Introduction
Benign
prostatic hyperplasia (BPH) is a prevalent disease, affecting 22% of men <
60 years old, and 45% of men 70-80 years old [1]. When BPH symptoms are
refractory to medical management, surgical intervention is recommended. Optimal
surgical management for large prostatic adenoma, defined as prostate mass >
100 g or volume > 80 cc, is controversial. While open simple prostatectomy
(OSP) remains the gold-standard surgical management for severe BPH, the
procedure is associated with significant morbidity, encouraging the use of
other surgical options. This blog will discuss the surgical management of large
prostatic adenoma, with emphasis on several alternatives to OSP, including bipolar
TURP, holmium laser therapy, photoselective vaporization of the prostate (PVP),
and robot assisted laparoscopic simple prostatectomy (RASP).
Open Simple Prostatectomy (OSP)
OSP is the gold standard surgical management for high volume (> 80 cc) prostatic adenoma. Advantages of this approach include more complete removal of prostatic adenoma under direct visualization, lower re-treatment rates, and no risk of TUR syndrome. A randomized controlled trial comparing transvesical open simple prostatectomy (TVP) with TURP for prostates > 80 cc demonstrated significant reduction in IPSS scores at 12 months post-op for the TVP group. Unfortunately, the peri-operative blood transfusion rate was 11% and 14% for the TVP and TURP arms, respectively (Figure 1) [2]. This morbidity associated with OSP has encouraged urologists to seek other alternatives for the management of large prostatic adenoma.
![]() |
Figure 1: Complications for both TURP (n= 35) and Transvesical Open Simple Prostatectomy (TVP) (n = 34). Ou et al. Urology 2010. |
TURP
Monopolar TURP
has been the gold standard surgical management for prostates 30-80 mL, but
concerns regarding TUR syndrome and excessive bleeding prevent its routine use
in larger prostatic adenoma. For this reason, many studies have focused on
Bipolar TURP, which enables the use of normal saline irrigation with no risk of
TUR syndrome. In a recent prospective, randomized trial comparing Bipolar TURP
vs. OSP for prostates > 80 cc, Bipolar TURP was found to resect
significantly less prostatic adenoma mass despite having similar pre-operative
prostate size to the OSP arm. However, a significantly less hemoglobin drop,
blood transfusion rate, and hospital stay was found in the Bipolar TURP arm [3].
Holmium Laser Therapy
Holmium laser
therapy emits light at 2100 nm in pulses. This causes tissue water vaporization
with limited (0.4 mm) tissue penetration. Because the procedure uses normal
saline for irrigation, there is no risk for TUR syndrome manifested by
dilutional hyponatremia. Laser settings commonly cited in the literature
include 2-2.5 J and 40-50 Hz [4]. Several retrospective studies have found
significant 6 month post-op reduction in IPSS scores for prostates greater than
75, 125, and 175 g [4-6]. Furthermore, these studies reported low
peri-operative blood transfusion rates of 1.9-3.5%, which is significantly less
than the reported OSP average blood transfusion rate of 8.5% or greater. For
this reason, holmium laser therapy is often cited in the literature as having prostate
“size independent” effectiveness.
Photoselective Vaporization of the Prostate (PVP)
Photoselective
Vaporization of the Prostate (PVP) is commonly referred to as the Greenlight
laser, as it vaporizes tissue at a wavelength of 532 nm. Because the laser is
selectively absorbed by hemoglobin, the relatively fibrous prostatic capsule is
resistant to absorption, making this procedure an attractive alternative to OSP.
The current generation of the Greenlight laser is the 180 W XPS laser. The
power has been increased from previous generations in order to improve adenoma
removal and lower re-treatment rates. A multi-institutional prospective trial
that looked at nearly 1,200 patients (2/3 with > 80 cc prostates; 1/3 with
< 80 cc prostates) who underwent 180 W XPS laser therapy found that the
larger prostate cohort maintained a mean IPSS reduction of 19 points at 6, 12,
and 24 months post-op [7]. However, significantly more of the > 80 cc
prostate cases had to be converted to TURP, most commonly due to bleeding that
obscured the visual field. Therefore, PVP appears to be an effective, but
imperfect alternative to OSP for large prostatic adenoma.
Robot assisted laparoscopic Simple Prostatectomy (RASP)
Robot assisted
simple prostatectomy (RASP) appears to be a very attractive alternative to OSP,
with the hope that it would produce the functional results of OSP while
reducing the associated morbidity, including hospital length of stay,
perioperative hemorrhage, and blood transfusion rates. The transvesical
approach provides excellent visualization of the extent of the prostatic
adenoma, while preventing injury to the ureteral orifices during incision of
the bladder mucosa (Figure 2).
![]() |
Figure 2: Transvesical RASP: Incision in bladder mucosa distal to the ureteral orifices. Screen shot credit: Misop Han, M.D. Brady Urological Institute at Johns Hopkins Hospital. |
Data from the
Brady Urological Institute comparing RASP to OSP found reductions in estimated
blood loss, blood transfusions, and hospital length of stay for the RASP arm
(Figure 3). Although there was no significant difference in pre-operative
prostate volume by transrectal ultrasound measurements, RASP had similar
adenoma resection weights as compared to OSP. A review that looked at 13 RASP
studies found an overall blood transfusion rate of 3.5% [8].
![]() |
Figure 3. RASP vs. OSP Peri-operative Outcomes. Brady Urological Institute at Johns Hopkins Hospital. |
An edited video
of a robot assisted laparoscopic simple prostatectomy performed at Johns
Hopkins Hospital can be found below.
Key Points
- Open simple prostatectomy is the gold standard surgical management for large prostatic adenoma
- Bipolar TURP may remove less adenoma than OSP
- HoLEP has prostate “size independent” effectiveness
- PVP is effective but bleeding my obscure visualization
- RASP is an excellent alternative for severe BPH for those well versed in robotic radical prostatectomy
This blog was written by Bijan W. Salari, a medical student at Wright State University Boonshoft School of Medicine. Bijan recently finished a four-week sub-internship at the Brady Urological Institute and gave a presentation to the department on "The Surgical Management of Large Prostatic Adenoma" from which this blog is inspired. Bijan is looking forward to a career in urology.
REFERENCES
1. Speakman et al. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - focus on the UK. BJU Int. 2015 Apr;115(4):508-19. doi: 10.1111/bju.12745. Epub 2014 Oct 16.
2. Ou et al. A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. Urology. 2010 Oct;76(4):958-61. doi: 10.1016/j.urology.2010.01.079. Epub 2010 Apr 15.
3. Geavlete et al. Bipolar vaporization, resection, and enucleation versus open prostatectomy: optimal treatment alternatives in large prostate cases? J Endourol. 2015 Mar;29(3):323-31. doi: 10.1089/end.2014.0493. Epub 2014 Sep 17.
4. Krambeck et al. Holmium laser enucleation of the prostate for prostates larger than 175 grams. J Endourol. 2010 Mar;24(3):433-7. doi: 10.1089/end.2009.0147.
5. Matlaga et al. Holmium laser enucleation of the prostate for prostates of >125 mL. BJU Int. 2006 Jan;97(1):81-4.
6. Kuo et al. Holmium laser enucleation of prostate (HoLEP): the Methodist Hospital experience with greater than 75 gram enucleations. J Urol. 2003 Jul;170(1):149-52.
