What Is A Barium Enema Health And Social Care Essay

Lower GI series, besides known as Ba clyster, Ba clyster process has two of them are x-ray or barium enema double-contrast Ba clyster. It is an x-ray trial in which a white liquid, called Ba, is inserted through a catheter ( tubing ) and the tubing will be inserted through the anus into the rectum and to run into the big bowel ( colon ) . X-ray movies taken of the colon and big bowel so that line can be seen. Barium enama Double-Contras and Ba are used to find normalcy and abnormalcy of colon and rectal anatomy.

i?? divertikulosis



colon abscessi??

unnatural intestine movementsi??

i?? enteric expansion

Hirschsprung disease ini?? babies


What are the hazards of the Ba clyster?

Rectal dilatation was non comfy, but merely a few patients felt really painful. Each X-ray scrutiny, the process involves some hazard of radiation. Radiation exposure is minimized by criterion techniques have been developed and approved by national and international commissions and board of radiology. All radiological engineering approved by the national enfranchisement board.

Womans who are or may be pregnant should state the doctor and radiology staff who conduct reviews because there is possible hazard of injury to the foetus to radiation exposure. Complications of Ba clyster scrutinies are rare. The tip of the catheter clyster or enteric dilatation may perforate the enteric wall and do a localised infection ( abscess ) or peritoneal inflammation ( an infection common in the abdominal pit ) . This normally occurs merely when inordinate force per unit area is used to attach the Ba in the bowels of ill or had a weak colon.

Preparation of the patient

Each internal and external stuffs that make the image less clear X ray may interfere with the truth of Ba clyster. Therefore, before undergoing Ba clyster ( lower GI ) , it is of import to take every bit much soil as possible from the colon and rectum, as required. Before the scrutiny, the patient will be asked to eat a clear liquid diet and clean clyster is frequently used to empty the intestine. Sometimes a medicine may be necessary to evacuate the bowel. External stuffs, such as excess vesture, metal devices, or jewellery removed before the scrutiny.

Ba clyster would be insertedi?? into the colon and rectum with a white liquid ( Ba ) through a catheter through the anus. It is usually performed, the patient will experience a comprehensiveness or mild uncomfortableness in the tummy and

Next, an x-ray machine isi?? placed in forepart of a patient with x-ray movie behind.

Photograph of the bowel wasi?? obtained by exposing radiation to the venters. Density Ba contrast between the colon and run into other constructions of the tummy is a clear x-ray movie and gives the line the colon are really good.

The radiotherapist will usei?? fluoroscopy, an x-ray device in which Ba can be seen in the motion that flows into the big bowel.

inactive image obtained fromi?? the enteric X ray movie or digital computerized images.

Barium can so be drained soi?? that merely a little figure of Ba remained attached to the intestine liner, and air into the colon.

X ray was taken to give morei?? inside informations about the beds of the intestine Ba X ray of the colon meet. This process is called a double-contrast Ba clyster for both air and Ba are used to supply images. Polyps and little malignant neoplastic diseases more easy found utilizing this technique ( called Air-contrast Ba clyster ) .

Barium clyster may take any ofi?? the 15 proceedingss to an hr depending on the jobs being faced and the patient ‘s specific anatomy of the colon.

How can patients obtain the consequences of Ba clyster

After the movies of x-ray procedure is completed, it will be sent to the radiotherapist, who interprets the organic structure construction visualized in the x-ray movie. The reading and coverage of Ba clyster continued to physicians who request proving are normally in one or two yearss. The physician can so reexamine the consequences with patient studies. The movie is really from the scrutiny can besides be sent to a wellness attention practician if necessary.


Barium clyster is an x-rayi?? process that is used to demo the anatomy of the big bowel ( colon ) and rectum ( anus ) to more clearly.

Barium enema run into the colon andi?? rectum with a white liquid stuff ( Ba ) , followed by air ( double-contrast Ba clyster ) .

Barium clyster include the riski?? of uncomfortableness during the radiation exposure, and perforation of the colon.

Womans who are or may bei?? pregnant should inform the doctor and radiology staff who carry out the process because the hazard of radiation exposure on the foetus.

Barium repast

What is Barium repast?

