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Papillomavirus is one of the most common infectious diseases, but many people learn about its existence only when faced with the formation of unpleasant growths on the body - papillomas. Often people ignore neoplasms on the skin, as they do not cause them much discomfort, but without timely treatment, they can develop from harmless warts into cancerous tumors.

What you need to know about papillomavirus, is it possible to cure this disease and in what ways.

The human papillomavirus is one of the most common infections in the world, which is carried by more than 70% of people. It includes more than a hundred strains, of which about 80 are pathogenic to humans, and cause changes in the epidermis. At the same time, various types of tumors are formed on the skin and mucous membranes, some of which can degenerate into malignant formations or interfere with the normal functioning of the systems of the human body.

Each strain of HPV has a serial number and belongs to low or high risk groups depending on the degree of oncological risk:

  • non-oncogenic types. These include strains 1,2, 3 and 5;
  • With a low probability of developing oncology. These are quite common types of HPV: 6, 11, 42, 43 and 44;
  • With an increased risk of developing cancer. Viral cells of these strains tend to degenerate into malignant ones. These include HPV types 16, 18, 31, 33, 35, 45, 56, 58, 68, 70 and 39.

Most often, the formation of cancerous tumors is provoked by 16 and 18 strains of the virus. It is these types of HPV that are found in cancer patients during examination. However, infection with oncogenic types of the virus does not always end in the development of cancer. With timely diagnosis and proper treatment, this can be avoided.

After entering the body, the virus can be in a state of suspended animation for a long time and not manifest itself in any way if the immune system is strong enough to suppress it. Symptoms of the infection begin to appear when it is weakened, while growths of various types appear on the skin and mucous membranes:

  • warts;
  • papillomas;
  • Condylomas.

Warts are round, rather hard, rough to the touch and have clear-cut growths that grow up to 1 centimeter in diameter. In most cases, they are localized on the hands. A papilloma is a benign growth, usually elongated and flesh-colored, brownish or yellowish in color, depending on the type. They can appear almost anywhere, and can spread and grow rapidly if left untreated. Condylomas appear on the mucous membranes of the genitals and anus, can grow strongly and cause serious pathologies of the genitourinary system in both men and women.

The disease has several stages:

  • Latent. The virus is in the body, but does not manifest itself in any way;
  • Clinical. It is characterized by the appearance of benign formations on the body;
  • Dysplasia. Progression of the disease, the beginning of the interaction of viral cells with epidermal tissues;
  • Carcinoma. Virus integration into tissues, malignant mutation, cancer development.

HPV is not a fatal disease, but it must be identified and treated. You can independently restore immunity, which will suppress the further growth of viral cells, however, papillomas that have already appeared on the body will not go away on their own: they will have to be removed by conservative or surgical methods.

Types of papillomas

Most of the growths that appear on the skin do not pose a serious health hazard. They differ in localization and appearance, although they have almost the same structure. The following types of papillomas fall into low-risk groups:

  • Vulgar. The most common type of papillomas, which look like small round growths of flesh or brownish color with a keratinized surface. Localized on the hands, knees, sometimes appear on the neck, back, face skin. They can be solitary or grow in whole groups;
  • plantar. Formed on the soles of the feet in the form of a large single outgrowth with a characteristic protruding rim. May cause discomfort when walking;
  • flat. Flattened outgrowths growing up to 3-5 mm in diameter. They are not dangerous, as a rule, they are localized on the skin of the face and palms;
  • epidermodysplasia warty type. Papillomas appear as small pale pink rashes on the back;
  • Laryngenital papillomas. Appear in the larynx, can cause difficulty breathing and swallowing, hoarseness, sometimes suffocation;
  • Papillomas of the esophagus. A rare form of HPV, in which there is an overgrowth of the epithelial tissues of the esophagus;
  • Papillomas of the nasal cavity, nasopharynx and paranasal sinuses. Small, soft growths that never spread. After deletion, they disappear forever;
  • Bowenoid papillomas. They differ in that they can appear both on the skin and on the mucous membranes. They have a flat shape and a smooth or slightly rough structure.

Genital warts appear on the mucous membranes of the genitals or anus. Their formation is usually preceded by itching, after which single outgrowths appear on a thin stalk, which can then spread and increase in size. This type of papillomas is more dangerous than the others.