7. Hueber et al. Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia Using the 180 Watt System: Multicenter Study of the Impact of Prostate Size on Safety and Outcomes. J Urol. 2015 Aug;194(2):462-9. doi: 10.1016/j.juro.2015.03.113. Epub 2015 Apr 4.
8. Patel et al. Robotic-assisted Simple Prostatectomy: Is there Evidence to go Beyond the Experimental Stage? Curr Urol Rep (2014) 15:443.
5. Matlaga et al. Holmium laser enucleation of the prostate for prostates of >125 mL. BJU Int. 2006 Jan;97(1):81-4.
6. Kuo et al. Holmium laser enucleation of prostate (HoLEP): the Methodist Hospital experience with greater than 75 gram enucleations. J Urol. 2003 Jul;170(1):149-52.
7. Hueber et al. Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia Using the 180 Watt System: Multicenter Study of the Impact of Prostate Size on Safety and Outcomes. J Urol. 2015 Aug;194(2):462-9. doi: 10.1016/j.juro.2015.03.113. Epub 2015 Apr 4.
8. Patel et al. Robotic-assisted Simple Prostatectomy: Is there Evidence to go Beyond the Experimental Stage? Curr Urol Rep (2014) 15:443.
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ReplyDeleteشركة البيت السعيد افضل شركة كشف تسربات بالقصيم تستخدم دائما ما شركة كشف تسربات بالقصيم يناسب وضعها ومكانتها فى سوق العمل افضل شركة كشف تسربات المياه بالقصيم , نحن نقدم اليكم خدمتنا , فاذا استعنت بنا فانت افضل شركة مكافحة حشرات بالقصيم الرابح الاكبر لا تترد افضل شركة عزل خزانات بالقصيم فى الاتصال وسوف نصلك فى اى مكان , شركة البيت السعيد افضل افضل شركة عزل اسطح بالقصيم وعلاجها وافضل شركة عزل مائى بالقصيم .
ReplyDeleteمجال التعليق الصوتي أصبح الآن فويس اوفر من أكثر المجالات شهرة ولابد من ان يعمل الشخص موشن جرافيك على تنمية المواهب و المهارات لديه إن كان يريد أن يصبح كورس فويس اوفر أفضل و مميز في مجاله حيث ان التعليق الصوتي لا يعتمد على الصوت فقط و إن كان اهم شي كورس التعليق الصوتى و لكن لابد من وجود بعض المهارات كورس الدوبلاج الاخرى التي تعمل على جعلك من المحترفين في هذا المجال
ReplyDeleteحافظى دائما على البيت صباغ بالكويت عطرا تفوح من ارجاء المنزل وهذا ما تفعله فني ستلايت بالكويت و لكن هل يمكن تعطير المنزل قبل التخلص شركة تنظيف بدبي من الروائح الكريهه فى مفروشاته فني كهرباء بالكويت و من المواد المتوفره فى مطبخك دائما ما تساعد شركة نقل عفش بالكويت على امتصاص هذه الروائح الكريهه هى الكربوناتو و البيكنج صودا قومى بنثر احدى المادتين ليلا على المفروشات الارضيه
ReplyDeleteتعد شركة ويب السعودية افضل شركة تصميم مواقع بالسعودية من الشركات التى افضل شركة تصميم مواقع بالرياض تعتمد على تقديم خدمات التسويق الالكتروني افضل شركة تسويق الكتروني بالسعودية وخدمات اشهار المواقع فى جوجل افضل شركة تسويق الكتروني بالرياض والفيس بوك وتويتر وتعمل على سرعة الإنتشار لذلك فهى تعتبر افضل شركة تسويق
ReplyDeleteتعتبر شركتنا افضل تسليك مجاري الكويت تعتبر جهاز الكمبريسور تسليك مجاري بالكويت من أهم الأجهزة المستخدمة تسليك مجاري فى الكويت في جميع أعمال تسليك المجاري شركة تسليك مجاري بالكويت حيث يعمل جهاز الكمبريسور على حل تسليك مجاري الكويت جميع مشاكل الانسداد شركة تنظيف منازل بالكويت الداخلي في المنزل .
ReplyDeleteتقدم افضل ما لديها في خدمة نقل العفش شركة نقل عفش بمكة حيث توفر افضل شركة فك وتركيب اثاث ايكيا بمكة جميع الآلات والمعدات الحديثة والمتطورة شركة نقل اثاث بمكة التي تستخدم في عمليات نقل العفش مثل الفك والتركيب والتغليف ويتم فك وتركيب الدواليب والاسرة والستائر بها .
ReplyDeleteI was diagnosed with stage 3 breast cancer in August of 2010. A precious friend told me about Dr Itua Herbal Center in West Africa,She gave me his contact number and email address,I contacted him quickly so he give me guaranty that his herbal medicine will cure my cancer and i will be heal forever I said Okay.I ask him about the process for the cure,he ask me to pay for the fees which i did and within 7 working days he sent me the herbal medicine then he instructed me on how to drink it for two weeks to cure.I told Gomez my friend about the herbal medicine so he gave me go ahead to drink it.So after drinking it for two weeks i was cured I'm so grateful and i promise i will recommend anyone with cancer to him and that what i'm doing.
ReplyDeleteDr Itua told me he can cure the following disease.Cancer,Hiv/Aids,Herpes,Diabetes,Parkison,Copd,Hepatitis.. Here Is His Contact Info......[Email...drituaherbalcenter@gmail.com/Whatsapp...+2348149277967]
بسم الله الرحمن الرحيم
ReplyDeleteفصل الصيف واحد من امتع الفصول في السنه خاصة في المدن الساحلية والمسابح الخاصه والعامه الكثير من الناس ان لم يكون جميعا يذهب الي المسابح والشواطئ للاستمتاع بالسباحه والميه والهروب من حر الصيف لذلك يجب تنظيف المسابح بشكل دوري حفاظا علي الزائرين
حيث ان هناك بعد الظواهر الخاطئة التي يفعلها الزائرين في المسبح مثل التبول مما يضر به ويخلق الكثير من البكتيريا الضاره داخل المسبح ناهيك عن ذلك وجود بعض
الشعيرات التى تسقط من الاشخاص داخل الحمام لذلك في هذا المقال سوف نشرح كيفيه تنظيف المسابح للحفاظ عليها زعلي الزائرين والمترددين عليهشركة تنظيف مسابح بالرياض
1 تحديد اماكن التلوث
هناك العديد من الأسباب لظهور التلوث في المسابح، تحديد التلوث هو أول خطوة للقضاء عليه، عادة يتم تحديد السبب بناء على لون وشكل البقعة، والتي غالباً ما تكون مزيج من لونين معاً كالأخضر والنبي، الأحمر والأزرق، الأحمر الوردي، البني
2 تنقسم الملوثات الي قسمين رئيسيين
الاول : هو الملوث العضوىافضل شركة تنظيف مسابح بالرياض
وهو الذي ينشاء من فضلات الانسان والحيوانات داخل المسبح وايضا ورقات الشجر التى تتساقط داخل المسبح مما يجعله يحتوى علي الكثير من مسببات الأمراض ولكن طريقه تنظيف المسبح من الملوث العضوى اسهل بكثير
من الملوث المعدنى حيث ان عند اضافه الكلور فقط علي أماكن الملوث العضوى تبدا البقع بالاختفاء عكس الملوث المعدنى الذى لا يتاثر بالكلور
ثانيا : الملوث المعدنى
هو الشق الثانى من الملوثات وينشاء هذا النوع من المعادن القريبة من المسبح مثل صدأ الحديد وتفاعل المعادن الاخر مع الماء وهذا النوع صعب جدا في تنظيفه حيث يحتاج الي متخصص كي يتمكن من إزالتها كيميائيا .