Barium is a calcareous white liquid that is given to the patient as a drink to see the gorge, tummy and duodenum. In order to obtain 3-dimensional position of the tummy and duodenum, the patient will be asked to get down a few grains of sodium carbonate or pulverization, which will supply some air current. It will be necessary for the patient to travel in the x-ray tabular array is difficult plenty in order for the Ba to surface the tummy and duodenum. Your place will be adjusted while the Radiological position Television proctor. Every clip a image is taken, the patient

will be asked to keep their breath. During this process, the patient may be given a shooting in the arm. This injection helps to loosen up the tummy, but may do the patient positions a spot obscure and ill-defined in 30 proceedingss.

These injections can impact the figure of patients with glaucoma. If patients enduring from glaucoma. Please inform the radiotherapist before the scrutiny.

How long does this cheque?

Normally, the clip spent in the x-ray room during the scrutiny is about 15 proceedingss. After 30 proceedingss, the patient may be ready to travel place.

Does it ache?

A You likely will non experience any hurting during the process, but may experience bloated as to hold no tummy for nutrient.

Are there any side effects after the review?

Possibly the intestine will take a twenty-four hours or two before the patient ‘s intestine prior to normal once more. It would be easier if the patient drinks plentifulness of H2O and a normal diet.

Is the patient able to drive?

Yes. However, if the patient is injected, it is proposed that the patient non to drive for approximately 30 proceedingss.

How the determination is given?

Although all the movies taken after prosedur.ianya be reviewed before you leave the section, radiotherapists need to analyze the radiogram carefully before doing analysis. After the radiotherapist will do a statement, it will be written and sent to the office of the X ray in a hebdomad. CPR should be displayed when having the consequences of x-ray.

What is the process after the patient enrolled in the section X ray?

Patients will be asked to wait a waiting room. Then the patient will be included in the X-ray room and asked to discase. After the patient is given a white frock to have on to cover their organic structure. All the accoutrements and jewellery such as necklaces and watchbands are besides asked to be removed. If the patient can non travel or hard to travel, the main X ray will supply aid and aid to alter apparels

Setelalah ready to run the process, patients will be told to have on the apparels, and be waiting for the consequences of this audit.

Who will see patients during x-ray section?

After geting at the x-ray section, the patient will be met with antagonistic inquiries in progress to register and take a bend for scrutiny. There, patients will see whether radiology, x-ray translators or counter clerk. They will have enquiries from patients before undergoing Ba repast scrutiny. In the x-ray room, radiology and x-ray translators will be a squad to carry on an scrutiny of the patient.

What are the hazards that need to be focused?

By utilizing modern and sophisticated equipment, for each radiation dosage is reduced. The staff who work in this section snetiasa monitored and equipment are besides monitored closely so that in good status Formulation used. In add-on, staff in the section X ray is besides a civilization that is safe and complies with the ordinances. It will besides guarantee the safety of the patient after the security measures taken.

However, if you are pregnant or may go pregnant, delight inform the staff in the radiology section itself or prior to the scrutiny.

Preparation instructions and diet?

fiber-free eating 2 yearss before patients undergo testing. Refrain from eating fresh fruits, salads and so on because they contain fiber. This is because the fibre expands in the tummy and so add the entire volume of the tummy so necessitate more clip and attempt in exchange for cleaning the digestive piece of land.

If the patient ‘s appointment padaa forenoon, the patient will be asked to non eat after 10 autopsy. Patients will be asked to fast for several hours before the scrutiny. Whereas if the patient assignment was at midday, the patient will non be allowed to eat after pkul 8 am. Patients can merely ate merely nutrients low in fibre.

A What patients need to follow this process readying?

Yes. It is really of import to wholly empty the patient ‘s tummy before the patients underwent the scrutiny. If the patient needs to take medicine, take it together after the process. If still in uncertainty, inquire the advice of specializers or physicians and radiotherapists.

Is the patient can eat and imbibe after the review?

Yes. Patients can travel back to eating whatever selpas review.

Is the patient agony from diebeties?

for patients enduring from diebeties, we try to give patients an Jaji in the forenoon. But we normally know about the patient ‘s medical history.


To measure the effectivity of Ba trial in pull offing patients with such a diperaktikkan.

A three to six months after the Ba repast scrutiny.

The requested information on patients ‘

symptoms, current medicine, ground for petition

scrutiny, and diagnostic work, including

degree of certainty and, after scrutiny,

about any alterations in diagnosing, diagnostic assurance,

or direction and to what delermine

review batch to assist or non.

