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Al Ansari Medical Clinic

Phone / 25658888 (If you get sick, he will recover) Phone / 25650666
On this page you will find most endocrine diseases in Kuwait
1- Summary of endocrine diseases
2- Thyroid diseases
3- Thyroid diseases
4- Vita Min D, its importance and the risks of its deficiency
5- Minerals and vitamins where they are
6 Harmful use of protein and hormones for bodybuilding
7- Delayed childbearing, male and female
8- Choose the gender of the fetus
9 – Menstrual strike
10- The pituitary gland increases the secretion of the milk hormone
11- Short stature
12 – Delayed puberty, male and female
13 – early puberty of the sexes
14- Gynecomastia for males
15-Increased cortisol secretion from the renal gland (Cushing’s syndrome)
16- Decreased secretion of cortisol (Addison’s disease)
17- Using Vicosta or Alexandana to help with weight loss
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1-: Introduction to endocrine and hormones

The importance of the endocrine system lies in the important functions it performs to preserve the life, health, and activity of the organism:
It is called endocrine because it has no holes or tubes that are excreted into the blood directly and transported to another place to perform its hormonal function. There are non-hormonal glands such as lymph nodes and their function is to strengthen immunity against diseases and have no relation to hormones.
There are many endocrine glands in the body, the most important of them
1- The pituitary gland, which controls some endocrine glands and secretes a number of hormones, including growth hormone, the main growth stimulator, prolactin milk hormone, TSH and thyroid-stimulating hormone, ACTH and adrenal reproductive stimulant LH, FSH in addition to oxycitin and has a strong relationship to birth and milk flow, and ADH The hypothalamus controls the functions of the pituitary glands.
2- It is also the thyroid glands that secrete thyroxin T3 and T4 and it has an important role in the body’s growth, activity and brain development.
3- As well as the adrenal glands and secrete several hormones, the most important of which is the cortisone, which plays an important role in maintaining salts and sugar in the blood and in the balance of pressure and in the activity of the body and its tolerance to stresses and tensions.
4- The gonads and secrete testosterone in males and estrogen in females and have a fundamental role in physical maturity and childbearing.
5- The parathyroid glands secrete the parathyroid hormone PTH and prevent calcium from falling in the blood
6- Likewise, one of the important glands is the pancreas, and it secretes insulin that prevents high blood sugar and alkaloquin, and that prevents hypoglycemia. These two hormones work to maintain a stable level of sugar in the blood.

2- Dysfunction of the thyroid gland

And its effect on the general activity of the human being. A report from KUNA with Ahmad Al-Ansari, on 15/07/2000
Dysfunction of the thyroid gland and its effect on the general activity of humans from the radius of the cataract, Kuwait – 7-7 (KUNA) – Consult a Kuwaiti consultant for the dysfunction that may affect the human body, whether excessive nervousness, anxiety, or fatigue and lethargy, to the dysfunction that may affect the activity of the thyroid gland. Al-Ansari consulted endocrine and hormones in an exclusive interview with the Kuwait News Agency “KUNA” that increased gland secretion leads to nervousness, fatigue and weight loss in spite of increased appetite and may be accompanied by vitiligo, heart palpitations, hand tremors and muscle weakness. He added, “On the contrary, the hypothyroidism Whether due To inflammation or eradication of the gland or lack thereof at birth leads to fatigue, lethargy and feeling cold and memory disorder and weight gain with the loss of delicacy …

Thyroid disease1- Thyroid Gland

Thyroid gland: It is a small gland with a normal weight of about 40 g. It is located in the front section of the neck and consists of two parts (two lobes) right and left and manufactures and secretes thyroid hormones (thyroxine and triiodtronone T4, T3)) necessary to maintain a balance and the functioning of every cell of the body well There is an association and coordination between the work of the thyroid gland in the pituitary gland located at the base of the head behind the eyes, which secrete the thyroid stimulating hormone (TSH). This hormone has an important role in controlling and controlling the thyroid gland.
Thyroid gland: it is the organ that makes its hormones from iodine and this iodine is necessary and is present in marine foods and some vegetables, table salt and deficiency leads to a decrease in the secretion of thyroid hormones and thus an increase in pituitary induction to TSH causes an enlarged thyroid gland to try to compensate for the deficiency of the thyroid gland and we need an appropriate amount of iodine. A decrease or an increase in it can cause an enlarged size or a malfunction in its function, which shows its symptoms. There are three thyroid diseases:
The main causes of goiter: – GOITRE1-

t is a lack of thyroid production of the hormone as a result of a lack of iodine, or even an increase in it, or as a result of the use of medications, and may be due to genetic or family reasons, or as a result of immune and antibody deficiency (Hashimoto’s disease) and chronic neck inflammation is an immune disease of a familial nature. It may lead to hypertrophy and deficiency in the work of the thyroid gland, which is recommended to monitor the patient and his relatives as well. Acute and subacute thyroiditis cause pain in the gland when swallowing or touching it. The thyroid gland enlargement has two types, the first in which there are several nodes at the same time in the lobes, and the second type is a single node, and it is usually a multi-node that is not cancerous, as thyroid cancer appears more in the form of a single solid node. Note that an enlarged and stable thyroid gland may not need treatment while medium and variable inflation is treated medicinally and monitored and severe cases alone need to be surgeon with confirmation that the emergence of any contract requires recognition of its type and ensure its integrity by taking a sample of it using the thin needle to know the contract that needs surgery or treatment A pharmacological and periodic monitoring. There is a new method called interventional radiology.

Increased thyroid secretion:

Thyrotoxicosis2–

It is caused by increased production of thyroid hormones (T3 _T4) and its most important form is G rave’s Diseases, which is characterized by symptoms of increased production (nervousness, anxiety, fatigue and weight loss despite an increase in appetite and sweat. Symptoms may be the result of gland inflammation or excessive amounts of thyroid hormones

It is: the causes of thyroid activity:

The immune system called harris is caused by increased production of thyroid hormones (T3 _T4) and its most important form is G rave’s Diseases, which is characterized by symptoms of increased production (nervousness, anxiety, fatigue, and weight loss despite increased appetite and sweat. An increase in the size of the thyroid gland. The appearance of symptoms may be the result of gland inflammation or excessive amounts of thyroid hormones
Viral inflammation of the gland
Enlarged gland associated with activity
Pregnancy
some medicine
Symptoms of thyroid activity include:
Increased heartbeat
Excessive sweating
Enlarged gland
Light hair
Insomnia
Nervousness
diarrhea
lost weight
Increased appetite
Trembling with two hands
Eye pains
Symptoms of pregnancy are the same as symptoms of gland activity, such as sweating, an increase in heartbeat and an eye pelvis, and lack of weight gain.

Complications from gland activity during pregnancy: –
Abortion
Premature birth
Decreased fetal weight
High blood pressure during pregnancy
Weakness of the heart muscle
During the 10-12 week of pregnancy, it is possible to increase the physiology of the thyroid hormone, then it should be followed up with the analysis and re-analysis after 12 weeks. If the gland hormone is high, then treatment should be started to avoid these complications and the treatment should be with PTU and pills to relieve symptoms when the patient is sick. Radiation therapy during pregnancy

Treatment :-

There are three ways to treat increased thyroid gland secretion, and doctors disagree on choosing which method is appropriate for all patients, and the best option is left for the patient to choose the best and easiest way as each method has its advantages and side effects. These methods are:
The first way: – Medicines Medical Therapy

Treatment with medicinal drugs (neomercazole or thiuracyl paroxylate) which interferes with the secretion of the thyroid gland itself and the duration of treatment is not less than 18 months with the start of large doses and its gradual decrease with the possibility of a return of increased secretion by 40% and some medication complications and this method is agreed therapeutically in European countries.
The second way: – Radiotherapy

Radiation therapy (deep-rays) where a radioactive substance is given that stops the final thyroid gland secretion or its radiation therapy, which is the common method in the United States.
The third way: – Surgcal surgery

The third method of treatment is surgery after preparing the patient and the most important complication of surgery is a decrease in gland secretion – the return of the disease and increased secretion again – hoarseness or loss of voice as a result of cutting the vocal cord – a lack of calcium as a result of removing parathyroid glands
Note :-
A conference was held in Denmark in 1990, where more than 2000 endocrinologists (thyroid gland) attended to discuss methods of treatment with its various types of medication, surgery, or radiation. Most of them agreed to give the patient the opportunity to be treated with drugs for a full course for a period of eighteen months. The patient is treated again with surgery or radiation therapy.

•   H ypothyroiddism

• 

• Causes of hypothyroidism and lethargy

• It occurs due to inflammation: a genetic factor, which is the most common or excision of the gland, or due to an enzymatic gland defect or lack of gland at birth, the most important symptoms of which are fatigue and lethargy – feeling cold, drowsiness memory – dry skin – weight gain with loss of appetite – hair loss and patients are diagnosed By lowering the level of thyroid hormones (T4-T3) and increasing the hormone (TSH), symptoms of congenital deficiency appear in the first months of a child’s life, or symptoms delay to the second or third year of life and the causes of congenital hypothyroidism: gland atrophy, the presence of the gland in its natural place, Illness in an enzyme that helps form a pyramid The gland, an imbalance in gland hormone receptors or a deficiency of the hormone TSH-TRH. The symptoms are clear at birth. In the affected person, we see enlarged and protruding tongue, swollen eyelids or neck failure, skin dryness. Usually the hair is rough and wrinkled, difficulty feeding, constipation throughout the bile for several weeks And if not treated immediately, a delay in the child’s mental abilities appears, which leads to a delay in sitting and walking, speaking, various skills, slow growth and short stature. It is necessary to diagnose and treat children immediately after birth so that the lack of hormones does not affect the child’s intelligence and development, and it treats children and adults with thyroxine in different concentrations.
  The thyroid gland is not related to menopause.
  There are no beneficial means for the prevention of thyroid diseases, but it is advisable when suspicious of patients with gland in children, especially if the mother complains of inactivity of thyroid gland secretions or takes gland therapy to do gland analyzes early to prevent complications.
  It is not possible to give a correct percentage of the prevalence of thyroid diseases in Kuwait due to the lack of a documented statistics yet. It was noted that places far from the sea and in desert areas because there are not enough quantities of fish and is the most important source of iodine to increase the rate of goiter.
  Congenital hypothyroidism affects children at the first months of a child’s life or symptoms delay to the second or third year of life and causes of congenital thyroid deficiency: atrophy of the gland, the presence of the gland in its natural place, impairment in one of the enzymes that help in the formation of the hormone gland, defect in receptors Hormone gland hormones or hormone deficiency TSH-TRH The symptoms are evident at birth and we see in the affected an enlarged and protruding tongue and swelling of the eyelids or neck failure skin dryness and usually the hair is rough and wrinkled, difficulty in feeding, constipation throughout the presence of bile for several weeks and if not treated immediately appear in Beyond T. Another in the child’s mental abilities, which leads to a delay in sitting and walking, speaking and various skills, slow growth and short stature. It is necessary to diagnose and treat children immediately after birth so that the lack of hormones does not affect the child’s intelligence and development, and it treats children and adults with thyroxine in different concentrations.
  Among the causes of congenital hypothyroidism: –
  Glandular atrophy
  The presence of the gland is not in its natural place
  Among its symptoms: –
  An enlarged tongue
  Eyelid swelling
  Neck short
  Roughness and wrinkles with hair
  Difficulty breastfeeding
  Delayed child’s mental abilities (delayed walking, sitting and speaking)
  Short stature and it is necessary to diagnose and treat children immediately after birth in order not to affect the intelligence and development of the child.