3 كيف يُمكن علاج البقع العضويه
نقوم اولا بنزع المسبب للبقع من المسبح مثل انتزاع اوراق الشجر خارج المسبح از الطحالب الموجوده داخل المسبح التي سقطت في المياه وغرقت في القاع، لذلك إزالتها أهم جزء من العلاج، لو تم اكتشافها في البداية ستكون إزالتها سهلة، لكن لو تركتها مدة طويلة أو لم تقوم سريعا بتنظيفها فور حدوثها قد يتغير لون المسبح بالكامل،
بالتالي لن يكون سهل إزالتها. يجب مراقبه جميع الاشجار والزهور المجوده بجانب المسبح لتقوم بإزالة أي أوراق أو زخور تسقط فيه قبل أن تتحلل. اغسل حوض السباحة بمادة كيميائيه
ثم بعد هذه الخطوه يجب ان تتم الخطوه الاهم في اي عمليه تنظيف وهي تفريغ المسبح كاملا من الماء الموجود فيهً كليا لكى نتمكن من معالجة الحوائط والقاع كما نُريد،
خاصة لو كانت البقع قديمة واصبح ليس سهلا إزالتها، في هذه الحالة لابد من استخدام مادة حامضية للتخلص من البقع أو اي تغير لون المسبح في الحوض،
لو كان الجزء الداخلي منه مصنوع من الجبس فيجب إزالة طبقة رقيقة جداً من الجبس لاستعادة لونه الناصع مرة أخرى، بشكل عام لن تُضطر
لتكرار هذه العملية إلا كل اربع سنوات، لو كنت تُحافظ على نظافة مسبحك باستمرار. استخدم منظف إنزيمي المنظفات الإنزيمية تُساعد على التخلص من البقع العضوية بسهولة، يُمكنك استخدام منظفات تُجارية ذات قاعدة إنزيمية، أو حتى استخدم الخميرة لو لم تستطع الحصول على
منظف مخصص للمسابح، المنظفات الإنزيمية بشكل عام تُعتبر الأفضل في هذه الحالة لأنها ليست مواد كيميائيه قويه فتضر بالمسبح من حيث الحوائط والارض، إضافة إلى قدرتها على التخلص من
الدهون بالتالي تجعل إزالة البقع أسهل. أضف كمية كبيرة من الكلور كما ذكرنا سابقاً المواد العضوية يسهل التخلص من باستخدام الكلور كما ذكرنا انه الاقوى في تنظيف وتنقيه مياة المسابح
من اي ملوث عضوى ولا تنسي اعطاء التعليمات للزائرين بعدم استخدام الاساليب الغير اداميه من تبول في الماء وعدم الاستحمام قبل النزول الي المسبح فيجب علي كل زائر الاعتناء
بالنظافه الشخصيه له قبل النزول الي المسبح فهاذا من أهم طرق الحفاظ علي مياة المسبح لان جسم الانسان قد يكون حاملا لاي ميكروب فيجب الاعتناء بالنظافه قبل النزول
تمتلك شركتنا شركه زين لتنظيف المسابح بالرياض احدث وافضل الاساليب لتنظيف المسابح حيث نقوم بتفريغ المسبح من الماء كاملا ثم تنظيف البقع العضويه والمعدنيه باحدث الطرق واقوى المعدات
ثم التنظيف بالمواد الكيميائيه التى لا تؤثرا نهائيا علي جدران المسبح ولا الارضيه لذلك نحن نمتلك خبره واسعه في هذا المجال مما يجعل عملنا هو من يتحدث عنا
حفظكم الله جميعا من كل شر ووفقنا دائما الي ارضائكم وسعادتكم
تعمل على توفير كل خدمات عمليات التنظيف شركة تنظيف بالبخار بجدة بالإضافة إلى الخدمات الاخري شركة تنظيف كنب بالبخار بجدة التي تحتاجها ربات البيوت وأصحاب الشركات شركة تنظيف سجاد بالبخار بجدة والعقارات ومن خلال شركتنا المتمزية فى خدمات تنظيف المفروشات شركة تنظيف مجالس بالبخار بجدة بالبخار بافضل الاسعار تعرف على كافة شركة تنظيف بالبخار بمكة الخدمات المتميزة التى نقدمها شركة نقل عفش بمكة اليكن والى كل عملائنا الكرام
ReplyDeleteشركة نظافة خزانات بمكة تقدم خدمات لا يوجد شركة تنظيف بمكة منشأة لا تحتاج لها حيث أن الخزانات تعد من أهم المحتويات التي تحتاج لها المنشآت المختلفة خاصة شركة مكافحة حشرات بمكة في المملكة العربية السعودية التي تعتمد على المياه الجوفية ومياه الآبار شركة تنظيف خزانات بمكة والعيون وتخزينها في خزانات شركة تنظيف بالبخار بمكة بعد تصفيتها وتنقيتها لذا ظهرت الحاجة الشديدة للاستعانة بشركة متخصصة شركة نقل عفش بمكة يستعين بها مختلف الأشخاص في تنظيف وتعقيم الخزانات لديهم من أجل الحفاظ على المياه نظيفة وغير ملوثة
ReplyDeleteالعمالة الفلبينية معروفة بأنها تتعلم شركة نقل عفش بجدة بسرعة كبيرة وجميع الأعمال التي تسند اليها تخرج جودتها بمستوى عالية فى حين ان مستوى الاجور لها منخفض وعليه فإن الشركة شركة تنظيف بالبخار بجدة تعمل على توفير تلك النوعية شركة تنظيف دكت المكيفات بمكة من العمالة ومن خلال افضل شركة نقل عفش بجده شركة تنظيف دكت المكيفات بجدة عمالة فلبينية سوف يتم الحصول على عمال متفوقين وقادرين شركة تنظيف دكت المكيفات بالطائف على نقل الاثاث بعناية كبيرة من اي مكان حتى الادوار العالية وتتم عملية النقل تبعا للأسلوب الحديث وهي كالتالي :-
ReplyDeleteتوفر شركة تنظيف دبي أفضل خدمات نظافة شركة تنظيف بدبي من خلال خبراء في عالم النظافة شركة تنظيف كنب بدبي لديهم احتراف ومهارة عالية وعلى درجة كبيرة من الأمانة والالتزام لديهم حلول شركة تنظيف عجمان عملية وسريعة لجميع شركة تنظيف بالشارقة مشاكل التنظيف ملتزمون بتلبية شركة تنظيف ابو ظبي رغبات العملاء وتنفيذها وعدم إهدار الوقت
ReplyDeleteتنظيف المساحات الشاسعة ليس بالأمر الهين شركة تنظيف دبي ولا يقدر عليه فرد واحد أو الخدم الذين قد يتواجدون شركة تنظيف ابو ظبي بالمنشأة حيث أنه يلزم توافر معدات خاصة شركة تنظيف كنب بدبي من أجل التنظيف تساعد شركة تنظيف بالشارقة على تقديم أفضل الخدمات وتعمل على تيسيرها بأسعار لا تعد عبء على من يبحث عن شركة تنظيف عجمان هذه الخدمات لذا تقدم الشركة كافة الخدمات التي تلزم في تنظيف الفلل شركة تنظيف العين بما تحتويه من محتويات وأغراض