Puting Inner-city wellness territory.

Patients-133 patients with indigestion referred

general practician attention for Ba repast

scrutiny, 31 of whom did non look to

scrutiny, or refused on reaching, or no

to the full completed questionnaires. Two patients

non ready to follow.

Size of cardinal decision-Spread radiologic

upsets and analyzing the consequence tije

As a consequence of direction, peculiarly alteration

in drug therapy.

Results-Fully completed questionnaires braces

available for 100 patients, 58 of them

under the age of 50. Most of the nutrient Ba study ( 64 )

is to corroborate the clinical diagnosing, merely 22 people

to except serious disease. Ninety-nine patients

already having intervention, with 39 download H2

receptor adversary. Fifty-eight Ba repast

scrutiny showed abnormalcies ( 31 major

upset ) , there is no malignant neoplastic disease and merely 18

patient was diagnosed as a occupation alteration

consequences. Although the Ba repast

addition assurance in direction determinations ( 63

patients ) and decreased patients ‘ anxiousness ( 46 ) , exchange

connected straight to the audit direction

occurred in merely 22 patients. Change direction

is little, normally dwelling of the exchange

alkalizers and H2 receptor adversaries.

Conclusions-Young people ( aged under 50 )

with indigestion remains overinvestigated.

Despite the increased diagnostic Ba repast

assurance and allays patients ‘ anxiousness, to the full

utilize communicating accomplishments in the early dialogues

may extinguish the anxiousness is more economical.


Indigestion in the UK spread

remain high. Although most patients do non seek

medical advice, a community study late more

than 2000 patients showed that up to ten were #

confer with their household physician for the symptoms

indigestion for more than six months was the fifth

investigated by Ba repast scrutiny when

in the yesteryear.

Despite the increasing handiness of endoscopy and

usage of H2 receptor adversaries country Ba repast

reviews are still really popular, accounting for more than 17 % of all petitions for general medical ten beam scrutinies

in the infirmary and the 2nd merely in frequence

petitions for chest X-ray scrutiny. Necessity

investigate immature patients with moderate

indigestions have been examined, “ 4 so much now

presume that the empirical intervention of symptoms

with H2 receptor adversaries may be sufficient, go forthing the

merely a little group of non-responder who requires


Many radiology sections work burden

alteration, and increasing resource demands needed

continue to measure the effectivity of diagnostic familiar

trial. Critical rating of the usage of

diagnostic rating of its impact requires

diagnosing, direction, and patient result. Many

surveies merely consider the value of a positive consequence, but

negative consequences may be the same value, the consequence

alteration and the scope of diagnostic possibilities5

public assistance of the value of collateral.

We conducted a prospective survey of the efficaciousness

Ba repasts in general pattern to prove

find the consequence of the trial consequences on the direction

and patient result.

Patients and methods

All patients with indigestion referred for a Ba

nutrient reviews by public physicians in town

and Hackney Health District are eligible for

survey, and 133 back-to-back patients referred by 40

general physicians who are registered. Upon petition

has been accepted for scrutiny

practicians are invited to finish an initial

questionnaire for a upper limit of three hebdomads before

review, giving inside informations of patient symptoms,

history, and major work diagnosing, and their

ain degree of certainty about the diagnosing. They

asked about the nature and continuance of any intervention

and the chief ground for bespeaking the trial:

specifically to corroborate or except the disease, to guarantee

patients, or as a consequence of direct force per unit area from


The 2nd questionnaire, completed by the general

practicians between three and six months after

analyzing inquiries about any alterations in diagnosing,

diagnostic assurance, and direction and how to assist

or the last review. General

Practitioners were non given transcripts of their initial

responses when they complete the 2nd questionnaire.

Consequences of the review study

classified as normal, unnatural, or ambiguous. Abnormal

The consequence is divided into major and minor abnormalcies ;

rated as the chief abnormalcy

may necessitate specific intervention ( for

For illustration, ulcer, reflux esophagitis, and eroding ) or

endoscopic or surgical intercession ( eg,

suspected malignant neoplastic disease, Striktur, etc. ) and minor fluctuations

as incidental findings ( eg, non complicated

visible radiation and little esophageal suspension hernia

motility upsets ) . Trials conducted

all patients with dual contrast technique

modus operandi usage by the registrar of smooth musculus relaxants ( 71 % ) , senior registrars ( 20 % ) , and advisers

( 9 % ) . All reviews performed by the Clerk

reviewed by a adviser or senior registrar before

The study was released.