• The treatment will be with thyroxine and in different concentrations.
  Questions that reply to me about the time of taking the idle pills during the gland during Ramadan. The hypothyroidism can be taken at two times in Ramadan, according to the first patient, which is taking the pills half an hour before suhoor and on an empty stomach for two hours before it.
  And the second half before half an hour before breakfast means with Maghrib ears with water and light food and he prays Maghrib and then eats after the prayer
  During pregnancy, in a pregnant woman, the body’s need for thyroid hormone increases, and it can affect pregnancy and the fetus, although the percentage is low, but it is better to avoid it with treatment.
  Complications from pregnancy:
  Abortion, especially in the first months
  Pregnancy-related high blood pressure
  Premature birth
  It increases the chance of a caesarean section
  Among its complications for the fetus: –
  Reducing the weight of the fetus
  It affects the development of the brain of the fetus
  Because of these complications, which can be avoided with the necessary treatment, periodic follow-up, and a gland analysis every three months to make sure of the correct dose, the doctor may increase it according to the gland analysis to avoid these complications. And the analysis must be repeated 6 weeks after giving birth in order to confirm the dose and it is possible to return the woman to her dose before pregnancy
  Hypothyroidism and its relationship to high cholesterol in the blood It was found that patients with hypothyroidism have an increased incidence of high cholesterol in the blood by more than 70%, and it is possible to improve the level of cholesterol in the blood with the treatment of hypothyroidism (thyroxine) must check the proportion of cholesterol and blood fat in patients Who suffer from hypothyroidism

• 3- parathyroidism

• First: the elevated parathyroid hormone Hyperparathyroidism

• These are four small glands the size of beans and are located behind the thyroid gland. Calcium is a very important component for the functions and activity of all cells, muscle and nerve movement, bone and tooth building, and the deficiency of this element in the blood has many dangers. As the parathyroid gland secretes the PTH hormone, which is the parathyroid hormone, this works. The hormone maintains a normal level of calcium in the blood 8.5 – 10.5 mg / fat 3 by increasing the absorption of calcium from the digestive system and reabsorbing calcium from the owls. If these two methods are not enough, the body works to withdraw calcium from the bones and teeth, which are the ester stock. Use calcium in the body to maintain a normal level of calcium in the blood.

There are three forms of increased parathyroid hormone.

Primary hyperparathyroidism increases due to adenoma in 85% of cases in one of the four glands of age. Or due to a carcinoma of the gland, which is rare, or due to an unknown cause Hyperplasia in 10% of cases of one or more parathyroid glands and sometimes hereditary cause what is known as MENI, MENIIA.
Secondary hyperparathyroidism increases due to a lack of calcium or an increase in phosphates for long periods. The reasons for this are a decrease in vitamin D, kidney failure, and increased calcium in the urine.
Tertiary hyperparathyroidism is a third-class parathyroid hormone caused by chronic kidney failure for a long time or after kidney transplantation.
Symptoms of the disease :
There may be many symptoms and may not be any symptoms, and symptoms include feeling weak and tired, pain in the body, especially muscles and bones, abdominal pain or intestinal ulcers, nausea, recurrence, and loss of appetite, bone fractures, poor memory and concentration, kidney stones, frequent urination.
Diagnosis: –
Measurement of the level of calcium and phosphate in the blood and parathyroid hormone, the percentage of calcium in the owls, bone rays may show erosion in the bone and in the thickness of the cortex.
Dexa rays may indicate osteoporosis due to parathyroid activity.
treatment :
Primary hyperparathyroidism
If the high calcium height is less than 11.5 mg / dm 3 and the patient does not complain from symptoms then the treatment is conservative by increasing fluid intake and avoiding thiazide diuretics and avoiding long sitting and exercising, and the patient may give Calcimimatic treatment that reduces the level of the hormone and calcium in the blood, as well as Andronite treatments Alandronate, which increases bone density. As for whether the patient has osteoporosis or suffers from disease or the calcium is more than 11.5 mg / dm 3, surgery is recommended to remove swollen glands.
Secondary and tertiary type
We give adequate amounts of vitamin D and calcium in the mouth, and if there is kidney failure then give phosphate reducers as well.
Second: Hypoparathyroidism
The thyroid gland is four small glands with a size of 5 mm adjacent to the back of the thyroid gland in the neck and secretes the thyroid hormone PTH. The function of this hormone is to maintain a normal level of calcium in the blood, i.e. limits of 8.5-10.5 mg / dm 3 in order to maintain vital functions For cells.
How does parathyroid hormone maintain the level of calcium?
This hormone stimulates the absorption of calcium from the intestine as well as reabsorption of calcium from the kidneys. If these two sources are not sufficient, the hormone works to provide calcium from the bones.
Symptoms of the disease
Decreased thyroid hormone leads to a decrease in the level of calcium in the blood, resulting in a group of pathological symptoms, including spasms and muscle cramps, especially in the fingers and extremities, a feeling of poor growth, poor academic and mental performance in chronic untreated cases, abdominal pain, white water in the eye, disintegration. Nails, numbness of the mouth and extremities, poor tooth development.

the reasons :-
Genetic recessive and common causes are among the most common
Acquired causes such as antibodies and thyroid surgeries
No response to the parathyroid hormone
Tests
Decreased calcium – high phosphate – decreased thyroid hormone
Measuring the level of magnesium may be low in some cases
treatment
By giving sufficient quantities of calcium and vitamin D, especially One Alpha, as it has a good effect in these cases, the level of calcium should be monitored regularly every month to three months to maintain the normal level of calcium and avoid high or low calcium due to an increase or decrease in the therapeutic dose.

Vitamin D benefits and deficiencies

Vitamin D can be obtained from nature and chemically. Our bodies can produce it once we are exposed to the sun. It is considered a hormone, especially for absorbing and depositing minerals in our bones and in some secretions of the body. Vitamin D can be obtained from nature and chemically. Our bodies can produce it once we are exposed to the sun. It is considered a hormone, especially for absorbing and depositing minerals in our bones and in some secretions of the body.
A * Vitamin D functions and uses:
– The most important functions of this vitamin or hormone are that the term will be to absorb minerals and deposit them in the bones and prevent calcium escapes in the urine, and it is considered very important to maintain bone density, but scientific studies have revealed other tasks of the vitamin, including if added to the calcium had anti-cancer properties:
1- It is used to boost the immune system, prevent autoimmune diseases and prevent cancer. The researchers also found that this vitamin plays an important role in treating some immune diseases such as multiple sclerosis, psoriasis, and skin diseases such as vitiligo, and lupus common.
2- The low level of this vitamin in the blood may lead to an increase in blood pressure in some people, which indicates that the presence of vitamin in a therapeutic rate can regulate blood pressure.
. 3- It was also found that this vitamin affects the biological balance, psychological state and behavior and helps to strengthen muscles
4- It is used in regulating levels of minerals, such as: phosphorous and calcium, as in cases of low family phosphorous, and low levels of calcium, such as a lack of activity of parathyroid glands.
5- It is used in diabetics, obesity, asthma, teeth and periodontal diseases.
* Symptoms caused by a deficiency of vitamin D?
1- Children: the most important symptoms: rickets, impeding normal growth, delaying the appearance of teeth and wasting, as well as osteomalacia, especially the bones of the skull in infants, and the occurrence of permanent abnormalities in the bones that cannot be treated.
2. Adults: The diseases of calcium deficiency (low calcium in the blood), as well as osteomalacia (low blood mineral content) and osteoporosis (a decrease in the total bone mass, are all linked to vitamin deficiency. Women who suffer from a deficiency may experience deformities in the pelvic bones. This causes them to have difficulty giving birth, so calcium, magnesium and other vitamins should be taken with Vitamin D to prevent these diseases.
* Nutritional sources from which we can obtain vitamin D:
1- Exposure to sunlight in the morning and before sunset.
2- Among the nutritional sources: whale liver oil, which is considered one of the most important sources in which a large amount of vitamin D is available, as well as fatty fish such as: salmon, sardines, tuna, sea bass, swordfish, herring, lobster and dairy.
* The appropriate daily dose of vitamin D?
– For high blood pressure and osteoporosis, the daily dose ranges between 400- 800 IU, and people who suffer from osteoporosis who have not taken calcium supplements are advised to add vitamin D and magnesium nutritional supplements to their diet and increase their exposure times to sunlight. It was also found that most patients who suffer from inflammatory disease of the mucous membranes of the intestine suffer from a low level of vitamin D and they must take this dietary supplement to protect them from osteomalacia.
* Symptoms of Vitamin D deficiency: *

Pain in the body, bones, and muscles * Muscle cramps * Muscle weakness * Walking unbalance * Sleep strikes – the normal range of Vitamin D (250 H VITD)
* Reasons for vitamin D deficiency:

Not enough exposure to sunlight or not eating food and supplements (the main reason) System diseases that limit absorption of vitamin D from the intestine – hepatic failure / kidney failure that affects the activation of vitamin D in the body. Taking certain medications such as epilepsy drugs.
Permanently untreatable bones.