ReplyDeleteسميت بحشرات الفراش لانها غالبا ما تتواجد شركة مكافحة حشرات بمكة فيه وتعيش وتتغذى على الدم سواء دم الإنسان أو الحيوان شركة تنظيف شقق بمكة تعد الحيوانات شركة تنظيف خزانات بمكة الأليفة ذات الشعر شركة مكافحة حشرات بالطائف الكثيف أيضاً أحد المصادر الناقلة لهذه العدوى تقوم حشرة البق بوضع البيض شركة نقل عفش بمكة الخاص بها على المراتب والآسرة شركة تنظيف خزانات بالطائف والذي يتميز بلون ابيض شفاف وملمس لز
ReplyDeleteيمكنكم اللجوء لتنظيف منازل عجمان إذا شركة تنظيف دبي أصبحتم في حاجة إلى تنظيف المنزل شركة تنظيف عجمان في أي وقت تحددوه أنتم , فقط اتصلوا بتنظيف منازل عجمان شركة تنظيف بالشارقة وسوف يرد عليكم فريق متخصص من خدمة العملاء والذي يحدد معكم المطلوب شركة تنظيف ابو ظبي والوقت المحدد لإتمام تلك المهمة الضرورية وفي أسرع وقت ممكن سوف تجدونها انتهت شركة تنظيف كنب بدبي , فقط انسوا هم الأسعار التي تقلق الجميع في حالة الرغبة في التعامل مع أي شركة نظافة
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ReplyDeleteكما يقوم فريق العمل بتنظيف الموكيت حيث أن الموكيت شركة تنظيف بدبي يعتبر من أهم الأشياء التي توجد في المنزل ويتميز بوجود الزخارف المختلفة شركة تنظيف بالعين به، لهذا فإنه يحتاج إلى التنظيف بكل دقة وحرص ويتم هذا من خلال استخدام شركة تنظيف عجمان الماء الفاتر والمنظفات المخصصة للموكيت، أو يتم تنظيفه عن طريق البخار شركة تنظيف كنب بدبي حتى يعطي أفضل النتائج وفي أسرع وقت
ReplyDeleteتعتبر طريقة التنظيف بالبخار من أفضل شركة تنظيف بدبي وأحدث الطرق التي تستخدم في عمليات التنظيف شركة تنظيف كنب بدبي للوصول إلى أفضل النتائج، وتقوم شركة تنظيف بالبخار في دبي شركة تنظيف بالشارقة في استخدامه في العديد من عمليات التنظيف؛ لهذا فإن جميع الأعمال شركة تنظيف ابو ظبي التي تقوم بها الشركة شركة تنظيف بعجمان تكون على درجة شركة تنظيف بدبي عالية من الكفاءة شركة تنظيف بالشارقة
إذا كنت ترغب في الحصول على مياه نقية افضل شركة كشف تسربات بالقصيم و خالية من الجراثيم و الميكروبات فلابد ان تقوم بتوفير افضل شركة عزل خزانات بالقصيم أجود خامات العزل على الخزان و التي يتم تركيبها في الجدرا و في قاع الخزان و ذلك من اجل المحافظة افضل شركة اسطح خزانات بالقصيم على منع تعرض أشعة الشمس بشكل مباشر على المياه و تسلطها بشكل افضل شركة مكافحة حشرات بالقصيم دائم مما يؤدي إلى التغيير في الخواص الفيزيائية في مكونات المياه
ReplyDeleteلدى الصراصير جهاز استشعار شركة تنظيف بالبخار بجدة حساس جدًا موجود في قرونها مع العلم أنها شركة مكافحة حشرات بجدة لا عين لها ولا تستطيع الرؤية لكنها إن دخلت شركة تنظيف خزانات بجدة في منزل فإنها سرعان ما تهاجمه وبالتالي يصعب السيطرة شركة تنظيف شقق بجدة عليها حيث أنها تتكاثر بسرعة وبأعداد كبيرة فإذا كان منزلك به صراصير شركة مكافحة البق بجدة فمن الأفضل الاتصال بشركة متخصصة للقضاء عليها في الحال.
ReplyDeleteفي البداية نحرص عبلي شركة تنظيف بالبخار بجدة ان يتم تفريغ الخزان من المياه شركة تنظيف خزانات بجدة و من بعدها نقوم بتوفير النظافة الدقيقة شركة مكافحة العتة بجدة لجميع اجزاءه الداخلية و الخارجية و من شركة مكافحة حشرات بجدة بعدها نحرص علي ان يتم اتباع افضل مواد العزل الامنة و التي شركة مكافحة النمل الابيض بجدة لا يمكن ان تلحث اي نوع من الضرر بالانسان و لهذا تواصل معنا عزيزي العميل لتجد خدمة تنظيف للخزان الخاص بالمنزل
ReplyDeleteمن الممكن أن يحصل العملاء شركة تجهيز ملاعب على أفضل أنواع النجيل الصناعي التي يرغبون شركة نجيل صناعي بها و التي تتنوع بين أكثر من شكل مختلف حيث يوجد النجيل المتداخل ، النحيف و العريض شركة تنسيق حدائق أيضا و جميع تلك الأنواع متوفرة في شركة لاندسكيب بالقاهرة من أجل أن تحقق إليكم الخدمات التي ترغبون شركة تجهيزات حمامات سباحة في الحصول عليها و ذلك لأننا متميزون في مجال تركيب النجيل الصناعي و نحاول أن نلبي جميع احتياجات عملائنا
ReplyDeleteهناك طريقتين يتم استخدامهم من أجل تنظيف تسليك مجاري الكويت مواسير الصرف الصحي و هما الطريقة اليدوية و الطريقة تسليك مجاري بالكويت الحديثة و الطريقة الاولى يتم اتباعها إذا كانت المواسير تسليك مجاري الكبيرة و التمديدات تعاني من انسدادها من خلال الأشجار بها و في تلك الحالة يتم التدخل من قبل متخصصين يقوموا بقطع تلك الأشجار و تحويلها إلى قطع صغيرة من أجل أن شركة تنظيف بالكويت يتم تنظيفها بالكامل
ReplyDeleteتعتبر الواجهات شركة تنظيف بدبي من أهم الأماكن التي يجب تنظيفها على أكمل وجه، حيث أن نظافة شركة تنظيف بالشارقة الواجهات هي دليل على نظافة المنزل؛ لهذا شركة تنظيف بدبي يجب الاهتمام بها بشكل كبير وذلك من خلال شركة تنظيف فى دبي التواصل مع شركة تنظيف واجهات منازل في الشارقة شركة تنظيف بعجمان فإن الشركة سوف تتمكن من القيام بهذه المهمة مع اختلاف أنواع المنظفات
ReplyDeleteعندما يكون هناك ارتباط بين عملية التنظيف شركة تنظيف شقق بمكة وانتشار الأمراض والجراثيم شركة مكافحة حشرات بمكة يجب ان يتم التخلص من جميع الأتربة والأوساخ في المكان مثل الشقة او الفيلا او المنزل الذي نعيش بداخله شركة مكافحة حشرات بالطائف حتى يتم حماية أطفالنا من خطر الإصابة بالأمراض وتوفر شركة تنظيف منازل بمكة جميع خدمات شركة تنظيف خزانات بالطائف التنظيف سواء التنظيف العادي او خدمات غسيل شقق بمكة او غسيل منازل بمكة شركة تنظيف خزانات بمكة ومن أهم ما يتم القيام به لخروج الخدمة بصورة مشرفة أمام العملاء
