabetes diet prevention generic actoplus met 500mg without a prescription. The onset of the resultant contraction response lags behind the action potential because the excitation contraction coupling process must occur before cross bridges activity begins. As a matter of fact, the action potential ends before the contraction mechanism even becomes operational. The contraction time lasts about 50 msec, although it varies with 84 the type of muscle fiber. The relaxation time lasts slightly longer than contraction time, another 50 msec or more. When an action potential depolarizes the presynaptic membrane, the transmitter cannot activate enough receptors to evoke an action potential in the muscle fiber. Autoimmune thymitis Enlarged thymus may also be another cause of myasthenia gravis. Autoimmune thymitis associated with the release of a hormone called thymopoietin (or thymin). Within minutes, some of these paralyzed persons can begin to function normally Muscle twitch Contraction of a whole muscle can be of varying strength. A twitch, which is too short and too weak for any use in the body, is produced as a result of a single action potential in a muscle fiber. Muscle fibers are arranged into a whole muscle and function with cooperation producing contraction of varying grades of strength stronger than a twitch. The number of muscle fibers contracting within a muscle the tension developed by each contracting fiber. Motor unit: Each whole muscle is innervated by a number of different motor neurons. One motor neuron innervates a number of muscle fibers, but each muscle fiber is supplied by only one motor neuron. Muscles producing very precise, delicate movement such as extraocular eye muscles and the hand digit muscles contain a few dozen muscle fibers. Muscles designed for powerful, coarsely controlled movement such as those of legs, a single motor unit may have 1500-2000 muscle fibers. This tension generated by the contractile elements is transmitted to the bone via the connective tissue and tendon before the bone can be moved. Intracellular components of the muscle such as the elastic fiber proteins and connective tissue collagen fibers have a certain degree of passive elasticity. There are 2 primary types of movement depending on whether the muscle changes length during contraction. Isotonic contraction: In this type, muscle tension remains constant as the muscle changes length. Isometric contraction: In this type, the muscle is prevented from shortening, so tension developed at constant muscle length. Isotonic contractions are used for body movements and for moving external objects. The submaximal isometric contractions are important for maintaining posture and for supporting the object in a fixed position. During a given movement, a muscle may shift between Isotonic and isometric contractions. The active transport of Ca++ ions back in to the sarcoplasmic reticulum, is energy dependent. Smooth muscle the majority of these muscles are present in the walls of hollow organs, blood vessels and tubular structures in the body. Their contraction exerts pressure on the contents and regulates the forward movement of contents of these structures. Smooth muscles are spindle-shaped, have 1 nucleus and are much smaller in size (2-10 m in diameter 92 and 50-100 m in length). Smooth muscles do not form myofibril and are not arranged in sarcomere pattern of skeletal muscle. Smooth muscle myosin interacts with actin only when the myosin is ++ phosphorylated. During excitation, cytosolic Ca increases, that acts as an intracellular messenger, initiating a series of biochemical events that result in phosphorylation of myosin. In Smooth muscles Ca++ binds with calmodulin and intracellular protein similar to troponin in structure. This calcium calmodulin complex binds to and activates another protein, myosin kinase, which in turn phosphorylats myosin. Phosphorylated myosin then binds with actin thin filament starting cross bridge cycle. Slow wave potential Slow contractile response of smooth muscle A smooth muscle contractile response is slower than of muscle twitch. A single smooth muscle contraction may last as long as 3 sec (3000 msec) compared to the maximum of 100 msec for a single contraction response skeletal muscle. Describe the generation of action potential, its phases, ionic basis and mode of propagation 4. Describe the transmission of neural signals at the neuromuscular junction of skeletal muscle. Cells need a constant supply of oxygen to execute energy-producing chemical reactions that produce carbon dioxide that must be eliminated continuously. Blood is about 8% of total body weight and has an average volume of 5 liters in women and 5. A very tiny portion of the cardiac output passes through each capillary, bringing oxygen, nutrients, and hormones to each cell and removing carbon dioxide and metabolic end products (waste products). Blood composition Blood consists of erythrocytes, leukocytes, and platelets suspended in liquid called plasma. The hematocrit averages 42% for women, 45% for men, with average volume occupied by plasma being 58% for women and 55% for men. They are biconcave disks, manufactured in the red bone marrow, losing their nuclei before entering the peripheral circulation. Red cells having nuclei seen on the peripheral smear suggest an underlying disease state. Their biconcave shape gives them enough 104 flexibility so they can easily pass through small capillaries to deliver oxygen to the tissues. The other 2 bonds (besides 4 nitrogen) are formed on either side of the planar porphyrin ring. The affinity of hemoglobin for oxygen is affected by pH, temperature, and 2, 3-diphosphoglycerate concentration. These factors facilitate oxygen uptake in the lungs and its release in the tissues. Structure of a hemoglobin molecule Globin is a tetramer, consisting of two pairs of polypeptide chains. Changes in the polypeptide subunits of globin can also affect the affinity of hemoglobin for oxygen. The major normal variants of hemoglobin, depending on its variation of globin chain is as follows: Table 10. A molecule of HbS contains two s normal chains and two mutant globin chains in which glutamate at position 6 has been replaced with valine.