* Nutritional sources from which we can obtain vitamin D:

1- Exposure to sunlight in the morning and before sunset.
Symptoms of Vitamin D deficiency:
Pain in the body, bones, and muscles * Muscle cramps * Muscle weakness * Walking unbalance * Sleep strikes – normal vitamin D level (250 H VITD)
Reasons for Vitamin D Deficiency:
Not having enough exposure to sunlight or not eating food and supplements (the main reason) diseases of the system that limit absorption of vitamin D from the intestine – hepatic failure / kidney failure that affects the activation of vitamin D in the body taking certain medications such as epilepsy drugs.
Preparations or supplements available in the local market?
There are two types of Vitamin D I, Vitamin D2, known as synthetic Ergocalciferol (Vitamin D3), known as the Natural Cholecalciferol (CHOLECALCIFEROL), and Vitamin D3 is best because it is natural. Vitamin D2 and Vitamin D3 are converted to the effective vitamin D after its passage in the liver and kidneys, because special active types are not disposed of except under the supervision of a doctor for patients who suffer from chronic diseases of the liver or kidneys that would weaken the ability of their bodies to convert the vitamin into its effective form. .
Side effects of vitamin D:
Recent studies say that a person’s intake of more than 1000 IU causes an increase in calcium in the body (high calcium in the blood), which leads to calcium deposits in soft tissues such as in the heart, lungs, kidneys and blood vessels in an unavoidable way. The excessive intake of vitamin D can also include nausea, loss of appetite, headache, diarrhea, discomfort and fatigue.
Note: If the person suffers from epilepsy, heart disease, diseases of the blood vessels, kidneys, liver, pancreatic diseases, chronic diarrhea or intestinal problems, they should see a doctor before using vitamin D.
Table: shows some of the nutritional sources selected from Vitamin D and their percentage in international units:
Food
IUs per serving * international units
Percent DV ** daily value
Cod liver oil, 1 tablespoon cod liver oil, 1 tablespoon
1,360 1360
340 340
Salmon (sockeye), cooked, 3 ounces salmon (red salmon), cooked, 3 ounces
794 794
199 199
Mushrooms that have been exposed to ultraviolet light to increase vitamin D, 3 ounces (not yet commonly available) fungi that were exposed to ultraviolet light to increase vitamin D 3 ounces
400 400
100 100
Mackerel, cooked, 3 ounces mackerel, cooked, and 3 ounces
388 388
97 97
Tuna fish, canned in water, drained, 3 ounces, canned tuna fish in water, 3 ounces
154 154
39 39
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies) orange juice, vitamin D, 1 cup (choice product labels, amount of vitamin D)
100 100
25 25
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV) yogurt 20% vitamin d 6 ounce
80 80
20 20
Margarine, fortified, 1 tablespoon margarine, 1 tablespoon
60 60
15 15
Sardines, canned in oil, drained, 2 sardines, canned sardines.
46 46
12 12
Liver, beef, cooked, 3.5 ounces liver and beef, cooked, 3.5 oz
46 46
12 12
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV) ready-to-eat cereals, 10% vitamin D, 0.75-1 Glass
40 40
10 10
Egg, 1 whole (vitamin D is found in yolk)
25 25
6 6
Cheese, Swiss, 1 ounce swiss cheese, 1 ounce
6 6
2 2

In the end, Vitamin D was a medical miracle, as it eliminated many chronic pain, muscle cramps, less fractures, and better psychological states, pressure and sugar.

Minerals and vitamines 5

Proteins and hormones for bodybuilding (between beneficial and harmful) 6-

Proteins and hormones for bodybuilding (between beneficial and harmful)

Before starting any protein or hormones, it is necessary to ensure the proper functioning of the liver, kidneys and prostate, and that there are no tumors in the family of first and second degree relatives and diabetes.
The materials used for building and completing objects are divided into:
1- Proteins and peptides: They are amino acid and creatine.
2- Testosterone derivatives Steroids: Estrogen – Cortisol – Testosterone – Decadiolabolin – Primobolan Depo – Sustanon – Andriol – Oxandrin – Dianabol – Mesterolone – Halotestin – Nandrolone – Winstrol.
3- Growth Hormone: It consists of 191 amino acids and avoids taking it to the stomach as is common
Androgenic steroid steroids AASs anabolic anabolic steroids (testosterone derivatives) are a group of steroid hormones derived from chemical modification to testosterone and builder expression that builds the body and increase the net and mass of body and androgenic indications of induced male characteristics despite the difference in their strength with different types of androgens, but all possess in particular And androgenic
The biological effects of androgenic androgenic steroids AASs:
Various effects, but the most prominent effect on male sexual discrimination and the creation of secondary sexual characteristics, including the growth and development of the prostate, seminal vesicles, penis, scrotum, beard hair, pubis, chest, armpit, vocal cord thickening, throat enlargement, and also induce nitrogen retention, increase in net body mass, and change the distribution of fats and erythropiens with a secondary increase in Hematocrit, and some testosterone is converted to estradiol (the female hormone) by an enzyme in the peripheral tissues.
4- Insulin and IGF1, more than one case of Balady’s death was recorded to take insulin and the other recorded cases of heart attack and paralysis from its use. We recommend avoiding them peptides.
5- Energy medicines (Power – Thyroxine – Kleinptrol and others (adrenaline and adrenaline).
There are those who use animal hormones, such as (Alkabouz), which are unsafe, and impure, and therefore we recommend to avoid them altogether.
Available methods of administration:
For cases with a deficiency of the male hormone and testosterone
Testosterone is available as a pill, injection, gel patch, or sublingual preparations.
The most common uses of androgenic steroids AASs are:
The most common uses are illegal or medical use to improve athletic performance or physical appearance in the belief that these drugs improve the body’s response to exercise, especially weight gain, about 50-80% of bodybuilders and weightlifters and we recommend that you do not use them except for the extreme necessity and the absence of any contraindications Such as family cancerous diseases or any other disorders of the liver, diabetes and others
How do androgenic steroids AASs help athletes? Albanian effects include increased nitrogen retention, protein synthesis, and anti-demolishing effects to restrict cortisol to its receptors and psychological impact. It increases body mass and muscle potential side effects of the use and misuse of androgenic steroids AASs: when increasing their use individually and in large doses and without medical supervision:
1- On the reproductive system: in males: testicular atrophy, sexual dysfunction and sperm deficiency.
In females: oocytosis, increased hair, roughness of the clitoris, and clitoral enlargement.
2- On the liver and kidneys: inflammation of the liver, hemorrhagic cysts and healthy and malignant liver tumors may occur, especially with the use of oral substances, which leads to hepatic failure, as well as kidney failure when long-term use and in non-medically studied doses.
3- On the heart: the enlarged and weakened muscles of the heart, angina, strokes, and high blood pressure.
4- The blood system: increased platelet count, ventricular thrombosis, and systemic emboli
5- Psychological: It affects the brain and causes aggressive behavior, accidents and lapses.
6- Skin: Increased production of fat, acne and baldness
7- Blood lipids: HDL deficiency and high harmful LDL cholesterol
8- Sepsis: Sepsis, septic arthritis, and needles sharing highlight the risk of hepatitis and AIDS.
9 bone adhesion before its time in adolescents, which results in stunted growth.
10 Breast: It is an increase in the size of the breasts in males. If giving the male hormone more than the normal level, it becomes a female hormone and complications begin.
11- Other effects: May lead to addiction and having to increase the dose, which leads to an increase in complications
-And- Weight gain due to fluid retention and increased body mass
A medical study has warned against using hormonal hormones outside medical supervision.

It is forbidden to use any hormones if there are cancerous diseases in the family and relatives of the first and second degree or the patient himself was infected
The name of the hormone
Way to take it
Specifications
The side effects
Growth hormone: GROWTH HORMONE Subcutaneous injection).

It is called the hormone strange, which helps in the process of growth, in children who stopped their growth early, and for the weak body and structure in small doses and codified by the doctor and under its supervision 0 in the human body: the hormone is secreted from the pituitary gland, as a result of some natural stimuli, such as (sleep, nervous pressure, deficiency The rate of sugar in the blood ..) The liver encourages the secretion of insulin-like growth factors, and other factors, and the liver’s ability to produce those factors is limited, so the hormone’s ability to function is limited.
Among the effect of this hormone:
1 first effect: This hormone has a strong structural effect, and increases protein synthesis, in the form of the large size of muscle cells, their number, and the increase in the number of cells that cannot be obtained by other stimulants.
2- The second effect: converting fat into energy, which reduces the volume of fat.
3 – The third effect: It strengthens the soft tissues, ligaments, and cartilage, which increases the strength of the athlete in a noticeable way: This hormone can be taken anywhere under the skin and has nothing to do with melting fats where the injection is taken.
Growth hormone does not have known side effects from other steroids, the main side effects of growth hormone when taken in unusual doses without doctor’s supervision, such as; It is a decrease in the blood sugar level with a decrease in the rate of function of the thyroid gland, collecting fluids in the body and leading to fatigue, enlargement and limitations of the heart and it may cause eating this hormone if ingested before puberty to the giant produced by increasing the hormone in the body, which leads to an increase in length, and some inflation Abnormally liver organs, leading to its failure.
After reaching puberty, it may cause acromegaly: it is a phenomenon that results from an increase in the hormone in the body, as the bone cannot increase in length, so it increases in width, and it appears in the form of excessive growth in size: palm, foot, jaw …
The new growth hormone, a genetic engineering product from bacteria for more than 10 years, is now used and is safer, better, and has fewer side effects.
.
Insulin

It is used to treat diabetes and it is not recommended for bodybuilding.

Creatine, aminuacid, and urea

It consists of three types of amino acids naturally present in: skeletal muscles, the heart, brain, testes, and other tissues in the body. Creatine is made mainly in the kidneys, liver and pancreas.
It can be obtained from food such as meat and fish, or by providing it directly as a food supplement.
Side effects: It is not considered safe to use for a long time. Because any defect in its system and its quantity leads to complications such as affecting the kidney function which leads to kidney failure.
And from the wrong information: There are treatments and anti-hormone drugs that prevent side effects and organized drugs, such as barnegel injection and nolvadex and others, as well as taking unlicensed medicines from the Kuwaiti Ministry of Health and some of these drugs are used to treat animals

Several medical studies have warned against using hormonal structures far from the supervision of a physician, and we advise against using it under the supervision of a physician or without his supervision.
In conclusion: We recommend that you do not take any external hormones, either under medical or non-medical supervision, and exercise the correct exercise and we recommend limited cases to see a doctor in order to prevent unexpected complications.

Delayed childbearing in men and women INFERTILITY

Checks and treatment for childbearing delays
That both the husband and wife are responsible for 50% of childbearing, and for women, the beginning of the menstrual cycle is by the bleeding of the menstrual blood, which is the first day of the cycle, and since the ovary in each female contains about 400 thousand eggs at birth and about a thousand eggs approximately try to reach monthly and may produce One or two eggs per month, so egg production may end in menopause, the menstrual cycle is interrupted, and a woman needs to have a healthy egg and that one of the fallopian tubes that connect the ovary to the uterus is open and balance in hormones that begin to be produced when the pituitary gland is located in the head behind the nose and eyes These hormones are FSH – LH, where the FSH hormone begins working from the first day of the cycle and for a period of two weeks to form the egg in the ovary. And on the ninth day approximately, the cervix begins to open gradually, turning the fish uterine secretions into thin secretions. On the fourteenth day, the LH hormone works to help release the egg into a channel The fallopian tube is usually on the 14th day of the first day of the menstrual cycle, and the egg may not be active for more than 12-24 hours. As for the husband, his function in childbearing is to deliver sperm through sexual intercourse to the egg, and this requires an erection of the male organ, then sexual intercourse, and the sperm count in ejaculation not less than 20 million, movement not less than 50%, and the number of natural forms not less than 75% and the absence of infections or Antibodies or immunity, and sexual intercourse should be in time for the egg to enter the fallopian tube until fertilization takes place, knowing that sperm may live within the vagina from 48 hours to 4 days. There are two types of male sperms Y and female sperms X and the choice of the sex of the fetus can be controlled by the grace of God Almighty Come on Z if the desire for the grace of God was born to recommend sexual intercourse from the fourteenth day of the session if the desire to either a baby girl Female Thanks to God, we recommend sexual intercourse before the day of the session 14
The most important causes of delayed childbearing:
For men: decreased sperm production due to testicular disease as a result of any bacterial or viral infections such as mumps and varicocele, erectile dysfunction or congenital causes. Smoking, alcohol and some medications are said to affect sperm production.
In women: fallopian tubes blockage, birth defects in the womb or fallopian tubes, infections, thyroid diseases, diabetes and hormonal disorders such as milk hormones, pituitary glands, ovaries, immunity and other unknown causes, sperm death inside the vagina or cervix due to a different pH or Inflammation or the presence of anti-immune systems
Check-ups for a couple:
Take the story of the disease.
2- General clinical examination to ensure the safety of the body.
Perform general tests to ensure the safety of the liver, kidneys and other tests, such as diabetes and fat.
Examination of the wife: The wife’s reproductive analyzes include the following:
Analyzing hormones in the blood during the first days of the menstrual cycle, which include: stimulating pituitary hormones for ovulation FSH – LH and milk hormone PROLACTIN and measuring the female hormone E2 and others. Also, the progestone hormone secreted by the yellow body must be measured on the 21st of the period, which indicates the occurrence of ovulation
Working the uterine and ovarian x-rays to ensure that one of the fallopian tubes is not blocked before starting treatment
Sonar worked during the ovulation period to ensure the size of the egg, not less than 18 mg, and from which ovary it descends.
Examination after sexual intercourse: It is usually carried out on the 12 or 13 day of the session so that we take a sample from the vagina to check the movement and number of sperms present and their safety and not to die within the vagina or cervix and the extent of the effect of immunity and wife secretions and determine the ratio of acid and alkaline mean to the wife or the presence of immunity or ulcers in Cervical examination is done two to four hours after sexual intercourse without washing.