ReplyDeleteنحن متخصصون في مجال التنظيف بالبخار لثقتنا شركة تنظيف بالبخار بجدة الدائمة في أن النظافة وحدها لا تكفى ويجب أن نوفر التعقيم شركة تنظيف بالبخار بمكة والتطهير معها لضمان مكان نظيف وصحي شركة تنظيف بجدة خالي تماماً من البكتريا والجراثيم خاصة شركة نقل عفش بمكة في وجود الأطفال فالبخار تقنية شديدة التأثير في قتل البكتريا والجراثيم لذلك نحرص على استخدامه ونوفر شركة تنظيف سجاد بالبخار بجدة أحدث التقنيات التي تعمل بالبخار لتقديم خدمات على مستوى عالي من الدقة والإتقان وتقوم
ReplyDeleteوقد اثبتت الدراسة والابحاث ان تلوث مياه الخزان شركة نقل عفش بجدة نتيجة المواد المصنوع منها الخزان ويعتبرافضل انواع الخزانات المصنوعة شركة تنظيف بالبخار بجدة من الحديد المجلفن او المصنوع من الزجاج وهم واقل عرضه للتلوث واغلاقه بطريقة جيدة فحرصا منا نحن شركة غسيل خزانات بالطائف شركة مكافحة حشرات بمكة على صحتنا وصحة اطفالنا يجب شركة تنظيف خزانات بالطائف تنظيف خزان المياه بصفة دورية حتى نتفادى جميع الامراض شركة تنظيف كنب بدبي ونقي اولادنا وانفسنا منها ونستخدم الخزان المصنوع من الصلب الغير قابل للصدا والمصرح به من وزارة الصحة.
ReplyDeleteعملية النظافة يجب ان تكون سلوك لدي المتواجدين شركة تنظيف بمكة في المكان فلا يمكن ان يتم إجبار فرد على التنظيف شركة مكافحة حشرات بمكة والعيش في مكان خالي من الأتربة اذا لم يكن لدية ذلم السلوك الحضاري الراقي شركة تنظيف بالبخار بمكة وعليه يجب على الأفراد دائما مساعدة شركة نقل عفش بمكة افراد العائلة أثناء عميلة التنظيف وزرع ورح شركة تنظيف خزانات بمكة النظافة داخل أبنائنا وأسرنا وعندما تتعرض إلى الاوساخ الصعبة فان في الجوار
ReplyDeleteيمكنك التواصل مع شركة تنظيف بدبي في أي وقت من أجل أن يقوم فريق العمال شركة تنظيف بالشارقة و الخبراء بالحضور إلى المنزل في الميعاد الذي تقوم شركة تنظيف بعجمان بتحديده حيث أن الفريق معروف بمدى التزامه بالمواعيد و الاتقان شركة تنظيف بابو ظبي في العمل فنحن نرغب في توفير الخدمة المثالية التي تمكنا من الحصول شركة تنظيف كنب بدبي على ثقة العميل الكبيرة بنا فنحن نجتهد لكي نستحق تلك الثقة بشكل مستمر
ReplyDeleteيعمل فريق الخبراء على تقديم التصاميم واجهات حجر هاشمى هيصم المختلفة الخاصة بالمطابخ أو الحمامات شركة تنظيف بدبي و يمكنك الاختيار فيما بينها و هذا من خلال حجر مايكا شركة تسليك مجاري بالكويت الذي يعمل على توفير الدعم و القوة على الغرف الموجودة في المنزل و تتعامل الشركة رقم صباغ رخيص بالكويت معكم بأقل الاسعار و التكاليف التي فني كهرباء منازل بالكويت لا مثيل لها في أي مكان آخر
ReplyDeleteمن خلال اختيار المجموعة ، يتم التعرف على أعمالنا من خلال الأخلاق العالية والساهرة لإعطاء الصنعة والدقة في إكمال الإدارة التي يقدمونها فى مجال تنظيف المنازل نحن نستخدم أحدث الأجهزة التي تؤثر على التنظيف لمعالجة بسيطة وأساسية. نحن نستخدم منظفات من الدرجة الأولى لإعطاء لمعان ولمعان للأثاث ليعود إلى ما كنت فيه
ReplyDeleteشركة تنظيف
تنظيف منازل
تنظيف كنب
تنظيف بيوت
تنظيف مطابخ
شرکة تنظیف منازل
The clinic of Dr. Niren Rao has become a specialized hub of prostate cancer treatment in Delhi. Robotic techniques and specialized treatments result in timely and efficient recovery of the patient. Firstly, a personalized consultation is provided and then the right treatment is prescribed to the patients. It is much more than selling clinical services for personal gains. Give a call today on 9811144680 and book a hassle-free appointment as per your need.
ReplyDeleteشركة تنظيف بالمدينة المنورة
ReplyDeleteشركة تنظيف خزانات بالمدينة المنورة
شركة عزل بالمدينة المنورة
شركة عزل اسطح بالمدينة المنورة
شركة عزل خزانات بالمدينة المنورة
شركة كشف تسربات المياه بالمدينة المنورة
شركة تسليك مجاري بالمدينة المنورة
شركة تمديد غاز مركزي بجدة
شركة تمديد غاز مركزي بجدة
I was diagnosed with stage 3 breast cancer in August of 2010. A precious friend told me about Dr Itua Herbal Center in West Africa,She gave me his contact number and email address,I contacted him quickly so he give me guaranty that his herbal medicine will cure my cancer and i will be heal forever I said Okay.I ask him about the process for the cure,he ask me to pay for the fees which i did and within 7 working days he sent me the herbal medicine then he instructed me on how to drink it for two weeks to cure.I told Gomez my friend about the herbal medicine so he gave me go ahead to drink it.So after drinking it for two weeks i was cured I'm so grateful and i promise i will recommend anyone with cancer to him and that what i'm doing.Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's disease,Schizophrenia,Cancer,Scoliosis,Bladder Cancer,Colorectal Cancer,Breast Cancer,Kidney Cancer,Leukemia,Lung Cancer,Skin Cancer,Uterine Cancer,Prostate Cancer,Fibromyalgia,a
ReplyDeleteSyndrome Fibrodysplasia ,Epilepsy Dupuytren's disease, Diabetes ,Coeliac disease, Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Sclerosis,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpes,Inflammatory bowel disease ,Copd,Diabetes.