Neoplasms caused by papillomavirus have blood vessels that provide them with nutrition and growth. Therefore, damage to the wart can cause bleeding.

Causes of papillomas

The source of papillomavirus is its carriers. There are three main routes of infection:

  • Contact - when interacting with a carrier of the virus;
  • Vertical - transmission of infection from mother to child during its passage through the birth canal;
  • Sexual - with any kind of unprotected sexual contact.

Contact transmission of the virus can occur in the following cases:

  • While touching the carrier of the virus: handshake, kiss;
  • When using personal belongings, clothing and hygiene products of an infected person, including: razors, soaps, washcloths, towels, cosmetics;
  • While visiting public pools, baths and saunas.

Infection with oncogenic strains of the virus most often occurs sexually. The risk group includes people who are promiscuous and neglect the hygiene of intimate areas. The virus can be transmitted through any type of sexual contact, including anal and oral. The risk of infection is especially high during traumatic types of sexual contacts: in this case, even the presence of a condom does not guarantee complete protection against infection with the HPV virus.

Despite the fact that papillomavirus is very easy to catch, contact with a carrier does not always lead to its entry into the body. The virus enters the epidermis through damaged areas where the skin or mucous membrane has:

  • wounds;
  • abrasions;
  • scratches;
  • cracks;
  • chafing;
  • Combs.

To get into the epidermis of the infection, even an imperceptible microtrauma is enough, which does not cause any discomfort. Therefore, it is important to monitor the condition of the skin and not neglect the rules of hygiene.

The presence of at least one of these conditions can lead to the suppression of the body's defenses. At the same time, papillomavirus begins to multiply, using healthy epithelial cells for this, which are copied uncontrollably, which leads to the appearance of neoplasms.

The danger of papillomas

Skin papillomas in most cases are safe, do not cause any discomfort and are perceived by a person as an unpleasant cosmetic defect. However, in cases where they appear in areas where they are constantly subjected to mechanical stress: the neck, armpits, the area under the mammary glands in women, the outer part of the genitals, there is a danger of injuring the growth. This, in turn, can lead to complications:

  • Inflammation;
  • Injury;

  • Malingization is a cancerous rebirth.

In case of injury to the papilloma, an infection may enter the wound, the formation of edema, suppuration and tissue necrosis. It also increases the risk of degeneration of the growth into a cancerous tumor.

Malingization is the process of malignancy of papilloma, leading to skin cancer. It occurs quite rarely, most often due to damage to neoplasms, the presence of chronic inflammatory diseases or the development of hormonal imbalances. In order to notice this process in time, you need to carefully monitor the condition of the papillomas on the skin. The following signs signal the degeneration of papilloma into a cancerous tumor:

  • Increase in growth;
  • The appearance of burning, itching, pain;
  • Change in color and shape of the build-up;
  • The appearance of bloody or serous discharge.

If the papilloma begins to itch, turns black, blood or serous fluid is released from it, you should immediately consult a doctor and remove it.

Unlike skin warts, genital warts almost always pose a serious threat to human health. They lead to disruption of the genitourinary system, interfere with normal sexual activity and the functioning of the urethra. Condylomas in the anus can cause problems with defecation, pain, and the formation of microcracks. Without timely treatment, these growths tend to grow and lead to erosion and cancer of the cervix in women and cancer or deformity of the penis in men.

Medical treatment

Drug treatment of papillomavirus includes immunomodulatory therapy, taking drugs that suppress the activity of the virus, as well as removing growths with the help of anti-inflammatory and cauterizing agents.

Most antiviral drugs contain interferon as an active ingredient. It increases the body's resistance to viruses of various origins. Most often, the following drugs are used to treat papillomavirus:

  • Groprinosin;
  • Viferon;
  • Panavir;
  • Allokin alpha.

Simultaneously with drugs that suppress viral activity, the doctor may prescribe a vitamin-mineral complex. It is impossible to completely recover from HPV: the virus will still remain in the body, but it will go into “sleep mode”, stopping its activity.

Preparations for topical use relieve directly from the growths formed on the skin and mucous membranes. Most of them can be freely bought in pharmacies, but it is undesirable to use them without a doctor's prescription: each drug has its own contraindications and side effects, and some of them cannot be used in certain areas of the epidermis. Only a specialist can choose the most suitable drug for a particular case.