 Treatment: Drugs are usually given orally, such as Clomid or Andogen or others. These work by activating the pituitary hormones to secrete the hormone FSH – LH to activate the ovaries indirectly. Treatment in this way requires the necessity of making sure that the pituitary hormones are normal and that the uterus is normal and the fallopian tubes Or one of them is normal, if you do not respond to drugs in the mouth, it can be given stimulant injections of ovaries such as humagone, intergallinone, and others, which is the extract of stimulant hormones for the ovary extracted from blood and urine for elderly women and that works directly on the ovaries, which is a FSH-LH hormone that gives the injection Its quantity is determined after the measurement of the female hormone and the sonar to prevent side complications and the determination of this amount varies from one patient to another and an oral treatment may be added to the injection. The hormone produced by the yellow body is measured by PROGESTERON to see if ovulation occurred or not, and on the 21st day of the cycle and to make sure the pregnancy is measured the pregnancy hormone B HCG in the blood three days after the session is late and it is advised not to have sexual intercourse until confirming pregnancy, some complications may occur in treatment (clomid and stimulant injections), including twin or more pregnancy, ophthalmia from the clomid, gastrointestinal disorder, allergies and ovarian enlargement, especially in cases of Ovarian cyst when giving activated injections of ovaries. In this case, it is necessary to consult a physician immediately.
There are other ways to help delayed childbearing.
First: Reproduction under the command of God Almighty needs the following.
A healthy sperm.
2- A healthy egg.
3- The uterus is normal, the tubes are tuned, and there is no obstruction.
The average person ejaculates a number of sperms that are not less than 15 million in 1 cm3 and the movement of spermatozoa is less than 50% and that the sperm form is normal. These sperm come into the vagina and need two hours to enter the cervix and from it to the uterus itself and a large number die Of these sperms in the womb and reach the fallopian tubes only about one hundred sperm, meaning that the uterus kills this huge amount of sperm as a line of defense for the body and these hundred sperms reach the fallopian tube and in the last third of the fallopian tube wait there where you live between two days to Almost four days pant It is apparent that the egg will come out of the ovary and that it does not live active for more than 12-24 hours. If God wants the reproduction to occur, the sperm fertilizes the egg in the last part of the fallopian tube, including the fertilized egg that walks back to the endometrium where it tries to establish itself in the endometrium and pregnancy occurs God willing. If there is any obstacle that prevents the fertilized egg from reaching the endometrium, it stops in the fallopian tubes and pregnancy occurs outside the womb
So, as we mentioned earlier, we need a healthy sperm, a healthy egg, a natural womb, and a fallopian tube that is open in both form and function.
Second: Artificial insemination.
This is to connect the largest possible number of sperms to the fallopian tube by taking the sperm from the same husband, and after that a portion of the sperm itself is inserted by means of a special plastic tube for a specific position of the wife into the fallopian tube directly through the vagina and uterus and this is a very simple method and it is one of the simplest Methods, but there is a condition for it, as the number of spermatozoa is not less than 15 million, its movement is good and active, and its success rate is between 18-22% only. In the best medical centers, you need to provide the wife with activated treatment, make sure the egg is descended with the sonar, and give the booster injection to the egg, and artificial insemination is usually done after giving the needle a period of no more than 36 – hours.
Third, IVF. There are three methods for IVF: –
1- Regular IVF method and its success rate is approximately 20%
2- Peat method and its success rate is approximately 20%
3- Asphalt method and its success rate is approximately 40%
** Using IVF **
Wife: When there is no fallopian tube, either congenital, adhesion, blockage, or removal of the fallopian tube through the process.
Husband: twice the number and movement of sperm, so that they are not in any way less than 15 million sperm, provided there is a natural movement of sperm.
Regular IVF method

   The wife gives the stimulant hormonal injection to the ovaries under close medical supervision and careful follow-up. When making sure of the presence of eggs, a careful operation is performed with the sonar to pull these eggs out of the abdomen, and they are placed in a tube and a special solution outside the abdomen, and sperm are added to them so that this egg is fertilized and the fertilized egg is returned after approximately 48-72 hours. This egg is injected and returned through the vagina and uterus

2- ZFFT method

is like its predecessor, but in this case the egg is released out of the uterus and mixed with sperm outside the body and returned to the fallopian tube directly through the endoscope and not by artificial insemination of the fertilized egg as is the case with a regular IVF method, but the fertilized egg is placed directly at the end of the fallopian tube .
3- ICSI: –
The Axi method. In recent years, it was found that the ICSI method succeeded and more than 80% of the cases that were treated in the way (ICSI egg injection) were fertilized – fertilization rate was at best 60%, while the pregnancy rate for the transferred embryos was 39%. The methods that treat patients and this method needs a healthy egg from the wife. As for the husband, this method is ideal for couples who complain of weakness in the number of sperm, even if it is only one sperm or even the absence of sperm by analysis, but there must be sperm in the testicle, then these animals are taken Sperm and inoculation directly to a Oocyte injection. Either way Alexi Vthakn sperm directly into the body Hilali itself is divided egg fertilized and then immediately be vaccinated to the fallopian tubes or channel for retrieval through the uterus. These way of the latest and most accurate ways known to treat delayed childbearing and success rate 25 – 40%
Fatwa 36 p / 84 on the legitimacy of IVF: –

Praise be to God, and may blessings and peace be upon the Messenger of God, his family, companions, and his parents.
The Committee on Public Affairs at the Fatwa General Assembly at its meeting held on the morning of Saturday, 29 Shawwal 1404 AH corresponding to 7/28/1984 AD presented to the Undersecretary of the Ministry of Health through the Undersecretary of the Ministry of Endowments, which reads as follows:
With reference to your book No. AF / LF / 19 / 1756/84 of 3/18/1984 CE regarding Fatwa No. 9A / 84 issued on the legality of trying to conceive in a pipeline method if it was between the spouses during the marital establishment and careful safeguards were taken into account to prevent mixing of tubes .. Please take note That as this method was permissible with the necessary guarantees to prevent the mixing of pipes, there are some cases that the Ministry would like to present to the Fatwa Committee to inform the opinion of Islamic Sharia about it. These cases are: –
First: The semen is taken from the husband and the egg from the wife, and the fertilized sperm is grown in the wife’s womb.
Second: The semen from the husband and the egg from the wife. The fertilized sperm is grown in the womb of another woman who is at the same time a second wife for the husband.
Third: The semen from the husband and the egg from the wife and the fertilized sperm is grown in the womb of another woman.
Fourth: The semen from the husband and the egg from a non-wife, and the fertilized sperm is grown in the wife’s womb.
Fifth: the egg from the wife and the semen from other than the husband, and the fertilized sperm is grown in the womb of the wife.
Sixth: The semen from the husband and the egg from a non-wife, and the fertilized sperm is grown in another woman.
Seventh: the egg from the wife and the semen from other than the husband, and the fertilized sperm is grown in another woman.
Eighth: The semen without the husband and the egg from the wife, and the fertilized sperm is grown in the wife’s womb.
Ninth: In the event that the husband’s semen is in the sperm bank, is it permissible to conduct the vaccination process with the wife, even after the husband’s travel or death, for example?
Please feel free to provide us with a definite legal opinion in these cases: –
The committee considers that the first case is the Shariah award, while the second, third, fourth, fifth, sixth, seventh and eighth cases are not permissible according to Shariah. It is preferable for this operation to be performed by a trusted Muslim physician for his religion and honesty. If a Muslim physician is not available for this operation, there is nothing wrong with a non-Muslim doctor performing it if adequate safeguards are taken into account to prevent the mixing of the tubes …
And God knows best, may God bless our master Muhammad and his family and companions.

The egg activation program
Madam: Hello and welcome to the egg stimulation program with needles and I am happy to give you a brief summary about the treatment in this way It is known that the ovaries, pregnancy and childbearing need a healthy sperm so that at least 20 million male sperm and movement is not less than 50% and a healthy egg from the female and to be one of my channel The fallopian tube is open and the female reproductive system is known to consist of a vagina, uterus, ovaries, and fallopian tubes, and every female has about 400,000 eggs. At puberty, the pituitary gland located in the head behind the nose and eyes begins to work where two hormones called FSH and LH are released into the blood and FSH begins to work from the first. Day of the session and for a period Two weeks to form the egg from the ovary, and on the ninth day, approximately, the cervix opens gradually to turn into uterine fish secretions into delicate secretions. On the fourteenth day, the LH hormone works, as it helps to release the egg into the fallopian tube.
treatment :
Activated injections for ovaries, such as humagone, pyralgone, and others. It is the extract of hormones that stimulate the ovaries extracted from blood and urine for elderly women, which work directly on the ovaries. It is a hormone FSH, LH. One patient and another as drugs are usually given orally, such as clomid orandogen or others, and these work by activating the pituitary hormones to secrete the hormone FSH, LH to activate the ovaries indirectly. Treatment in this way requires the necessity of making sure that the uterus is a normal and ductile form. The web or one of them is normal by doing oily rays on the uterus HSG This radiation works before starting the treatment also requires treatment to make sure the examination after intercourse from 2 to 6 hours to ensure the safety of sperm and not death inside the vagina or cervix due to the difference in the degree of acidity or any infections or The presence of immunomodulators as you may need to do an analysis of the effect of sperm immunity and marital secretions by requesting semen analysis from the husband and analysis of the wife and put on a glass slide to make sure of the movement of sperms when meeting with the secretions of the wife As for the sonar it is very necessary to know from which ovary Egg This is important for one-channel wives as it is necessary to know the number of the egg size so that it is not less than 18 mm and the ovarian response to treatment and then given the injection of HCG (placenta hormone) and taken from the urine of the pregnant woman to help the egg exit from the ovary and measured the hormone produced by the yellow body PROGESTERON To find out if ovulation occurred or not on the 21st day of the cycle and to make sure of pregnancy, the pregnancy hormone B HCG is measured in the blood three days after the period is due. Some complications may occur from (colomide and activated injection), which is pregnancy with twins or more, and the misuse of the eye from colomide, disturbance of the digestive system, allergies, ovarian enlargement, especially cases of ovarian cysts and cases of taking activated injections of ovaries. In this case, it is necessary to consult the physician immediately.
We pray to God Almighty to bless you with good offspring, God willing.
(Note that the attending physician does not guarantee the success of the treatment except, God willing.
Tests and treatment of delayed childbearing with ovarian stimulants
You should always remember that the husband and wife are each responsible for 50% of childbearing. Remember, Madam, the dates of the menstrual cycle start with the flow of red menstruation blood. When we say the fifth day we mean the fifth day from the first period of the cycle and so on … And treatment begins with taking the disease story for the husband and wife in detail and making sure That there is no empty disease that may affect childbearing.
First: marriage checks