Here Is His Contact Info......[Email...drituaherbalcenter@gmail.com/Whatsapp...+2348149277967]
If you have Herpes in your whole body such as fever blisters, hsv, or roofing shingles you know what it is like to stay with the pain and discomfort that herpes delivers. I don't need to tell you how awesome it would be to find something that works so well that you no longer need to fear about stress or outbreak,Dr Itua herbal medicine cure my herpes in two weeks of taking it.is genuine and natural herbal medicine it has no side effect, The reason I'm writing this is that I promised Dr Itua I will share his herbal work to the world to see Herpes is no more a big deal.also Dr Itua can as well cure the following diseases...HIV,Hsv 1/2,Hepatitis B,Cancer, Diabetes, Men/Woman Infertility, Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
ReplyDeleteSyndrome Fibrodysplasia Ossificans Progressiva.Fatal Familial Insomnia Facator V Leiden Mutation , Lottery Spell,Copd, Shingles,Fibroid, Fibromyalgia, Liver/Kidney Inflamotry, Epilepsy, Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Sclerosis,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic Asthma. Here His Contact...drituaherbalcenter@gmail.com/Whatsapp Phone.+2348149277976. I paid for his herbal medicine and sent it to me through Courier Service which I pick it urgently and used.
HOW DR PERFECT ENLARGEMENT CREAM HELP ME TO ENLARGE MY PENIS YOU CAN ADD HIM UP ON WHATSAPP +1(256) 251 3614
ReplyDeleteMy name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. you can also view my blog http://davidrichardson12356.over-blog.com. He also specializes in the following things
Herpes virus
Cancer
Hsv
Chronic venous disease
and others
HOW DR AZIBA HELPED ME ENLARGE MY PENIS SIZE FROM 3.5 INCHES TO 11INCHES LONG AND 8.0 GROWTH
ReplyDeleteI got married 2 years ago and it just seemed that there was no excitement in my sex life. My dysfunction to perform to the best of my abilities in bed made it harder for my wife and me to have a good time during sex. And i was having the feelings that she may decide to get a divorce one day. I knew something had to be done in order to improve my sex life and to save my marriage because my marriage was already falling apart, so when i was on my Facebook page i came across a story of how Dr Aziba helped him enlarged his penis to 8ins better.so i Immediately copied the Email address of the Dr and explained to him my problem,he gave me some simply instruction which i must follow and i did easily and my friends Today, i am the happiest man on Earth, All Thanks to Dr Aziba for saving my marriage and making me a real man today.i asked him about some popular diseases like HERPES,HIV AIDS,HEPATITIS, DIABETICS, CANCERS, WART, Get Ex back ,etc....... which are affecting most people he said there is no disease without a cure , he has it all...You can as well reach the Dr below for help on your problem, for he has the solution to all...
Email:[ PRIESTAZIBASOLUTIONCENTER@GMAIL COM ]
WhatsAPP DR [ +2348100368288 ]
HOW DR AZIBA HELPED ME ENLARGE MY PENIS SIZE FROM 3.5 INCHES TO 11INCHES LONG AND 8.0 GROWTH
I got married 2 years ago and it just seemed that there was no excitement in my sex life. My dysfunction to perform to the best of my abilities in bed made it harder for my wife and me to have a good time during sex. And i was having the feelings that she may decide to get a divorce one day. I knew something had to be done in order to improve my sex life and to save my marriage because my marriage was already falling apart, so when i was on my Facebook page i came across a story of how Dr Aziba helped him enlarged his penis to 8ins better.so i Immediately copied the Email address of the Dr and explained to him my problem,he gave me some simply instruction which i must follow and i did easily and my friends Today, i am the happiest man on Earth, All Thanks to Dr Aziba for saving my marriage and making me a real man today.i asked him about some popular diseases like HERPES,HIV AIDS,HEPATITIS, DIABETICS, CANCERS, WART, Get Ex back ,etc....... which are affecting most people he said there is no disease without a cure , he has it all...You can as well reach the Dr below for help on your problem, for he has the solution to all...
Email:[ PRIESTAZIBASOLUTIONCENTER@GMAIL COM ]
WhatsAPP DR [ +2348100368288 ]
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ReplyDeleteUnfortunately there are a lot of AIDS/Herpes denials on Herbal cures still out there. I did research on them after I was tested HIV/Herpes positive I was so worried am I going to die soon. I continue my search again on herbal remedy for Std, then I found lots of testimony on how Dr Itua Herbal Medicine Cured HIV/Aids, Herpes Virus,Copd, Hepatitis, Diabetes, On websites sharing their testimonies, which made much more sense to me. All the authors pronounce Dr Itua As a man with Good Heart, I pick interest in their testimonies and I contact him about my situation then he gave me procedure how it works, I proceed after one week he courier his Herbal Medicine to me and instruct me on how to drink it for two weeks to cure. I receive His Herbal Medicine so I drank it for two weeks as I was told then after 2 days I go for a test I found out I was cured from HIV/Aids & Herpes Virus, I pay homage to him 2 months ago to his country to celebrate with him on his African festival which he told me it usually happens every year. I know there are lots of (HIV)/Aids&Herpes Virus denials of Herbal Remedy movement the same few doctors and they represent a very small faction of the community. I could have died because I refused Natural Herbs Cures for so long, but luckily, by the grace of God I am alive to tell my story. Contact Info...Whatsapp Number...+2348149277967,Email...drituaherbalcenter@gmail.com/My Instagram Username...avat5634 Just in case you need someone to talk with. He cure tthe following diseases below...1. Herpes 2. cancer 3. HIV / AIDS 4. hepatitis 5. Bring my ex back 6. Leprosy 7. SARS 8. Bubonic plague
ReplyDelete9. Cerebrovascular disease 10. Lower respiratory infections 11. Syphilis 12. Influenza A-H1N1 (swine flu) 13.Ischemic heart disease 14. Chronic obstructive pulmonary disease 15. Whooping cough 16. Perinatal complications 17. diarrhea 18 .. lung cancer.
Irrespective of receiving daily oral or future injectable depot therapies, these require health care visits for medication and monitoring of safety and response. If patients are treated early enough, before a lot of immune system damage has occurred, life expectancy is close to normal, as long as they remain on successful treatment. However, when patients stop therapy, virus rebounds to high levels in most patients, sometimes associated with severe illness because i have gone through this and even an increased risk of death. The aim of “cure”is ongoing but i still do believe my government made millions of ARV drugs instead of finding a cure. for ongoing therapy and monitoring. ARV alone cannot cure HIV as among the cells that are infected are very long-living CD4 memory cells and possibly other cells that act as long-term reservoirs. HIV can hide in these cells without being detected by the body’s immune system. Therefore even when ART completely blocks subsequent rounds of infection of cells, reservoirs that have been infected before therapy initiation persist and from these reservoirs HIV rebounds if therapy is stopped. “Cure” could either mean an eradication cure, which means to completely rid the body of reservoir virus or a functional HIV cure, where HIV may remain in reservoir cells but rebound to high levels is prevented after therapy interruption.Dr Itua Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's disease,Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
ReplyDeleteSyndrome Fibrodysplasia Ossificans Progressiva.Fatal Familial Insomnia Factor V Leiden Mutation ,Epilepsy Dupuytren's disease,Desmoplastic small-round-cell tumor Diabetes ,Coeliac disease,Creutzfeldt–Jakob disease,Cerebral Amyloid Angiopathy, Ataxia,Arthritis,Amyotrophic Lateral Sclerosis,Alzheimer's disease,Adrenocortical carcinoma.Asthma,Allergic diseases.Hiv_ Aids,Herpe ,Copd,Diabetes,Hepatitis,I read about him online how he cure Tasha and Tara so i contacted him on drituaherbalcenter@gmail.com even talked on whatsapps +2348149277967 believe me it was easy i drank his herbal medicine for two weeks and i was cured just like that isn't Dr Itua a wonder man? Yes he is! I thank him so much so i will advise if you are suffering from one of those diseases Pls do contact him he's a nice man.