List of the most popular and effective remedies for local removal of papillomas:

  • Dermavit;
  • Ferezol;
  • Oxolinic ointment;
  • Viferon;
  • Betadine;
  • Panavir cream;
  • Salicylic ointment;
  • Kondilin;
  • Verrukacid;
  • Super cleaner;
  • Isoprinosine;
  • Lapis pencil;
  • Cryopharm;
  • Solcoderm;
  • Solkovagin.

Properly selected drug treatment allows you to quickly and painlessly get rid of papillomas without resorting to surgical intervention.

Surgery

If there are medical indications or at the request of the patient, papillomas can be removed by one of the existing surgical methods:

  • Cryodestruction. The papilloma is exposed to liquid nitrogen, due to which its nutrition is disturbed, tissue necrosis develops. The treated area becomes hard, white, insensitive to external influences. Dead tissue is left in place to avoid infection, and after a few weeks they fall off on their own. The operation is painless, does not require hospitalization, but does not guarantee the absence of relapses. It is usually performed when the papilloma is injured or there are many small formations. Contraindicated in case of intolerance to cold, the presence of an acute infection, as well as the formation of malignant tumors;

  • Electrocoagulation. An effective way to remove papillomas by exposing them to electric current. In this case, the protein structure of the growths is destroyed, because of which they are charred and wrinkled. The procedure is carried out using special devices of alternating and direct current. After it, a crust remains at the site of the neoplasm, which disappears after 1-2 weeks. The operation has a number of contraindications, in addition, it is quite painful, and there is a high probability of a scar or a pigmented spot;
  • Surgical excision. This method is indicated for suspected degeneration of papilloma into a cancerous tumor. It is used only on large areas of the skin - at least 3 centimeters. The procedure is performed under local anesthesia, but this does not guarantee complete painlessness. It is often accompanied by bleeding, and after removal of the build-up, the wound has to be sutured, which increases the likelihood of scar formation. Full recovery after surgery occurs in 1-2 weeks. In some cases, instead of cutting the papilloma with a surgical scalpel, curettage is done: scraping off the growth with a special tool - a curette.
  • Radiosurgical removal. Non-contact method of removing papillomas. During the procedure, a special tool is used - a radio knife. The papilloma is affected by high frequency waves, because of which it begins to heat up, and then collapses from the inside. Healthy tissues are not affected. The procedure is fast, the tissues do not bleed, which prevents the possibility of infection or viral cells entering the bloodstream. Recovery after surgery is fast, scars do not form at the site of growths, and the likelihood of recurrence is very small. The only disadvantage of this method is the high cost. Radio wave removal is contraindicated in pregnancy, diabetes and cancer.
  • laser removal. The procedure is carried out using an erbium or carbon dioxide laser, each of which removes papillomas of a certain type. The growth is exposed to a beam of small diameter for 1-2 minutes, after which a scab is formed, which disappears within a week. The operation is sterile and reduces the likelihood of infection in the blood. One of its advantages is the ability to remove several growths at once in one go. Local anesthesia is used during the procedure, but many patients still report pain.

If it is necessary to treat papillomas with a surgical method, the doctor selects the operation suitable for a particular case, based on the individual characteristics of the patient's body.

Folk methods

Small, non-oncogenic papillomas can be removed at home using folk remedies. Like traditional treatment, alternative therapy is aimed at increasing immunity and removing growths. In this case, plant and chemical agents are used. Most of them have a mild gradual effect, however, it should be borne in mind that folk methods take longer to achieve the desired effect.

Papillomas can be removed with the help of celandine juice, essential oils, apple cider vinegar, iodine, ammonia or potassium permanganate. These substances have a cauterizing effect, destroying the structure of tissues affected by the virus. They should be used with caution, as in the process of treatment it is possible to damage healthy skin or cause inflammation of the growths.

To help the body fight the virus, in parallel with local treatment, it is necessary to take decoctions and infusions of herbs that have immunomodulatory properties. The selection of funds is recommended to be carried out in conjunction with a doctor.

Some traditional healers say that it is important to treat according to the lunar calendar. The effect of self-hypnosis can play a significant role in the fight against the disease, but to believe it or not is a purely individual question.