At the terminal of the survey completed the full 100 braces

questionnaires available for analysis. From

Recruit 133 patients, 10 failed to look for

review, one refused scrutiny on reaching,

21 did non finish the questionnaire in full or non

return, and the two are non ready to follow. It

the concluding survey group consisted of 57 work forces and 43 adult females,

58 % of them are under the age of 50 and 24 below 30.

The bulk ( 64 ) of the 100 referrals for Ba repast

reviews carried out to corroborate the clinical diagnosing

and the 21 grounds mentioned is to except serious

disease ; security of patients accounted for 11 and

Direct patient force per unit area for four people. All but one patient

attend to the trial contains a figure of

intervention ; 39 H2 receptor adversary burden, and

the remainder take alkalizers or other intervention,

to 22 contain more than one drug. In a 4th

patient ‘s symptoms had improved in

requested review clip. Eight patients

supply proved history of peptic ulceration before.

Tables I and II shows the findings on Ba repast

scrutiny, 58 of the trials showed abnormalcies.

Propors disorder that requires

equal intervention in patients under age 50

( 31 % ) and more than 50 ( 33 % ) . There were no patients have been found

either tummy or esophageal malignant neoplastic disease, although people

Ba repast findings were used to further

found to hold the mass-aortic nodes of

high class lymphoma.

Table III compares the working diagnosing before

and after the trial, in 64 instances of work

confirmed diagnosing and in 18 it has changed. In

the staying 18 provided no specific reply,

likely because physicians by and large can non

retrieve their initial province diagnosing. In the concluding 17

expressed by the general medical diagnosing does non hold

with the consequences of the scrutiny ( Table IV ) .

Although the bulk of patients diagnosed before

scrutiny did non alteration, the belief in the clinical

diagnosing increased after the trial ( diagnostic

certainty or near certainty of 63 patients after the trial

v 18 patients before the scrutiny ; Table V ) .

Changes in direction occurred in 40 patients selepaspemeriksaan ; at 22 this is a direct consequence of

while the find of 18 is non recognized as

Therefore the general doctor. In 14 patients intervention

was stopped and the 23 alkalizers and H2 receptor

adversaries are interchangeable. Five patients with

findings from the scrutiny of direct music

H2 receptor adversaries are treated. Belief

early direction grew in 45 patients. Lima

patient referral for endoscopy accelerated the determination ;

stomachic ulcer which required an probe of two, two elucidations

nodular visual aspect of the duodenum, and

a elucidation of equivocal statements. In 46 patients

reported anxiousness was reduced as a consequence of

scrutiny, 16 patients did non look to follow

up within three months after the scrutiny. Overall,

General practicians thought that the scrutiny

really helpful in 76 patients, in five patients, in whom

Consequences are equivocal or do non hold with the clinical

impact or importance of revelation of

scarred duodenal cap is non appreciated, review

considered to be no aid.


The efficaciousness of diagnostic trials need to vote

on several degrees. Obvious direct effects on

physician ‘s diagnosing, but outside of that information

influence determinations about intervention. Finally,

The trial will impact patient results, which may

more complex than the present alleviation of symptoms and

including security and satisfaction that the diagnosing and

morbidity have been formed from tests.6

For a diagnostic trial to hold good clinical

effects must be accurate. Although less sensitive than

endoscopy in the sensing of superficial mucosal eroding,

consequences of dual contrast Ba repast scrutiny

performed by an experient radiotherapist who membandingkanmenguntungkan with endoscopy in observing peptic

ulcer disease and esophageal and stomachic force

and in measuring the suspension hernia, gastro-esophageal

reflux, and nutrient oesophagitis.7 Ba scrutiny

remains an effectual and popular study of outpatient

for indigestion, with good patient credence and

low morbidity.