• 1- Taking the story of the disease
  2- General examination of the patient to ensure the safety of the body
  3- Perform general tests to ensure the safety of the liver, heart, kidneys, and other tests
  Necessary for diabetes and others.
  4- Reproductive tests:
  Blood hormones (FSH sperm and LH and other hormones)
  B) Analyze the semen and verify its number so that it is not less than 20 million and the movement is not less than 50%
  And the absence of infections
  C) Measuring the body’s immunity against sperm.
  W) Take a sample from the testicle in order to ensure the presence of sperm inside the testicle when not
  The presence of sperms for analysis.
  Second: wife’s examinations.
  1- Taking the story of the disease
  2- General examination of the patient to ensure the safety of the body
  3- Perform general analyzes to ensure the safety of the liver, heart, kidneys and other tests
  Necessity, diabetes and others
  4- Reproductive analysis, including: –
  The work of oil rays to ensure the shape of the uterus and not blocking the fallopian tubes
  The sonar worked during the ovulation period to ensure the size of the egg and from which ovary the egg is released
  Measuring hormone analyzes from the blood working in the first days of the menstrual cycle, pituitary hormones stimulating ovulation FSH, LH and milk hormone PROLACTIN, measuring female hormones E2 and other hormones and other routine analyzes and measuring the progestone hormone produced by the yellow body on day 17 and day
  21 which indicates the occurrence of ovulation.
  The examination after sexual intercourse usually works about 12 or 13 days from the ovulation period so that we take a sample from the vagina to check the movement and number of sperms present and determine the acidic and alkaline mean of the wife or the presence of immunity or ulcers in the cervix, and this examination works after two hours to four hours of sexual intercourse without washing and not Forget about the good supplication during sexual intercourse (God bless us Satan and Satan away from what we have been given) and in the event that the period is late for the date we do a blood pregnancy analysis BHCG and we advise against sexual intercourse until confirming the pregnancy and if God does not help you
  Pregnancy Please see your physician for the first days, and you should have a period

  Choosing the gender of the newborn

  God Almighty said: “God, the King of the Heavens and the Earth, creates what a female wills and donates to whom the males want @ or marry them a memorial and a female and makes those who are sterile. He is omnipotent.” God Almighty believed – Shura verse 49-50. And the medical needs imposed by many diseases related to the male fetus alone or the female fetus, and since the eighties of the last century, research is ongoing in this regard and there is a scientific rule that says that the gender of the newborn is determined by the type of chromosome carried by the sperm, either female (x-chromosom) (or male) chromosom Y-) while the oocyte Thi do not carry only (chromosom X) for any female chromosome. If the convergence between a sperm carries a female chromosom X with the egg, the result is a female X-X.
  If the confluence between a sperm carries a male chromosom (Y-) with the egg, the result is a male X-Y
  Means for choosing a newborn: –
  First: Sex – Timing
  It is known that the semen of a man contains two types of sperm, the male sperm Y is a small body is lightweight fast moving but lives for a short period of time, while the female sperm X is heavy weight slow moving lives for a longer period of time and accordingly it is determined The date of ovulation for the woman to intervene relatively by setting the appropriate timing for sexual intercourse, so that the result is the desired sex.
  For the fetus the memory: it is preferred to have sexual intercourse immediately after the occurrence of ovulation with interruption of intercourse 4-5 days before ovulation, the cuff is more likely for males.
  For the female fetus: sexual intercourse is preferable to be 3-5 days a day after the completion of the cycle and stop 3 days before the ovulation date
  Second: – Diet
  The ion balance of sodium and potassium versus calcium and magnesium is a vital influence on the receptors with which the sperm are attached to the egg wall, which leads to the attraction of male or female animals to these receptors. In simple terms, the increase in the percentage of sodium and potassium in the food and the decrease in the percentage of calcium and magnesium leads to attracting the male sperm and vice versa. To follow this method, the woman must follow a diet for a period of not less than two months. We support the food stock that encourages the desired sex. May help give birth to females, God Almighty will have, with which calcium is milk and its products, bread, almonds, hazelnuts, fish and vegetables, while magnesium is bran, cocoa, peanuts and soybeans, and foods that may help give birth to males with permission God Almighty is a food rich in sodium, it is table salt, while potassium is found in corn, corn flakes, fruits, especially bananas, apricots, melons, and vegetables such as beans, flowers, potatoes, tomatoes, chicken without skin, sugar and rice.
  Third: – the acidic medium P.H.
  It is known that the acidic medium is more suitable for female sperm, and the alkaline medium is suitable for male sperm
  *** – How to follow the food and timing of sexual intercourse under medical supervision with the help of a vaginal shower: –
  To follow this method, the woman must follow the aforementioned dietary method for two sessions – two consecutive months – preceding the menstrual cycle during which the program will be applied, and before starting the food program, the following checks are necessary
  (1) the level of sodium and potassium in the blood for those who wish to have children
  (2) the level of calcium and magnesium in the blood for those who wish to have children
  During the menstrual cycle, ovulation is monitored by the woman and determines the appropriate sexual intercourse time for the desired sex and can be used with vaginal showers, according to the desired sex, according to the previously explained.
  Fourth – Sperm screening, separation and artificial injection I..U.I
  And this method is done by separating the sperms laboratory, but it does not make a complete separation 100%.
  Fifth: – Cytometry / Sperm Separation (flow)
  And this method is carried out by separating the sperm by relying on the contents of the DNA with very complex tools. However, this method is still limited to very limited centers in the world and very expensive and the results are very weak.
  Sixth: Taking a biopsy from a fetus to test the sex of the newborn
  This is a method related to IVF, in which the type of embryos is studied after they are formed and divided before returning to the womb of the woman using PGD (Preimplantation Genetic Diagnosis).
  Seventh: – The Chinese program
  It is one of the hypothesis methods that have limited success, and it is a schedule that depends on the age of the woman and the month in which vaccination is carried out mainly. It has spread widely in the public circles, but it did not achieve the required success.
  Summary The percentage of males
  (1) Food + Intercourse timing + vaginal basal shower. . = 70%
  (2) Artificial injection + special food = 80%
  (3) The normal percentage without adopting any method for selecting the gender of the newborn = 51%
  (4) Basal food for change of the vaginal medium … = 55%
  And God and His Messenger know best. These are just theories and research. Results are not guaranteed, except by the grace of God Almighty

Menstrual disorders and increased hair growth for women and acne( PCO)

The main reason for increased hair growth, acne and menstrual disorder is an increase in the male hormone. It is said that the fetus at the beginning of the three months of his life inside the belly of a nation does not distinguish his reproductive systems. As for a boy or girl, and at puberty, where the cells of the pituitary gland begin to work, the ovarian cells are activated to show the female qualities, and sometimes the remnants of the male cells swell with them to secrete male hormones. A very small percentage, and if any disturbances occur in the balance of these hormones, they are caused by some pathological symptoms and the most important reasons:
1– Ovarian cyst caused by hormonal disorder (increased testosterone) in puberty, or ingestion of some hormones, or for unknown or familial reasons.
2- Lack of congenital enzymes that lead to an adrenal gland disorder (above the kidney)
3- Take medications that contain male hormones.
4- Male hormonal disorders that are common among family members (that is, they spread to a specific family) and this is the type prevalent in Kuwait.
5- The male hormones are present in the blood in two forms: free and linked to a special protein carrying SHBG, and the lack of a protein that carries the male hormones increases the free form of the male hormone and this type is the most prevalent in Kuwait.
6- Excessive sensitivity of the skin cells to the male hormone, which increases hair growth in the skin.
7- The menstrual cycle disorder may be caused by an increase in the milk hormone (prolactin), a thyroid or adrenal disorder, or other hormonal causes, birth defects of the reproductive system, or psychological factors.

Symptoms of an increase of the male hormone in a female may appear in whole or in part
1- Menstrual disorder.
2- Increased hair in the face and body and roughness of voice.
3- The appearance of acne.
4- Hair loss.
5- Obesity.
6- Apply the skin
7- The secretion of milk from the breasts when pressing.
8- Changes in the reproductive systems.
We would like to confirm that an increase in the male hormone or the presence of cysts in the ovary does not prevent pregnancy, but may delay it.
Diagnosis
A- General clinical examination.
B – Conduct the following analyzes: –
Sugar, liver and kidney functions to ensure organ safety
The male hormone and pregnant protein have TESTOSTERONE / SHBG
3- Measuring the female hormone E2, the prolactin and the thyroid hormone TFT
4- Measuring the pituitary hormones LH – FSH
5- Sonar for ovaries to detect the presence of cysts (note that 20% in cases may not appear with sonar)
6- Other examinations decided by the attending physician, according to the case.
Treatment
1-A special drug against the male hormone (endocrine), which prevents the male hormone from affecting the skin cells, which helps to get rid of excess hair in the female and treats acne and menstrual disorders in addition to a female hormone with a low concentration to increase the protein that carries the male hormone and other similar drugs. From it, it is possible to give glucophage when increasing the hormone insulin.
2-Hair removal by a special device that works to deliver a light electric current to the roots of the hair, which leads to its attachment and ease of hair or laser removal, even if there is a reservation for some specialized medical centers abroad from this type of treatment and this treatment does not differ from other methods as it is not treated The cause of the problem, which is, as we mentioned, cysts on the ovaries and other reasons, and the process of removing cysts on the ovaries practically stopped WEDGE RESECTION because they cause adhesions to the pelvis, which results in blockage of the fallopian tubes, and some are still used to ovulate the laparoscope and may succeed in the first six months of treatment, then the condition may return and As is the attic feel disgusted newly also added the use of the laser ovaries and still under testing for some cases and the use of super sprays Factbook nose.
Drug therapy does not prevent pregnancy after discontinuation.
Show signs of improvement in treatment.
If the appearance of hair decreased in new places.
If the period of hair removal increased, that is, if the hair was removed by one week and the period became every two weeks
If soft hair appears instead of coarse hair
If you are menstruating
In the case of acne, we recommend avoiding the following foods: –
1- Chocolate
2- Cocoa
3- Coffee
4- Hot drinks
5- Fatty foods
6- Whole milk and its derivatives, such as cheese
7- Cake

Increased secretion of the milk hormone from the pituitary gland

هThe milk hormone is usually secreted during pregnancy to increase the secretion of milk when breastfeeding
It is possible for the male hormone to rise in men and women
Among the reasons for increasing the secretion of milk hormone: –
Pregnancy
Pituitary tumors secrete the milk hormone, and the amount of hormone secretion depends on the size of the tumor
Transmission of some tumors to the brain, such as breast cancer, some medications, such as psychiatric disorders, metoclopromide, and some medications to treat high blood pressure (methyldopa) and estrogen.
Hypothyroidism
Some patients with polycystic ovaries
Stress and exercise
Symptoms of the increase in the milk hormone: –
For men: sterility and reduce sexual arousal and milk secretion
In women: menstrual irregularities and milk secretion
To diagnose the reason for the increase in the secretion of milk hormone:
Medical history
Clinical examination
Hormone analysis
MRI head
Treatment depends on the reason for increasing the milk hormone: –
If a tumor in the pituitary gland depends on size, it is possible to start medications such as cabergolin or by surgical operation.

