Sehha Com Issue121 Apr12

8/2/2019 Sehha Com Issue121 Apr12

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Thyroid disorders..............................................................................1

Weaning................................................................................................5 ............................................................................................................9Ankle Sprain.......................................................................................................9

..........................................................................................................16 .........................................................................................................17

Gastric cancer....................................................................................................17 ..............................................................................................................30

( ) ...................................................................31

Risk of Narcotic Drugs (Atremadole or Atramale........................................................31 Penis size.....................................................................................35

................................................37 :.........................................................................................40

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Thyroiddisorders

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l

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Weaning

:

( )

( )

6

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( ) 47

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5 )60 (

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:

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.

:

Abrupt weaning ) )

3

Gradual weaning

( )

Partial weaning

Natural weaning

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AnkeSprain

inversion-type twist | ) (

neurovascular compromise bone tenderness 6 fibula

. tibia

muscle spasm

elevation compression

distal 32talofibular ligament

3 555

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stretch

) plantar flexion

dorsiflexion.

100



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anterior talofibular

calcaneofibular posterior talofibular

% 5 %inversion sprains 85deltoid ligament medial ligament eversion sprains

10 . %syndesmotic injuries

tensile limits

predisposing provocative.

proprioception.



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.athletic competition

% 30

23,000

10,000

% 25

.

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|



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23

13

air splints .plastic braces

tissue healing

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23

.good stability

46



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Gastriccancer

1940

70 median age

74 Hispanic

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,the cardia the body pylorus

parietal cells endocrine cells

4 : the mucosa thesubmucosa the muscularis the serosal.

ventral portion



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long axis 50 % 25 %10 %10 %

35 %

, diffuse type intestinal type



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adenocarcinoma

celiac artery

|



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splenic hilum

porta hepatis suprapancreatic nodal groups gastroduodenal areas.

:

: 2001 850,000 522,000 328,000

nonmelanoma skin cancers - 12,39 (%10,4,

%) (%17,8) (9,4%) (%8,8 (10,4

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5 3050 %1025 %

adjuvant therapy.

70 74

25 %31 %

32 %unstaged.

dysphagia melena,



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peritoneal and pleural effusions

cachexia jaundice anastomosis

)Sister Mary Joseph nodule (

acanthosis nigricans circinate erythemas

peripheral thrombophlebitis .microangiopathic hemolytic anemia

pernicious anemia adenomatous polyps

chronic atrophic gastritis inheritedsyndromes

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Helicobacter pylori 50 %5 %

10 %

30 %

carcinoembryonic antigen

% 4550

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cancer antigen 19-920 %

endoscopic ultrasound.



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adenocarcinoma 9095 % tubular papillary

mucinous signet-ring undifferentiated

ulcerative polypoid scirrhous superficial spreading multicentric Barrett

ectopic adenocarcinoma

Immunohistochemistry specific antibody antigen

) intestinal () diffuse )



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Lymphoma Leiomyosarcoma.

total gastrectomy subtotal gastrectomy

distal carcinomas

5 survival rates

bypass operation

- -



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5 6090 %3050

1025 %

local and systemic relapse.

) ,cyclophosphamide

vincristine doxorubicin (rituximab 5 4060 %

30 12.

anastomotic failure ( )ileus

|thromboembolism.

dumping syndrome 12 reflux esophagitis .

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15 %5



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( )

RiskofNarcoticDrugsAtreadoeorAtraae

( ) 20 40

100mg50mg l200mg225mg500mg l

225mg200mg100mg

%) 3 ( Atramale Atremadole

parkinol lysergic acid diethylamide

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Penissize

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Sehha Com Issue121 Apr12