Related video

The main causes of papillomas are infection with a virus, weakness of the immune system. When it enters the body, the pathogen multiplies intracellularly, which leads to the proliferation of the epithelium.

The nature of the external manifestations of replication is determined not only by the type of HPV, but also by the localization of the formation. In the presence of papilloma inside the cervix, infection with viruses of high oncogenic risk cannot be excluded.

Genital warts during pregnancy can also be provoked by carcinogenic pathogens. Against the background of a decrease in immunity during childbearing, formations are actively growing.

If the genital growth is formed by a type 16 virus, there is a risk of infecting the child. When passing through the birth canal, the baby can take a breath of air. This behavior leads to the entry of HPV into the respiratory tract and the formation of papillomatosis of the trachea, bronchi and larynx. To prevent such complications, women with human papillomavirus infection are recommended to give birth by Caesarean section.

Why papillomas appear on the body in women

Papillomas appear on the body for several reasons:

  • HPV infection;
  • Decreased immunity;
  • Damage to the skin.

The risk of infection is significantly reduced if the principles of disease prevention are observed.

Numerous clinical studies have not identified the underlying causes of people's predisposition to HPV. After infection, most patients do not develop clinical symptoms. External manifestations of the disease can be observed 20 years after the entry of the virus. The clinical course of papillomatosis significantly depends on the state of the immune system.

The tendency to the appearance of papillomas on the body is increased in people with skin diseases, the presence of autoimmune and allergic diseases. In women, against the background of menstrual irregularities, hormonal disorders are formed, which is a provoking factor for papillomavirus growths on the skin when infected with HPV.

Vaccination is effective against human papillomavirus prior to infection. It is rational to administer it to young girls three times before infection. The traditional age for vaccination is 11-12 years. Before the procedure, it is mandatory to diagnose the presence or absence of HPV using a polymerase chain reaction.

No girl would like to have her appearance spoiled by some sudden ailment, whether it be a simple coryza with its consequences in the form of a red nose and watery eyes; acne that popped up in the most prominent places at the most inopportune time; Or even more papillomas that appeared out of nowhere. These unpleasant formations spoil the mood and make you grimace in annoyance, looking at yourself in the mirror. But they not only have an unaesthetic appearance, but also talk about some internal problems. It is about why papillomas appear that will be discussed further.

So, if papillomas are suddenly found on the body, you should not be very upset. Alas, according to statistics, this problem weighs every tenth inhabitant of the earth. Moreover, nodules can appear on the face, on the neck, under the armpits and even on the genitals. But everything is solvable - modern medicine is quite capable of coping with them.

Who is guilty

So what are these same papillomas? As creepy as it sounds, they are classified as tumors. Indeed, good quality. And papillomas appear due to the fact that a virus lives in the body, it is called the human papillomavirus, HPV for short. And it spreads, unfortunately, quite simply - through touch, the use of other people's towels, jewelry, bedding or personal hygiene items. In addition, HPV can be picked up on the beach, in the pool, sauna or bath, it is transmitted from mother to baby during childbirth; through kisses; sexually ... In a word, almost as he pleases - no one is insured.

However, for quite a long time, HPV can doze off calmly, without showing itself in any way. But as soon as the body fails, out of nowhere, small nodules of flesh-colored or brownish color grow on the skin. What are the reasons for the appearance of papillomas on the body? If a person is a carrier of HPV, then the virus can be activated in the form of rashes due to:

  • suffered a severe cold;
  • some gynecological problems;
  • a course of antibiotics;
  • abuse of tobacco and alcohol;
  • taking birth control pills;
  • severe physical or mental overwork;
  • exacerbation of diseases of the stomach or intestines;
  • non-observance of personal hygiene.

In general, if papillomas began to appear on the body, this is not a reason to panic, but a reason to go to the doctor, especially if the neoplasms gradually increase in size. Relying on chance in this matter is not worth it - seemingly harmless nodules can cause a lot of trouble if you do not pay due attention to them in time. Experts have proven that a severely neglected disease can even transform into cancer.

What to do

First of all, make an appointment with your doctor. You need to make sure that the neoplasms found are really papillomas. And then a specialist - it is better that it be a dermatovenereologist - will give a referral for tests, find out what caused the papillomas, and prescribe treatment.

This can be laser or electrocoagulation, cryodestruction, surgical removal (excision).