I am 29 years old and I was diagnosis of Breast cancer, easy well and have a similar story except my first acceptance as a Herbal medicine denials. I wasn’t into the movement Perseid and didn’t establish connections with any of them really, just had faith in believing how they work. I say this because it was during using Dr Itua herbal medicine i now then testify herbal medicine is real, Dr Itua herbal medicine cure my breast cancer I was suffering from for 2 years. Dr Itua herbal medicine is made of natural herbs which has no side effect and is easy to drink as well. Contact Dr Itua herbal Center if you are suffering from the same Breast Cancer or any kind of human Diseases including....HIV/AIDS, HERPES COLORECTAL CANCER, BLADDER CANCER, PROSTATE CANCER, KIDNEY CANCER, LUNG CANCER, SKIN CANCER, UTERINE CANCER, LEUKEMIA, VIRUS, HEPATITIS, WOMEN/MEN INFERTILITY, LOVE SPELL,LOTTERY SPELL. HIS CONTACT EMAIL/WHATSAPP: drituaherbalcenter@gmail.com/+2348149277967
ReplyDeleteNội dung bài viết thật tuyệt vời. Mình cũng muốn giới thiệu về một Công ty dịch thuật uy tín - Công ty dịch thuật miền trung - MIDtrans trụ sở chính chính tại địa chỉ 02 Hoàng Diệu, TP Đồng Hới, tỉnh Quảng Bình có Giấy phép kinh doanh số 3101023866 cấp ngày 9/12/2016 là đơn vị chuyên cung cấp dịch vụ dịch thuật, phiên dịch dành các cá nhân. Hệ thống thương hiệu và các Công ty dịch thuật con trực thuộc: dịch thuật bình dương - dịch thuật miền trung tại địa 123 Lê Trọng Tấn, Dĩ An, Bình Dương là địa chỉ chuyên cung cấp dịch vụ dịch thuật chuyên nghiệp tại Bình Dương và các khu vực lân cận ; dịch thuật chuyên ngành tại sài gòn địa chỉ 47 Điện Biên Phủ, Phường Đakao, Quận 1 TP HCM, dịch thuật công chứng kon tum : địa 101 Trần Hưng Đạo, TP Kon Tum là nhà cung ứng dịch vụ dịch thuật uy tín hàng đầu tại Kon Tum; Công ty dịch thuật Viettrans và dịc vụ binh duong translation: dịch vụ dịch thuật tại Bình Dương cho người nước ngoài có nhu cầu, giao diện tiếng Anh dễ sử dụng; dịch thuật tiếng Ý (italia) tại sài gòn: nhà cung ứng dịch vụ dịch vụ dịch thuật phiên dịch hàng đầu tại TP Hồ Chí Minh; dịch thuật tiếng Anh tại Đà Nẵng : Địa chỉ 54 Đinh Tiên Hoàng, Quận Hải Châu, TP Đà Nẵng chuyên cung cấp dịch vụ dịch thuật công chứng, dịch thuật đa ngôn ngữ, đa chuyên ngành tại Đà Nẵng; Viettrans 43 Điện Biên Phủ, Quận 1 Sài Gòn: chuyên cung cấp dịch vụ dịch thuật đa chuyên ngành toàn quốc; Công ty dịch thuật Hà Nội MIDtrans chuyên cung cấp dịch vụ dịch thuật tại an giang : địa chỉ 55 Lê Thánh Tông, TP Long Xuyên là nhà cung ứng dịch vụ biên dịch, phiên dịch chuyên nghiệp tại địa bàn An Giang. Ngoài ra, Chúng tôi cũng cung cấp các dịch vụ biên dịch và phiên dịch, dịch thuật công chứng chất lượng cao hơn 50 ngôn ngữ khác nhau như tiếng Anh, Nhật, Hàn, Trung, Pháp, Đức, Nga, .vv... Dịch thuật MIDtrans tự hào với đội ngũ lãnh đạo với niềm đam mê, khát khao vươn tầm cao trong lĩnh vực dịch thuật, đội ngũ nhân sự cống hiến và luôn sẵn sàng cháy hết mình. Chúng tôi phục vụ từ sự tậm tâm và cố gắng từ trái tim những người dịch giả.Tự hào là công ty cung cấp dịch thuật chuyên ngành hàng đầu với các đối tác lớn tại Việt nam trong các chuyên ngành hẹp như: Viettravel - vietnamese tourist information and travel tips tại 46 Trần Cao Vân, TP Huế chuyên trang về thông tin du lịch và các tour đặc sắc tại Việt Nam, y dược (bao gồm bệnh lý), xây dựng (kiến trúc), hóa chất, thủy nhiệt điện, ngân hàng, tài chính, kế toán. Các dự án đã triển khai của Công ty dịch thuật chuyên nghiệp MIDtrans đều được Khách hàng đánh giá cao và đạt được sự tín nhiệm về chất lượng biên phiên dịch. Đó là kết quả của một hệ thống quản lý chất lượng dịch thuật chuyên nghiệp, những tâm huyết và kinh nghiệm biên phiên dịch nhiều năm của đội ngũ dịch giả của chúng tôi. Hotline: 0947688883. email: info@dichthuatmientrung.com.vn . Các bạn ghé thăm site ủng hộ nhé.
ReplyDeleteمن الخدمات المتميزة التي تقدمها الشركة شركه تنظيف بالبخار بجده هو تنظيف بالبخار فى جدة و التخلص من جميع البقع الموجودة شركه مكافحه البق بجده بها من أجل أن تصير نظيفة شركة مكافحه العته بجده تماما و خالية من أي قاذورات بها قد تكون السبب في التقليل شركة نقل عفش بالقاهره من مستوى نظافتها و هذا لان الشركة فني كهربائي في الكويت تعتمد على أحدث أجهزة و آليات البخار موشن جرافيك و التي تقوم بالتخلص من كافة البقع مهما كانت و يمكنك الاستعانة شركة تنظيف بدبي بخدمات شركتنا فني تركيب ستائر في الكويت افضل شركات التنظيف بالبخار بجدة في أي وقت فنحن نعمل على مدار 24 ساعة من أجل أن نتلقى جميع استفسارات العملاء و الشكاوي الخاصة بهم شركة تنظيف كنب بالبخار بجدة حتى نتأكد من حصولهم على أفضل مستوى من النظافة شركة تنظيف سجاد بالبخار بجدة الذي يحلمون به
ReplyDeleteعملية نقل الاثاث شركه نقل اثاث من الرياض الي الاردن دائمة ومستمرة ما بين الحين والاخر نجار فك و تركيب بالرياض حيث يقوم الناس بالتنقل دائما شركه تنظيف موكيت ومجالس بالرياض من مكان الي اخر ويقومون بنقل العفش وقد يستعين بعض الناس بأشخاص غير متخصصين شركه تركيب ستائر بالرياض في عملية نقل العفش فيقومون بنقل العفش بطريقة عشوائية وغير منضبطة فتؤدي الي وقوع خسائر بالعفش من خدوش وكسور .