Reasons for short stature and its treatment in children 11 –

Growth and adulthood
There is a misconception that growth stops puberty, as adulthood is the stage in which sexual maturity is achieved for females and males. This is accompanied by physical changes that usually occur between the ages of 10-14 years for girls and between 12-16 years old for boys. In the beginning and above all, I would like to assure you: if the genetic factor of your class, which is the inherited length in the family, you have some environmental factors that help you more and affect the final length during and after the puberty period. On the other hand, Even if the genetic factor is not from your class, i.e. the height gene is not present in the family, but despite that, environmental factors play an important role in determining the level of the final length, and it is possible to gain more length regardless of inheritance. Between males and females in adulthood. As height increases by an average of 30-31 cm for young adults, they constitute 18% of the final height. While the increase in height for girls ranges between 27-29 cm, which also constitutes 18% of the final height.
Both sexes have a noticeable jump in length that usually ranges from two to three years. And the period when they get the closest height they may reach after puberty. Some individuals may experience a decrease in the level of growth hormone. In this case, when the doctor diagnoses this, he describes to the patient the alternatives to growth hormone, which are given by intramuscular injections in regular doses, after which the patient can follow his growth again. But in some cases, the reason for the lack of growth is not the lack of growth hormone, but malnutrition also plays an important role in this. Hormones cannot be synthesized in the body without any food. Hormones need the basic components of calories (which are vitamins, minerals, proteins, fats and carbohydrates) in order to be created in the body.
Factors affecting the final length level:
Sleep: In adulthood, the number of hours of sleep should be 9-10 hours. Adequate sleep helps release the growth hormone that is necessary for bone growth and development. But if the teenager does not get enough hours of sleep, this will affect the growth hormone ratio and, consequently, the final length.
Nutrition: Nutrition should focus on eating low-fat dairy products such as milk, milk and cheese, in addition to eating proteins rich in amino acids such as boiled eggs, as it facilitates the release of growth hormones. The role of fruits and vegetables is not hidden, as they are an essential source of vitamins and minerals necessary for bone growth and development. And one of the important nutrients that a lot of zinc may overlook is because it is a small mineral that must be obtained daily within the diet, but only in small quantities (50 mg or less).
The importance of zinc in nutrition and growth: it plays an important role in partnership with hormones in relation to the following: the manufacture and secretion of growth hormone. HGH works to produce somatomidine C in the liver. Activation of the somatomidine c hormone in bone cartilage. In addition, zinc metal interacts with other bone growth hormones such as testosterone, thyroid hormones, insulin, and vitamin D3. Therefore, and in the event of a lack of zinc metal, this imbalance will result in a loss of weight and height. Among the best sources rich in zinc, we mention: milk, potatoes, cheese, legumes, whole grains, brown rice, peanuts and seeds Pumpkin (pumpkin seeds).
Aerobic exercise: Exercising some exercise, such as stretching exercises and dry swimming movements, will help to soften the body and give it additional flexibility that helps it grow more freely, in addition to light physical activities such as walking, cycling and basketball, for example. But although exercising leads to health benefits for the heart and other body functions, excessive exercise during childhood and adolescence can negatively affect growth at this stage. Excessive physical activities are associated with delaying changes that occur in adulthood. Studies have also demonstrated that gymnasts and young dancers have experienced delayed puberty, especially during the intensive training period.
Genetic factors: The period of puberty occurring is influenced primarily by the genetic factor. Where the pace of growth, the timing and rate of sexual development, the maturity of the skeleton and the development of teeth, these are all affected by genetic factors by 40-70%. However, as I mentioned earlier, different environmental conditions affect the average length over the period of growth.

Preparing the child and sensitizing him to adulthood: The psychological and physical preparation for this stage has positive effects on growth. By providing all the nutritional elements that the body needs for growth and attention to the quality of the child’s food and the number of meals, in addition to this it is very necessary to educate the child about the changes he will face, and to educate him consciously in proportion to his age. These things have the best effect on his psychology and how his body interacts and grows. Percentage of hormones in the body: The changes that occur in the body depend on the release of the gonadotropins, leptin, sexual steroids and growth hormone. Before puberty, growth hormone (G.H) and thyroid hormones are the primary primary hormones for growth.HGH makes proteins and inhibits the formation of fats and carbohydrates. And it is necessary that helps the proliferation of cartilage cells in the epiphyseal plate, which allows longitudinal growth. As for thyroid hormones, they are essential for the normal growth process and the development of the central nervous system. Thyroid hormones also work in conjunction with growth hormone to promote cartilage growth and bone formation. Insulin hormone: Insulin plays an important role in regulating the growth process by securing the products of metabolic processes and metabolism of cells, and by interacting with other growth factors to promote growth in the fetal stage. Testosterone: The high level of the male testosterone during puberty plays an essential role in promoting production and secretion of growth hormone by stimulating it to the pituitary gland to produce growth hormone. But this effect is temporary, that is, only during the first period of puberty. After that, the production of growth hormone decreases in late adulthood, despite the persistence of high levels of testosterone. As for females, the matter is completely different, in contrast, low doses of estrogen stimulate the production of growth hormone, while higher doses impede the production of growth hormone.
Tips for increasing height after puberty:
Food quality: You must obtain a large amount of soft proteins, such as fish, chicken and low-fat dairy products. These components help in muscle growth and obtain a strong bone structure. Avoid simple carbohydrates, such as pizza, cake, sweets and soda. Calcium must be obtained as it promotes bone growth. The most important sources rich in calcium are green leafy vegetables such as spinach and turnip, in addition to dairy products such as cheese, milk and milk.
Obtaining an adequate amount of zinc, as I mentioned previously, about the importance of zinc, because a lack of food intake of it affects bone growth and all growth processes. Obtaining an adequate amount of vitamin D as it promotes bone and muscle growth and helps the body absorb calcium, and from the main sources of vitamin D we mention fish and mushrooms, in addition to moderate exposure to sunlight. Avoid smoking, alcohol, and steroidal stimulants, as these factors all hinder and inhibit growth processes.
Drink plenty of water daily. Water enters into all the vital processes that take place in the body and to promote growth processes. The body must be kept hydrated and prevented from drying out.
Simple regular aerobic exercise: where you should exercise daily for half an hour, such as running, walking or swimming, but without lifting weights or excessive heavy sports. In addition, stretching exercises are magical and effective in increasing length. Therefore, it must be maintained for five minutes per day. Obtaining enough hours of sleep each night: As I mentioned earlier, the growth process takes place during the period of sleep, so getting enough hours of sleep is an equivalent method for obtaining additional growth periods. Boosting the current length by a few steps Only: pay attention to the standing and sitting position: a good position must be adopted, with a tight back and shoulders slightly backward, as this position gives a much longer appearance than it is. Wearing clothes that highlight the lines and contours of the body: loose clothes hide these features, so the person appears smaller or shorter Than it is, but inevitably it should not be overstated Clothes because they are uncomfortable and hinder the flow of blood. Wear dark clothes. Color: especially if all clothes are dark, that is, upper and lower clothes, since the appearance of the body appears thinner, which gives a longer appearance. Wearing clothes with vertical stripes: the body appears to be taller, unlike clothes with cross lines that give the body a shorter appearance, therefore it is preferable to avoid clothes with cross lines.

 Among the common problems among children, and this problem has a major impact on the hearts of children. It is important to know that the length of children varies from one child to another, and the reason for this difference is due to environmental and genetic factors as well, and thus the short stature means that the length of the child is less than the third level It is worth noting that the length of the newborn is about half a meter, and when he reaches the year he is seventy-five centimeters in length, then his height increases about 5-7 cm each year until he reaches adulthood about (150 cm) so the growth of the child is considered slow if less than 4 cm a year
There is a mathematical equation used to find the average inherited height of an expected height after the age of 19 years and they are:
Add the father and mother length together, then divide the summation by two, then add the number fifteen to the result, and the end result is the expected length number,
Sometimes the length of the parents is a genetic mutation, so the children do not inherit it, and they come shorter, and the length of 170-175 cm is considered the ideal and acceptable average length, so that the owner is considered neither tall nor short.
When does height stop for young people ?? Height increases rapidly in males at the age of twelve and fifteen, and in most cases the male length continues to increase until the age of eighteen with a little thing, then it stops, but bone growth stops at males at the age of nineteen with an increase or decrease in a year Or at least two years, and only muscle growth continues.
Height growth stops for females around seventeen,
And the opportunity to increase height after the age of nineteen is very small,
Causes of short stature children
1- Genetic genetics
Genes are made from the DNA that determines the length of growth and is also responsible for their development until the end of adulthood. The genetic program is responsible for stopping growth due to one mutation in one gene that guides the production of growth hormone.
2- The lack of growth hormone
When there is a short stature in one or both parents, parents should focus on improving the diet of their children before puberty to help the body build healthy cells that do from lengthening the bones and thus lengthening the stature, there are possibilities for genes to lengthen the stature but the lack of growth hormone may be the reason The height increase stops prematurely
3- Health care
You will not believe that emotional deprivation or disease deprivation may be real reasons behind stopping height and growth because lack of care slows growth and is practical
4- Sometimes medical conditions, such as:
Short stay and late puberty
Patients with short stature usually demonstrate during adolescence, and failure of growth in most cases is associated with delayed puberty, although there are exceptions. Although the mechanisms that initiate the process of puberty are not well understood and although they are partly related to heredity, there is probably a threshold for body weight that acts as a trigger for normal puberty in boys (intermediate [+/-] 2SD for stage 1 is 12 [+/-] 2.5 years) and girls (Stage 1 is 11.2 [+/-] 2 years old, and menstruation starts at 13 [+/-] 1.9 years.) Young adults with delayed puberty are often underweight when they see a doctor and are as young as children. In rare cases, patients review at a later stage of life without the failure of puberty they have been investigated, and in this case, long bone screens have not been closed by sexual steroids. These people have Eunuchoid proportions, i.e. they tend to be taller than the palace and have long hands and legs relative to the length of the trunk.
Reasons for short stature.