The method of surgical intervention is suitable for those who are concerned about one or two fairly large tumors. If there are a lot of papillomas on the body, then most likely the doctor will prescribe laser or electrocoagulation, that is, burning the nodules with a laser or current, or cryodestruction - freezing with liquid nitrogen.

Doctors often prescribe cryodestruction to remove papillomas.

Well, in order to minimize the risk of papillomas, you need to follow the following simple rules:

  • never take someone else's personal hygiene items;
  • in public places, after washing hands, use only paper napkins or a dryer, and during washing, take only liquid soap;
  • do not borrow jewelry and jewelry from girlfriends;
  • wash your own rings and earrings periodically in soapy water;
  • in hot weather, do not be shy to use antibacterial wet wipes for hands and body, as well as special wipes for the face;
  • if possible, do not keep your hands in water for a long time - HPV loves moisture;
  • try to avoid severe stress and anxiety;
  • regularly strengthen the immune system with a healthy diet and, as far as possible, exercise, consume vitamins.

Subject to all the above requirements, there is a good chance that HPV, even if it somehow got into the body, will not manifest itself and remain in sleep mode without causing any discomfort.

In addition, it is important to remember that since papillomas have nevertheless appeared, under no circumstances should you try to cut, squeeze or rip them off on your own - the consequences can be unpredictable. It is better to immediately seek qualified help.

We wish you beauty and health!

Content

Any growths on the skin require timely diagnosis and treatment. The patient must know not only what papilloma is, but also the causes of its occurrence on the body, infection in the body. In fact, this is a wart that can be treated with conservative and surgical methods. The skin becomes ugly, a pathogenic virus develops in the body. The localization of the focus of pathology is difficult to predict, but action is required immediately.

What is HPV

This is one of the most common infections that, once entering the body, remains there forever. The harmful effect and increased activity of HPV are observed only under the influence of provoking factors, otherwise, human papillomavirus prevails in a "sleeping form" in the absence of alarming symptoms. Papillomavirus equally occurs in women and men, is contagious to others. Among the potential complications, doctors do not exclude skin papillomatosis with frequent relapses.

What does a papilloma look like?

Outgrowths on the body can be localized not only on the skin, but also on the mucous membranes. Outwardly, this is a compacted head on a leg, and the wart itself is hanging. The incubation period from the moment of penetration of the papillomavirus to the appearance of the papilloma itself on the body varies from several weeks to several years. The patient does not experience internal discomfort, does not complain about the appearance of large growths and the presence of pain. The wart develops rapidly, may resemble a mole in color, but differs in shape, method of attachment to the epidermis.

Types of papillomas

There are several dozen varieties of HPV that enter the body in different ways. Some - by contact-household way, others - sexually. Infection is not excluded in childhood or with a seasonal weakening of the immune system. In practice, there are numerous types of papillomas on the body, below are the most common and often diagnosed among them:

  1. Flat papillomas. They are considered teenage, are light protrusions on the skin, differ from moles in color and shape, are eliminated by a dermatologist. Localized on the forehead, neck, cheeks.
  2. Vulgar papillomas (ordinary, simple). They are localized on the fingers and feet, protrude 3 cm above the surface of the dermis, and have a rough surface. Small, but numerous in the focus of pathology.
  3. Perianal genital warts. Outwardly, they resemble cauliflower, they are placed on the genitals - the penis in men, the labia or in the vagina in women. Localization - oral mucosa, anus.
  4. Filiform warts (acrochords). Elongated stem, elongated shape above the skin surface, mobility. Occur after 40 years, localized in the places where the endocrine glands lie.
  5. Squamous papillomas. A dangerous type of growth, because against the background of increased mobility, doctors do not exclude the development of squamous cell carcinoma - a malignant neoplasm.
  6. Plantar warts. The foci of pathology are located on the foot, differ from the skin in color, are prone to excessive dryness, do not cause general discomfort, but require treatment.
  7. Inverted papillomas. The foci of pathology are in the nose and paranasal sinuses, extend to the maxillary and frontal sinuses, the ethmoid labyrinth. They occur extremely rarely, but are fraught with serious health complications.
  8. Fibropapilloma. Neoplasm of a benign nature, which has a mushroom shape. Slowly grows in the folds of the skin, easily injured. It is prone to malignancy, contributes to the development of melanoma.
  9. Angiopapilloma. This is an internal papilloma of a benign nature from the connective tissue, which is attached to the vessels, can develop an oncological disease. At the initial stage, it can be difficult to diagnose.