Degree of fluctuation from 58 % in this survey shows

high diagnostic consequences, although merely 31 patients

( 31 % ) were relevant to the symptoms of abnormalcies,

therefore justifying particular intervention. Clinical degree

abnormalcies was significantly higher than that

Chest X raies are reported to be asked by the general doctor,

revealed abnormalcies of the relevant

21 % % 8 As most of our patients, nevertheless, their status

clinically diagnosed before the Ba repast

The chief consequence of scrutiny and review

is to corroborate the original diagnosing and convincing

the physicians that the proposed direction


Surprisingly, most patients referred ( 58 ) old

under 50, and the sensing of important abnormalcies

about indistinguishable to that of more than 50

age group, as opposed to the first data.4 No

force is found in both GI

groups, although in 22 % of patients with the exclusion of

serious status, normally malignant neoplastic disease, is the chief ground

province to bespeak reviews. There

ample grounds that the probe indigestion

in immature patients ( aged under 50 ) are seldom

good in footings of incidence management.349

less force in this group, and the patient

normally present with extra symptoms of anorexia

and organic structure weight. ‘0 There may be several grounds why

petition for continued scrutiny for Ba repast

immature patients. Standard clinical instruction that

diagnosing is required before get downing intervention with

expensive drugs. The fact that 15 trials

conducted merely to convert or as a consequence of

direct force per unit area from the patient ‘s troubles reflect the

empirical direction, particularly in patients with

recurrent indigestion. Curative effects of music

findings on scrutiny may be significant in many

patients, and in about half the survey group patients ‘

Anxiety decreased by review. As security

may hold been a factor for the failure of the 16 patients

General after audience with the physician ‘s scrutiny.

Management alterations of40 % was adequate

11 % higher than that reported in immature dyspeptic

patients4 and compares favourable with other

normally used trials. A survey of the effects

Barium enema scrutiny to show assorted

symptoms indicate that a serious exclusion

64 % ofpatients conditions and alteration direction

at 24 % . “ In other surveies, plain abdominal movie

alteration direction in 10 % of acute surgical acceptance. “

2 In most of our patients, nevertheless, direction

requires a reasonably little alterations in use,

H2 receptor adversaries are normally the exchange and

alkalizers. Like all but one patient who received intervention at the clip samabentuk review

The chief consequence is to halt the intervention, all

intervention withdrawn in 14 patients and H2

receptor adversaries in the eighth pulled the

terminal of follow up.

Although the resulting alterations in direction may

does non look of import, the scrutiny is considered as

aid in 76 patients. The chief benefit seems

that in order to better diagnostic and curative

beliefs of the physician manager and cut down

exigency patients. Like the more limited commissariats

wellness attention resources may be made in support

trials to turn out the efficaciousness of quality in the diagnosing

direction and is hard to find

should be placed on the patient ‘s assurance and

physician. In some patients might look into

prevent dearly-won referrals to outpatient audiences.

As, nevertheless, in most patients with early diagnosing and

right direction of the general doctor may

hold more assurance in their primary diagnosing

and alleviate patients ‘ anxiousness by pass oning their

assurance. After several efforts earlier intervention

patients will doubtless stay a possible later

benefit from the probe.

Overall we conclude, in common with Williams et

Al, 3 that immature patients with simple indigestion

be overinvestigated and that the first measure in

direction should be a tribunal of alkalizers or H2

receptor adversary. Our survey shows that the Ba

The trial repast was deserving in the group to convert

patient and physician satisfaction, but the same

The consequences can be achieved by to the full pass oning

initial audience.

MJGF is a Wellcome Trust senior lector. This survey

supported by a research grant from Smith, Kline and Gallic

Laboratory support for the disposal allowed to be




Some patients takingfish oilfor primrose oil and arthritis, and acetylsalicylic acid

the bar of vascular upsets. Is at that place danger in taking this

substances together?

Both fish oil and primrose oil affects thrombocyte map by interfering

the production of thromboxanes A2. Maxepa ( fish oil ) 50 ml per twenty-four hours

inhibit thrombocyte map degrees lower than 325 milligram of aspirin every twenty-four hours.

Size effects of flushing primrose oil is unsure but improbable

greater than the effects of fish oil. Aspirin besides inhibits thrombocyte map

through its consequence on the synthesis of thromboxanes A2, and the consequence will be

may be linear to those of fish oil and primrose oil.