With delayed puberty: structural / familial.
Systemic disease (such as asthma, malabsorption, celiac disease, cystic fibrosis, kidney failure).
Psychological distress.
Neurotic ointment.
Extreme physical effort.
Hypogonadism (see Table 16, also Turner syndrome in girls).
Other endocrine diseases (such as Cushing’s syndrome, primary hypothyroidism, and pseudo-hypothyroidism).
Without delayed puberty:
Isolated growth hormone deficiency.
Previous puberty with epiphyseal closure (such as congenital adrenal hyperplasia, McCon-Albright syndrome and frequent histiocytosis in Langerhans cell).
There is a previous problem that limits growth and has now been cured (such as failure of intrauterine growth, congenital heart disease).
Structural anomalies (such as Achondroplasia, a mucopolysaccharide drug).
A clinical evaluation:
Patients who have short stature with delayed puberty must obtain a general medical history and perform a clinical examination. The current height and weight should be lowered and the progression of puberty assessed on normal growth charts (see Figure 12). Figure 12: Differential diagnosis of short stature growth diagrams. Parent lengths, older siblings, and age at which puberty development occurred may support the diagnosis of Constitutional pubertal delay. The final length at 95% of normal children is within 8.5 cm of the median parent length. Previous childhood development measurements that can usually be obtained from school health records are useful. Children with growth hormone deficiency are usually young during the previous period, while the change in the speed of growth that leads to the intersection of percentages [moving to a lower percentage line] reflects on Most likely a recent disease. Patients with HGH deficiency (fill) descriptively with increased subcutaneous fat. They are therefore short, but not underweight. Anosmia suggests the possibility of a Kallmann’s syndrome caused by isolated GnRH deficiency. Some light hair may develop in the armpits and pubis due to the production of adrenal androgens, however the patient is hypogonadal. The psychological effect of short stature and sexual immaturity on the young patient needs careful attention because that is the main determinant if the specific treatment is appropriate or not.
Surveys:
Before the blood sample is taken, ask the patient to do the exercise (for example, running up and down the stairs or running around the car park until it becomes breathless) in order to alert the growth hormone secretion (normal more than 15 mmu / l). Measurement of growth hormone, testosterone (in boys), estradiol (in girls), LH, and FSH are performed. Systemic disease screening tests include blood tests, kidney and liver function tests, and thyroid function.
Antigliadin and antimyosin are a useful means of screening for Celiac disease. A simple carpal radiography should be compared to a set of standard images for bone age. The bone age is late in puberty and hypogonadism and is advanced in other cases, for example after early puberty. There are other tests that are performed when you suspect growth hormone deficiency or hypogonadism, hypogonadism, and these tests are described later. It should be noted that growth hormone responses to alert the normal state in children around puberty need to pre-supply the pituitary gland with sexual steroids for several days and that the growth hormone secretion is weakened by the presence of any other systemic disease. Detection of the presence of hypogonadotropic hypogonadism must be followed by a chromosome analysis to detect Turner syndrome (XO, 4545 with a female phenotype) or Klinefelter syndrome (XXY, ء47 with a male phenotype).

Measure: The treatment of specific endocrine adenomas was discussed elsewhere. In patients with delayed puberty, puberty can induce puberty by using low doses of oral estrogen for girls (for example, Ethinylestradiol by 2 micrograms per day) or testosterone in children (for example Depot testosterone ester injection at a dose of 50 mg intramuscularly each month). Higher doses carry the risk of early adhesion of the epiphysis. This treatment must be given in a specialized clinic, with monitoring the amount of improvement in order to ensure the occurrence of puberty internally, and then the preparatory treatment can be stopped, usually within less than one year. Isolated growth hormone deficiency is treated daily with subcutaneous growth hormone injections. Growth hormone also has a confirmed role in Turner syndrome and in chronic kidney failure. As for its use in children of short stature without proving the presence of endocrine glandular anomaly, it is controversial, as current growth speeds up but does not lead to an increase in the final length. Patients who have reached puberty and have giants joined together cannot be induced to grow more.
Causes of delayed puberty for unisex and its treatment
Definition of puberty: –
Puberty is the stage in a person’s life during which the formation of the main and secondary reproductive organs is completed. It includes the internal and external reproductive organs. At this stage, the bone growth in the body increases and various psychological and physical changes appear as the adrenal cortex completes and the androgen secretion increases in a greater stage (6). – 8) for females and (7-9) for males. The genital secondary signs are the appearance of hair under the armpits and pubic hair in females and their appearance throughout the body in different males. As for the main ones, it appears in the normal growth of the male and wet dreams of the boys, the start of the menstrual cycle and the natural growth of the breasts and the external organs of the female.
The stages of breast growth in girls: –

Breast growth
Annual age
Bone age
1-2
Before adolescence and the beginning of the enlargement of the nipple and around it8.5 – 13.38.5 – 13.2

3 -Breast enlargement and palpation of the glands9.8 – 14.610.2 – 14.0
4 –
Increased breast enlargement nipple11.4 – 15.011.5 – 15.0
5 -Female adult full growth11.6-16.412.5 – 16.0
6 -Adolescence among girls and the beginning of the menstrual cycle9.9 – 14.911.3 – 13.6

Natural growth of testicle size and average height in males compared to the great age: –

Testis volume (ml)
Annual age
Bone age
1-
4

2-
4 – 5
9.2 – 14.2
9.0-14.2
3-
7 – 11
10.5 – 15.4
10.5 – 15.0
4-
9 – 17
11.6 – 16.0
12.5 – 16.0

Delayed puberty:

• If there are no signs of growth for the reproductive and secondary organs until the age of 13 years for girls and 14 years for boys, we call this stage delayed puberty. This situation causes many psychological troubles for the persons concerned and their parents and fears of the gravity of the situation except for the general social effects. In order to treat delayed puberty we must discover the reason that led to this and examine the person concerned and see his parents together.
  Causes of delayed puberty:
  1 – benign growth retardation: it is characterized by a short stature with a delay in the age of the bones and a decrease in the androgen hormone rate, this type occurs family where it was found that 50% of patients complain of their parents or some members of their family of the same problem.
  2 – hypogonadism and caused by a defect in the secretions of the pituitary gland or hypothalamus (the hypothalamus gland in the brain), and this type has various reasons, the most important of which we mention:
  For males: –
  In males, a decrease in the secretion of reproductive hormones occurs with an increase in the secretion of the pituitary gland due to congenital diseases such as the Klinefelter syndrome where the person has an extra chromosome (47 XXY) instead of the normal (47 XY), or because of a disturbance in the formation of the male hormone (testosterone) and other diseases .
  This may occur due to acquired diseases such as testicular injuries or surgery, atrophic testicular syndrome, testicle inflammation, radiotherapy or inhibitory drugs for any reason which leads to a lack of normal sperm growth.
  This may also happen when hypopituitarism and hypogonadism are caused by diseases of the hypothalamus (hypothalamus gland in the brain), which are multiple such as familial hormone deficiency and Kalman syndrome (hypo secretion and inability to distinguish odors), tumors and injuries, as long as hypopituitarism Complete or decreased growth hormone secretion or tumors that affect it leads to growth retardation.
  And some other diseases in the body lead to growth retardation, such as: fibrocystic disease, chronic kidney failure and inflammation of the intestine (Crohn’s disease).
  For females:
  Decreased secretion of gonadotropin hormones with increased pituitary gland secretion occurs in females congenitally in Turner syndrome and other diseases where there is an imbalance in the genital chromosomes (XO / XY, XY), or lack of growth of ovaries and early ovarian failure and may be caused by diseases Acquired as immune ovarian inflammation in Addison’s patients and in thyroid inflammation and may arise due to injuries or surgeries. Decreased secretion of the gonads and pituitary gland (or hypothalamus – the sub-Mahdia gland), such as a lack of secretion of the hormone stimulating gonads and can be family, and a lack of food reproductive hormone (GONADOTROPHIC), with the lack of the ability to distinguish odors (Kalman syndrome), tumors and injuries, and affect diseases Chronic growth, including a lack of appetite for nervous food, patients with fibrous vesicles, chronic kidney failure, Crohn’s disease.
  Symptoms:
  The girl complains of not having breasts or not starting the menstrual cycle despite reaching fifteen years of age, and the male complains of short stature, small genitalia and obesity, and it should be remembered that the appearance of the armpits and pubic hair does not mean that the growth of the main genitals is normal, and boys complain of the small size Testicle: less than 4 ml.
  It is sometimes difficult to diagnose the condition and differentiate between benign delay in patients unless there are clear signs of some of the causative diseases. Therefore, a comprehensive clinical medical examination must be conducted. The necessary tests have been identified to be able to give the necessary treatment and it is recommended that this be done early so that the condition does not reach It cannot be completely cured.
  Tests:
  Determine the age of the bones.
  A ray of the Turkish chair.
  Examination of the girl’s reproductive chromosomes to prove or deny Turner syndrome and in boys to deny the Klinefelter syndrome.
  Measuring the reproductive hormone (testosterone in boys and estradiol in girls), and measuring hormones stimulating their production (pituitary hormones), such as (ESTRADIOL, TESTOSTERONE, PROLACTIN, FSH, LH, TFT)
  Sonar pelvis in girls to see ovarian and uterus growth.
  Biopsy of the testicles.
  treatment :

Benign delay: This type does not need treatment in the natural way, but rather needs to understand the person and his family for the situation and related to giving hormones in this case psychological disturbances to the person, if there is an urgent need can be given the following:
Male hormone (testosterone) 50 mg per month for 3-6 months for boys to stimulate sexual development. This hormone with this dose does not negatively affect longitudinal growth. HCG can be given in different doses.
Girls give small amounts of estrogen (female hormone) for six months.
Hormonal deficiency:
Males give 50 – 250 mg / month the male hormone subcutaneously or in tablet form, or inject the HCG hormone in different doses.
Girls can be given small amounts of estrogen by mouth, such as ethinyl estradiol, 0.1 micrograms / kg body weight per day, followed by administration of combined pills (estrogen and progesterone to stimulate the cycle).
The female.
Early puberty, both sexes.
It is a medical condition in which some or all of the signs of puberty appear before the normal age, and this age is set at the age of eight years for females and ten years for males.
A physiological view controls the hormones of gonadotropins, that is, stimulating gonads (LH + FSH), which are secreted from the pituitary gland, which controls whether or not puberty begins, as it increases the activity of the gonads (ovary or testis). Estrogen (from ovarian and adrenal) or testosterone (from testicle and adrenal) and the effect of these two hormones is what causes puberty signs.
Reasons:
It is important to know the cause of precocious puberty, so did it happen due to an increase in the quadotropin from the pituitary gland or without an increase in quadotropin.
If there is an increase in quonadotropins, then the cause is often from the brain (central), such as brain tumors or pituitary or autoimmune unknown cause.
Firstly, central hormone gonadotropins are low.
The causes are either adrenal, ovarian, or testicular, such as benign or benign tumors or a disease called Mcune Albright, or it may be the use of drugs that contain stimulating hormones to reach like some creams or medications.
Necessary checks
Measuring the gonadotropin stimulating hormones (LH – FSH).
Measuring estrogen or testosterone.
Pelvic ultrasound: adrenal, ovary.
▪ magnetic rays of the brain.
Treatment
According to the cause: If the cause is central, then the need for a hormone for pron (leprolide) is stimulated and inhibited at the same time and prevents the secretion of quanadotropins. If the cause is decentralized, then the cause is treated, for example, adrenal or ovarian tumors, which are eradicated, usually if the patient is treated early, the results are excellent and one of the most important things that should be avoided is the short stature accompanying early puberty. .