Why papillomas appear on the body

The main cause of the appearance of dangerous processes on the skin is HPV, which penetrates the patient's healthy body from the outside. This is not only intimacy without barrier contraception with an infected partner, other ways of transmitting a dangerous infection are also not excluded. The most common causes of papilloma are detailed below:

  • disturbed metabolism;
  • weakened immunity;
  • non-compliance with the rules of personal hygiene;
  • diseases of the digestive tract;
  • the presence of bad habits;
  • prolonged use of oral contraceptives;
  • promiscuity.

How HPV is transmitted

Papillomavirus has several ways to infect a healthy body. First of all, this is intimacy with a person in whose body such a pathogenic infection already predominates. Doctors recommend selective attitude to sexual relations, not to change sexual partners; know what papilloma is. In addition, other ways of HPV transmission, diagnosed in modern medicine, are not excluded. It:

  • from the surface of the skin through abrasions, injuries;
  • during childbirth from an infected mother to a child.

Why are papillomas dangerous?

By itself, papillomavirus is not dangerous to health, since it can “live in the body” for years and not manifest itself in any way. Health problems begin in the relapse stage, when warts begin their rapid growth. When asked if papillomas on the body are dangerous, the answer is definitely yes. Initially, these are benign growths on the skin, but in the absence of timely treatment and under the influence of pathogenic factors, they can develop into malignant tumors that are fraught with metastases. Potential complications are:

  1. Papilloma in the throat, on the tongue can lead to impaired breathing, asthma attacks.
  2. A growth on the clitoris or in the vagina leads to an inflammatory process in a feminine way.
  3. Papilloma on the skin or mucosa in case of injury can lead to bleeding.
  4. The formation of polyps, which in the human body is shown to be removed promptly.
  5. Human papilloma when injured can lead to blood poisoning, death of the patient.

Papillomas - treatment

Wherever the wart is located - on the abdomen, buttock, back or in intimate areas, it must be treated in a timely manner. These can be conservative methods, the use of folk remedies or an operation. Effective treatment of papillomas is selected by the attending physician after diagnosis, the main thing is to determine the nature of the pathology, a potential threat to health. You should not start with surgical procedures, you can try to remove the wart at home. Here are reliable conservative methods:

  • antiviral drugs: Isoprinosine, Panavir, Allokin alfa, Groprinosin;
  • antiseptic formulations: Octacid ointment), Wartner Crio, Verrukacid, salicylic acid;
  • immunostimulants: Polyoxidonium, Viferon.

How to get rid of papillomas at home

At the first signs of papilloma on the skin, you can use alternative medicine methods that demonstrate a steady positive trend in the disease. Warts disappear, and the human body regains a presentable, healthy appearance. Productive disposal of papillomas at home is possible after prior consultation with your doctor, superficial self-treatment is excluded:

  1. To leave the growth of papilloma, the best way is to rub it with dry laundry soap or celandine juice. Repeat the procedure several times until the unpleasant symptoms disappear completely.
  2. Prepare castor oil, which rub papillomas all over the body. It is allowed to carry out the procedure up to three times a day. Alternatively, use garlic paste, sour apple puree, or dandelion juice for viral warts.
  3. Iodine in combination with kerosene is also effective. If you qualitatively smear papilloma on the palm or foot with such a therapeutic composition, then after the first session it dries up, after the second it finally disappears.

Prevention

In order not to know what papilloma is in the future, it is important for the patient to control his sexual relations and choose only protected sexual contacts. This is the first rule of effective prevention of papillomas, which significantly reduces the risk of highly unwanted infection. Seeing the photo of what skin papilloma looks like, it is already clear what to be afraid of. Other preventive measures for adults and children are detailed below:

  • proper nutrition, getting rid of destructive habits;
  • careful observance of the rules of personal hygiene;
  • taking multivitamin complexes;
  • preventive vaccination;
  • avoidance of microcracks, abrasions, skin injuries;
  • pregnancy planning;
  • use of personal items.

Video: papilloma

Photo of papilloma on the body

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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