Equally far as I aware of the effects of this combination on thrombocyte

map has non been measured. Hazard of hemorrhage, nevertheless, may

greater if a 3rd substance that is taken in combination with, the effects of fish

oil and primrose oil in combination may be greater than

own-may good be approximately tantamount to 325 milligram of aspirin.-

LINDA BEELEY, adviser clinical pharmaceutical chemist, Birmingham




Modern imagination section is presently pulling the patient made good usage of electromagnetic radiation ( seeable visible radiation, X-rays, wireless moving ridges in the Magnetic Resonance Imaging ) or supersonic ( force per unit area moving ridges ) . X-ray photon frequence and energy are several times higher than seeable light and they can perforate the patient ‘s organic structure. Their photon energy is so big that they can interrupt chemical bonds and cause ionisation. X-ray skiagraphy can be detected in the movie and the assorted fluorescent stuffs.

Radio moving ridges are used in Magnetic Resonance Imaging has a frequence and photon energy is much lower multiple than seeable light. Such as X raies can perforate their organic structure. They have non plenty energy to do ionisation of anything, but they can do molecules vibrate, which means that they produce heat. These wireless moving ridges are detected by the aerial.

Ultrasound consists of force per unit area moving ridges of much higher frequence than the voice can be heard. Good ultrasound energy is generated and detected by piezoelectric crystals. USG spread throughout the organic structure and do the quiver of molecules to bring forth heat once more on the web.

All contrast media in diagnostic imagination has a responsibility, to increase the differences between the assorted “ voxels ” in the organic structure of their ability to absorb and / or reflected energy from electro-magnetic radiation or ultrasound. A “ voxel ” in this context can intend any construction, such as a piece or pieces of music web, or complete variety meats, or pathological procedures or other morphological inside informations. Different contrast media influence of electro-magnetic radiation or ultrasound by different mechanisms.

To transport out their responsibilities to accomplish the concentration of contrast media should be different in different constructions, or “ voxels ” . The greater the difference in the concentration of contrast medium between the constructions, the constructions are smaller ( stand foring morphological item ) can be detected while still in the image.

Contrast media should be a good influence of electro-magnetic radiation or ultrasound energy in the organic structure, but should, ideally, have no other consequence on the web alive. Unfortunately, this is non possible and all the side effects of contrast media.

Rontgen beam Contrast Media ( X ray )


Computerized imaging and conventional radiology, contrast media can be classified as positive or negative media.

Negative contrast media ( air, C dioxide and other gases ) attenuate X raies less than the web package organic structure, because the gas ( negative contrast medium ) contains per unit volume is much lower fading of atomic radiation from the patient soft scope.

Positive contrast media and networking package of the same organic structure contains the figure of atoms per unit volume. Some of the atoms in the contrast media ( eg, I or Ba ) holding atomic Numberss higher than the scope of package ( H, C, N, O ) . Higher atomic Numberss are normally associated with an increased ability to rarefy X raies. In the photon energy used in diagnostic radiology, radiation is attenuated by photoelectric soaking up and Compton scattered. Weakening as comparable to the 3rd or 4th power of the atomic figure. In positive contrast media, I or Ba atoms attenuate radiation 50-1000 times more than an atom of the human web package ( such as C, N and O ) .

Positive contrast media can be dissolved in H2O, which in current clinical pattern this means that the H2O solution of organic compounds with I covalently bound to an aromatic construction, or water-soluble contrast media, which in pattern agencies that mundane crystal dissolves in the aqueous suspension of Ba sulfate.

Positive contrast media


Water soluble I contrast media to the extracellular infinite

Contrast media was used for endovenous urography, angiography and for contrast sweetening in computing machine imaging.

History – the mechanism of toxicity

In 1895 Wilhelm Conrad Rontgen discovered X raies. At the beginning of 1986 was the first arteriography performed in a manus amputated. A contrast medium consisting a suspension of lime H2O is injected into the arterias. The first H2O soluble I contrast media used in 1920 and found for patients with poxs at the clip was treated with Na iodide. Sodium iodide was observed in the tummy image as “ increasing the denseness ” of the kidney. Sodium iodide, nevertheless, has a high toxicity when used as contrast media.

Negative contrast media


Negative radiological contrast media air gas, O, azotic oxide ( N2O ) or C dioxide ( CO2 ) and they can be combined with H2O suspension of Ba sulphate for dual contrast images of the GI piece of land and H2O soluble iodinated contrast media contrast with the dual joint probe.


Read phonetically

Dictionary – Position detailed dictionary

Google Translate for my: SearchesVideosEmailPhoneChatBusiness

About Google TranslateTurn off blink of an eye translationPrivacyHelp

A©2010Business ToolsAbout Google TranslateBlogShare your storyPrivacyHelp