Gynecomastia in men 14-

 

Causes and methods of treatment.
. To avoid the resulting embarrassment
Gynecomastia in men is not a serious problem, but it sometimes becomes very embarrassing, and some people may suffer from breast pain as well, and it may even lead to a discharge from the affected nipple.

The problem of gynecomastia in men is a problem due to an imbalance between the hormones estrogen and testosterone, and it may affect only one breast or both breasts in a homogeneous or heterogeneous manner at times, 1- it may also affect newborns,
2 – Boys of puberty during puberty, there is a defect in the levels of hormones, which may cause an increase in the percentage of female hormones in the male for a certain period leading to an increase in the size of the breast. This usually lasts for gynecomastia in men
Causes and methods of treatment.
. To avoid the resulting embarrassment
Gynecomastia in men is not a serious problem, but it sometimes becomes very embarrassing, and some people may suffer from breast pain as well, and it may even lead to a discharge from the affected nipple.
The problem of gynecomastia in men is a problem due to an imbalance between the hormones estrogen and testosterone, and it may affect only one breast or both breasts in a homogeneous or heterogeneous manner at times, 1- it may also affect newborns,
2- Boys in adulthood During puberty, hormonal ratios occur, which may cause an increase in the female hormones in the male for a certain period leading to an increase in the size of the breast. Usually this condition lasts about 6 months to two years, then it disappears, and in some cases it lasts more than two years.
3- Older men due to the process of changing the natural hormones that occur in these age periods. This problem will disappear on its own if it occurs in the aforementioned age periods, and it may continue until after that due to an organic cause or imbalance in the hormones,
4- Unfortunately, most of the cases that took me back to the clinic from using stimulant hormones to build muscle to convert from male hormones to female hormones
Or some of the drugs that may cause this condition, which include anti-androgen medications used to treat prostatic hyperplasia, AIDS drugs, anti-anxiety medications, depression, and chemotherapy in cases of cancer, alcohol, and some antibiotics.
5 – the presence of a genetic disease or a lack of growth hormone or some cancers affecting the testicle or adrenal or pituitary food, increased secretion of thyroid hormones or liver failure and cirrhosis,
•• Methods of treating gynecomastia in men in most cases the problem of gynecomastia disappears without resorting to any type of treatment, but in the case that it continues, the doctor must take a healthy history from the patient and do a medical examination and after the x-rays and analyzes necessary to determine the most effective treatment plan for the patient.
** The first option is the treatment without surgery, which is summed up in a group of drugs that restore the hormone estrogen and testosterone again, such as tamoxifen, raloxifene, and dostinex in the event of an increase in the prolactin hormone (milk hormone)
** The second option is surgical intervention, and it consists of two types. The first is liposuction of the fatty tissue present in the breast, leaving the glandular tissue. The second type is the process of removing the breast with adenocarcinoma and adipose tissue. This process is often performed laparoscopically to reduce the recovery period.

15 – Cushing syndrome

First: increased cortisone (Cushing’s syndrome): adrenal gland

Cushing’s syndrome is a medical condition that results in an increase in cortisone, most often affecting people between 30 and 50 years old or who have been exposed to steroids for a long time. The hormone cortisone is secreted from the adrenal gland under the action of the adrenal stimulator of the pituitary gland, which is controlled by another stimulating hormone secreted from the hypothalamus called CTH. The cortisone is secreted at 12.5 mg per square meter of body area per day and if the body is exposed to a greater amount of this it may appear on it Changes known as cushing syndrome.
Cortisone function
1- Maintaining blood pressure and salts – sodium and potassium naturally.
2- Balancing the effect of insulin and protecting the body from low sugar.
3- Protecting the body from internal immune rejection.
4- Adjusting the balance of protein, fats and carbohydrates in the body.
5- Resisting tension by producing more cotizone.
* How does the disease appear ??
Most of the affected individuals have a distinctive morphology including a round red face, obesity in the upper half of the body, increased fat around the neck, and upper back, weakness in the muscles of hands and legs, and slow growth in children. The skin becomes thin, easily bleeding and scratching, with slow wound healing. Purple and red stripes in the lower abdomen, thighs, and arms.
Osteoporosis and exposure to fractures, menstrual disorder and increased hair growth in women, headache, depression, anxiety, chronic fatigue, high blood pressure, and high blood sugar.
This disease should not be confused with other similar diseases such as obesity, ovarian cyst and depression, as there are some similar symptoms between these diseases.
Causes of illness
We also mentioned that Cochin syndrome is caused by exposure to excess hormone cortisone or other steroids for a long time in an amount exceeding the body’s need.
1- Either the quantity is high for reasons outside the body, such as giving medicines that contain cortisone and its derivatives.
2- Or for internal reasons, including the tumors of the pituitary gland, which constitute 70% of the internal causes, known as {Cushing’s disease}, and affects the female five times more than the male.
3- Adrenal gland tumors: This type also abounds in women within the limits of 40 – 50 years. Most of these tumors are adenomas benign, but cancerous ones are less prevalent and cancerous ones are characterized by the rapid onset of pathological signs and a very high elevation of cortisone.
4- Other tumors that secrete the stimulus of adrenal ACTH outside the pituitary: In most pulmonary tumors, they appear in males more than in females.
* How is the disease diagnosed ??
1) Ensuring that the patient does not take any medications that contain cortisone or its derivatives such as prednisolone and dexamethasone or even ointments and creams that contain these hormones in large quantities.
2) Measurement of the hormone cortisone in the morning and ACTH periods
It is measured by evening, since in normal cases, the hormone is low in the evening before bed and high when waking up in the morning. In cases of Cushion, the hormone rises in the evening and the length of time remains high.
3) Measuring the free cortisone in the collected urine within 24 hours.
4) Measurement of cortisone after giving a dexamethasone dose by mouth.
5) CT or magnetic beams of the pituitary or adrenal gland to ensure the absence of tumors.
Treatment

According to the cause of the disease, if the cause is medications, it works to stop them gradually. If it is a tumor in the pituitary, it is removed by surgery, as well as for adrenal tumors, it is removed surgically.

16-: Adrenal insufficiency (adrenal) hypothyroidism
Adrenal insufficiency occurs due to a lack of hormones cortisone and aldosterone and this may lead to serious or fatal complications in some cases, and affects the disease from 1-4 per 100,000 people, and affects both males and females at all ages.
* Adrenal function
It is known that the adrenal gland consists of the pulp and the cortex and secretes the hormone adrenaline and noradrenaline, and they are known as a hormone of fear and anger, as it prepares the body to prepare for dangers and affect the muscles and increase the amount of blood flowing from the heart, etc.
As for the cortex, it secretes hormones cortisone, androstenedione and aldosterone, and it works to maintain the level of salts and water and prevent low blood sugar and blood pressure, as well as to withstand physical and psychological stress.
Causes of adrenal insufficiency
Immune rejection: This is known as Addison’s disease, and it is one of the most common causes, and it constitutes about 80% of the causes.
Infections: such as tuberculosis, spinal fever, malaria and septicemia.
Carcinomas and hemorrhagic diseases.
Genetic diseases: abundant in children such as adrenal enlargement and adrenal insufficiency.
Centralization: This includes the weakening of the pituitary gland and the hypothalamus.
Symptoms

Symptoms usually begin gradually and are difficult to detect for a non-specialist. Common symptoms are persistent fatigue, muscle weakness, loss of appetite, increased desire to eat salt, weight loss, as well as nausea, return and a drop in blood pressure, especially when suddenly standing up. As well as increased brown skin spots, especially in the appearance of the fingers and the inside of the hand, the effects of old wounds and the appearance of a dark color on the oral membranes.
* Tests
Sodium and blood sugar may be low and potassium elevated, especially during seizures, as well as low blood cortisone. Measurement of cortisone after stimulation of the pituitary hormone stimulating the adrenal ACTH, where the cortisone rises in natural conditions, and does not rise in pathological cases. A pituitary stimulation test with CRH to see if the pituitary secretes ACTH.
Treatment
Chronic conditions are treated by giving hydrocortisone by mouth twice daily in addition to fluoronium once a day to regulate blood pressure, while critical cases give cortisone 100 mg intravenously immediately then 100 mg every 6 hours for a day to two days, in addition to fluids in good quantities intravenously as well, patients are also advised By increasing the dose of Hydrocortisone twice the dose followed when exposure to other diseases and for three days to avoid getting into Addison’s shock.

17- VICTOSA / SAXENDA

What is the product Viktoza and Alexandra?
It is an injection given under the skin and is now approved by the American Food and Drug Administration to lose weight and it is only a drug that was used for diabetes (the type that is not dependent on insulin) and is injected under the skin and helps in the following:
1- Control blood sugar levels
2- It increases insulin hormone production and low blood glucagon level
3- Slows the emptying of food from the stomach and reduces the intake of more food and then reduces weight in a noticeable way by activating the satiety center in the brain.
4- It prevents the liver from making too much sugar
You should not use Viktosa and saxenda in the following cases: –
1- If you are allergic to allerglotide, which is the effective substance for Viktuza
2- If there is a personal or family history of medullary thyroid gland cancer, difficulty swallowing, vomiting, or shortness of breath
3- Pancreatitis (severe abdominal pain, which extends to the back with or without vomiting
4- Kidney problems or diseases
5- Low blood sugar or symptoms of low blood sugar, such as dizziness
Severe sweating, dizziness in the eyes, mood swings, headache, fast heartbeat, and feeling very nervous)
6- Inflammation in the gallbladder or gallstones
7- Liver disease or alcohol consumption
8- The patient’s age is not less than 18 years
9- In cases of pregnancy and lactation
HOW TO USE VICTOSA AND SEXANDA: –
Vicotosa is used in conjunction with diet and exercise and is injected under the skin (intravenous or muscle injection is not carried out) and is injected into the upper arm, thigh or abdomen and injections are made without regard to meals and day and time times, and the best time after one meal is eating –
0.6 mg is injected daily for one week, then the dose is increased to 1.2 mg, and the dose can be increased to 1.8 and then to 3 mg – the condition should be evaluated after 16 weeks, and treatment will be stopped if the weight does not decrease below 4% of the basic weight with a loss of 5-10% of the mass The body is being studied on different types of injections taken once a week
The most common symptoms caused by the use of Vicosa and saxanda: –
Nausea – diarrhea – headache – vomiting
What are the tests that should be done before taking Vicosa and saxanda?
Clinical examination should be done to ensure that there are no symptoms of pancreatitis and that there is no thyroid cancer in the family – then the following laboratory analyzes are carried out: –
Blood sugar – liver function – kidney function – cholesterol and blood lipids – vitamin D – pancreatic enzymes – thyroid gland and calcitonin measurement for the diagnosis of thyroid cancer – and some other tests that may be determined by the attending physician

We wish recovery to everyone