Thus definition of diabetes mellitus type 1 buy genuine actoplus met online, the diagnoses of the control size involved in a given outbreak diabetes test after meal buy actoplus met without prescription, and in the demographic subjects are potentially biased away from ReA diabetes symptoms metallic taste buy actoplus met pills in toronto, because a recent characteristics of the small diabetes you magazine cheap actoplus met 500mg online, highly selected outbreak popula infection was part of the criteria for that diagnosis. Population-based studies allow for a determination of al [67, 68] studied patients referred to rheumatology clinics incidence with use of an unselected group of patients and bac with new onset arthritis rather than subjects with conrmed terial strain types. A study by Locht et al [66] studied ReA following nitions and study methods likely play a role in this difference, Campylobacter infection in Denmark with use of patients with although genetic factors in the disparate populations could also enterotoxigenic E. The California study was performed using a an increased risk of developing reactive joint symptoms fol mailed screening questionnaire that addressed arthritis and lowing Campylobacter (16%) infection, compared with enter other symptoms. It is often stated that susceptibility infection within 8 weeks of their positive culture. In the population-based study monella or Campylobacter infection, 38 actually occur [1, 69]. A proposal for the classication of patients for clinical and experimental studies on reactive arthritis. Reiter, his syndrome and his Nazi Thus, a case denition that is narrow, including only subjects past. Ideally, examiners would be blinded to the infection his establishing a consensus on the denition of and diagnostic investi tory of study subjects, and they should use objective measures gations for reactive arthritis. The European Spon Acknowledgments dylarthropathy Study Group preliminary criteria for the classication of spondylarthropathy. Food-related illness and death in Clostridium difficile enteritis as a complication of Helicobacter pylori the United States. N Z Med J and other rheumatic conditions in the United States in 1997: total and 2004; 117:1 p following U1023. Reactive arthritis testinal symptoms after infection with Campylobacter jejuni/coli and following an outbreak of Salmonella typhimurium phage type 193 in enterotoxigenic Escherichia coli. High frequency of reactive joint Annual incidence of inammatory joint diseases in a population based symptoms after an outbreak of Salmonella enteritidis. Low incidence of reactive burden of illness caused by nontyphoidal Salmonella infections in the arthritis in children following a Salmonella outbreak. A clinical and immunogenetic study following an mune response and clinical sequelae of Salmonella infection in a point outbreak of salmonellosis. People with arthritis can fnd strength in each other, manage stress and take control of their health care through informed choices. Last year we began to elevate the level of patient involvement in the creation of Arthritis by the Numbers. We believe patients must be fully integrated into everything we do, and that their diverse needs and outcomes, the ones that are most important to them, are represented. Conservative estimates only include patients who report they have doctor-diagnosed arthritis, indicating that more than 54 million adults and almost 300,000 children have arthritis or another type of rheumatic disease. While researchers try to fnd more accurate ways to estimate the prevalence of this disease and the burdens it causes, we do know that it is most common among women, and the number of people of all ages with arthritis is increasing. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. They may stay about the same for years and then may progress or get worse over time. Some types of arthritis also affect other body parts, like the heart, eyes, lungs, kidneys and skin. The following facts describe some of the features common to many forms of arthritis. By age 30, bones are at peak bone density, and cell turnover remains stable for several years in most people. This may lead to the development of osteopenia (a less severe form of bone density loss) and osteoporosis. However, the spine, hips, ribs and wrists are the most commonly fractured when a person with osteoporosis falls. Of the pre-menopausal women who develop this disease, it is thought that 50 to 90 percent have a secondary cause. Anyone who injures or overuses their joints, including athletes, military members and people who work physically-demanding jobs, may be more susceptible to developing this disease as they age. According to a 2016 Nielsen consumer needs survey conducted for the Arthritis Foundation, 92 percent of those patients say there are lots of ways around any problem. I have every imaginable arthritis-friendly utensil, jar opener, lightweight serving dishes and more. Learn and practice as many self-management skills you possibly can: keeping body weight under control, staying active, exercising, pacing yourself. For these people, there is substantially more time for greater disability to occur. There are currently no medical or surgical treatments Pain and physical limitations are a source of shame and that will improve this alarming trajectory. There were more than 80,000 primary procedures in 2011, increasing by around 3 percent annually. But the immune system can go awry, mistakenly attacking the joints with uncontrolled infammation, causing joint erosion and damage to internal organs, eyes and other parts of the body. The goal of treatment for these diseases is to reduce pain, improve function and prevent further joint damage. One of the biggest challenges was accepting that I could no longer be as independent as before. So, I became a nurse educator and have worked in the same hospital for 35 years in a variety of nurse-related roles. Some days I hardly think about it at all; other days I think about it a lot and feel down. Over time, there is loss of cartilage, and the joint spacing between bones can become smaller. Over the years, she has immersed herself in leadership roles with the Foundation and speaks nationwide to inspire patients living with chronic illness. In my work with different arthritis groups, I am seeing more and more patients who are teenagers and young adults. My friends and family also wanted to be supportive and help in fundraising and events. Liz: the turning point for me was connecting with fellow patients through the Arthritis Foundation. Being part of the Arthritis Foundation community is important for a variety of reasons. Lupus is systemic, meaning it affects a wide part of the body, including the joints, kidneys, skin, blood, brain and other organs. According to a 2016 Nielsen consumer needs survey conducted for the Arthritis Foundation, 90 percent of these patients say they can meet the goals they set for themselves. Buy actoplus met overnight delivery. Diabetes ka gharelu hal - Subah Saverey Samaa Kay Saath 10 Nov 2015. |