ReplyDeleteأعزاءنا العملاء يمكنكم الاستعانة بأفضل شركه تركيب اثاث ايكيا بالرياض فهي توفر جميع الادوات والآلات والمعدات الحديثة فني سيراميك بالكويت التي تستخدم في نقل العفش وتوصيلة الي المنازل مع اقوي فريق عمل متميز وماهر .
تقدم افضل شركات نقل العفش بمكة جميع الادوات والمعدات الحديثة التي تستخدم في فك وتركيب وتغليف وتحميل وتوصيل العفش شركه نقل عفش بالكويت من مكان الي اخر حيث توفر مفكات حديثة صباغ الكويت وروافع نقل العفش وشاحنات وعربات نقل وسيارات مجهزه شركة تنظيف مكيفات بالرياض ومخصصة لنقل العفش
الاهتمام بتنظيف المفروشات شركة نقل عفش بينبع جزء لا يتجزأ من نظافة المنزل و الاهتمام بكل التفاصيل الموجودة به شركة تنظيف خزانات بينبع و من خلال شركة تنظيف بالبخار بجدة بالبخار بجدة يمكنك الحصول على أفضل الأساليب شركة تنظيف بالبخار بجده التي تساعد على إزالة جميع البقع و القاذورات التي قد تكون موجودة في جميع أنواع المفروشات شركة تنظيف دكت مكيفات بجدة من الكنب ، السجاد ، الموكيت و الستائر و جميع المفروشات الموجودة في المنزل و من خلال التواصل مع شركتنا شركة تنظيف مساجد بجده كن واثقا أنه يمكنك الحصول على أحدث الأجهزة شركة تنظيف مداخن مطاعم بجده التي تعمل عن طريق البخار و التي تقوم بإزالة كافة الشوائب شركة تنظيف خزانات بجده التي تكون موجودة على قطع الأثاث على سبيل المثال شركة عزل خزانات بجده و هذا لأن الشركة تعتمد على فريق من الخبراء فني المنيوم الكويت و العمال الذين يمتلكون المهارة في التعامل مع ماكينات البخار لإزالة أصعب البقع
ReplyDeleteHOW DR PERFECT ENLARGEMENT CREAM HELP ME TO ENLARGE MY PENIS YOU CAN ADD HIM UP ON WHATSAPP +1(256) 251 3614
ReplyDeleteMy name is David Richardson from USA I want to share a testimony of how Dr Perfect herbal mixture cream saved me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing and I was also having weak erection problem. I can't make love to my wife and my penis was just too small, a full grown man like me having 3 inches penis and to worsen it I don't last long in sex I can't even last four minutes it was really a big shame to me. My wife was really tired of me because my sex life was very poor, she never enjoyed sex, I was always thinking and searching for solutions everywhere until when I saw a testimony of how Dr Perfect herbal mixture cream have been helping people regarding their sex life, so I decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 10 inches I couldn't believe my eyes and as I speak now my penis is now 10 inches long and I don't have weak erection anymore. I can make love to my wife longer in bed. And my marriage is now stable my wife is now enjoy me very well in bed. All thanks to Dr Perfect for enlarging my penis he indeed save my marriage. You can contact him at solutiontoallproblems1@gmail.com or you can add him up on WhatsApp +1(256) 251 3614. you can also view my blog http://davidrichardson12356.over-blog.com. He also specializes in the following things
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HOW I GOT MY EX HUSBAND BACK WITH THE HELP OF REAL AND EFFECTIVE SPELL FROM DR Osasu My name is Olivia Jayden, I never thought I will smile again, My husband left me with two kids for one year, All effort to bring him back failed I thought I'm not going to see him again not until I met a lady called Jesse who told me about a spell caster called Dr. Osasu , She gave me his email address and mobile number and I contacted him and he assured me that within 48hours my husband will come back to me, In less than 48hours my husband came back started begging for forgiveness saying it is the devils work, so I'm still surprise till now about this miracle,i couldn't conceive but as soon as the spell was cast,i became pregnant and gave birth to my third child,if you need any assistance from him you can contact him via:email: drosasu25@gmail.com Or WhatsApp or call him now:
ReplyDeleteWebsite http://Drosasu.com.ng +2347064365391 . Dr.Osasu also cures: 1. HIV / AIDS 2. HERPES 1/2 3. CANCER 4. ALS (Lou Gehrig’s disease) 5. Hepatitis B
HOW I GOT MY EX HUSBAND BACK WITH THE HELP OF REAL AND EFFECTIVE SPELL FROM DR Osasu My name is Olivia Jayden, I never thought I will smile again, My husband left me with two kids for one year, All effort to bring him back failed I thought I'm not going to see him again not until I met a lady called Jesse who told me about a spell caster called Dr. Osasu , She gave me his email address and mobile number and I contacted him and he assured me that within 48hours my husband will come back to me, In less than 48hours my husband came back started begging for forgiveness saying it is the devils work, so I'm still surprise till now about this miracle,i couldn't conceive but as soon as the spell was cast,i became pregnant and gave birth to my third child,if you need any assistance from him you can contact him via:email: drosasu25@gmail.com Or WhatsApp or call him now:
ReplyDeleteWebsite http://Drosasu.com.ng +2347064365391 . Dr.Osasu also cures: 1. HIV / AIDS 2. HERPES 1/2 3. CANCER 4. ALS (Lou Gehrig’s disease) 5. Hepatitis B
Get rid of Cold Sores, unexpected Outbreak and Herpes Virus? then you don't have to keep waiting for treatment when the is a herbal medicine that cure this virus. I was searching online for Herbal Cure for Herpes Virus when I saw a testimony online about Dr. Akintunde and how he cured a lady of HSV1 with his.
ReplyDeletenatural herbal medicine and tested Negative and in less than a month she was cured of this virus. So it took me time to believe that this was true, because my family Doctor tried all his best to get rid of this virus in my body system but yet no cure and I suffered from outbreak and Cold Sores always. I had to contact Dr. Akintunde after I have access his website and i had faith in God that I was going to be fine and free of this virus one day. Finally I contacted Dr. Akintunde on his WhatsApp number that I saw on the testimony post online, and after our conversation the Doctor only promise me that I was going to be cured and free of this virus after taking his natural herbal medicine because I was tired of my situation with this virus it was so distracting to my life and whole family. Later Dr. Akintunde send some Herbal medicine to me through UPS courier service, with instructions on how to used this medicine, to my biggest surprise first week of taking my herbal medication I saw great improvement and I still think that it's a dream but this is real, I now test Negative of this virus today and my blood pressure well regulated now, my family doctor after my test was extremely surprise to see my test result change to HSV1 Negative and no more symptoms, cold sores, sores throat and outbreak again. I wish to tell everyone about this, mostly if you have this virus then do yourself good to contact Dr. Akintunde and see what the Lord can do through this Herbal Doctor's medicine in less than a month. 100% free from herpes Virus. I and my family say "thank you" Sir, for helping my life. You are a blessing to this generation and God will reward you richly
Email: drakintundehomecare@gmail.com
WhatsApp number: +234 703 524 5593
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