Mais la polymyxine n'est pas du tout absorbée dans le sang du système gastro-intestinal et n'a d'effet que dans l'intestin et est utile pour le traitement des infections intestinales amoxicilline prix Internet en y faisant des achats permettant d’économiser jusqu'à soixante-dix pour cent, tout en étant sûr de la qualité des produits pharmaceutiques.
Microsoft word - thermography intake form.doc
Thermography Clinic Inc. BREAST HEALTH HISTORY
Name: _________________________________________ Age: _____ Date of Birth: _______________________ Address: _______________________________ City: ______________________Postal Code _________________ Home Tel: ____________________ Work Tel: _____________________ E-mail ___________________________ Occupation: __________________________________________________________________________________ Marital Status: S M D W SEP. Number of Children: _____ Referred by: _______________________________
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Do you have a family history of breast cancer? r Self r Mother r Maternal Grandmother r Sister r Daughter r None
Do you have any diagnosed breast conditions? r None r Fibrocystic r Cystic r Other ______________________________________
Have you previously had a thermogram? Date of most recent _______________________ Was it: r Normal r Abnormal r Suspicious r Being watched
Have you had a mammogram? Date of most recent _______________________________ Was it: r Normal r Abnormal r Suspicious r Being watched
Have you had a breast ultrasound? Date of most recent_____________________________ Was it: r Normal r Abnormal r Suspicious r Being watched
Have you had a breast exam by a doctor? Date of most recent _______________________ Was it: r Normal r Lump Found
Any breast biopsies? When and what type (i.e. needle, core)? ___________________________
Any breast surgeries? When and what was done? ____________________
Have you had a mastectomy? When? _____________________________
Have you had radiation? When was it last performed? ________________
Have your had your ovaries removed? At what age? _______________________________
Do you have children. At what age was your first full term pregnancy? _______________
Did you nurse for at least three months? How long ________________________________
Are you currently taking birth control pills? At what age did you start? _________________ for how many years? ________________
Are you in menopause? At what age did it begin? _________________________________
Have you ever taken synthetic hormone replacement (ex. Premarin, Provera)?
Are you currently using natural progesterone cream? Applied to r Breasts only r Rotating body areas
Are you currently using herbals, homeopathic medicines, or supplements to stimulate or simulate estrogen? Explain ___________________________________________________
Do you feel that you are overweight? How many pounds overweight? _________________
Are you experiencing any of the following with your breasts?
A lump. Date found: _________________ by r Self r Doctor It is: r Hard r Soft r Mobile r Tender
Pain It is r Dull r Sharp r Burning r Stinging r Tender r Changes with my cycle
Skin changes (r Color r Texture r Over the lump)
It is r Bloody r Milky r Through one duct r through multiple ducts
Nipple changes r R r L Breast Change in: r Color r Texture
Other __________________________________________________________________
Place an [O] on the diagram in the exact area of the lump, finding on your mammogram, or area being watched, and an [X] in the area of pain, tenderness, thickening, or skin changes.
Please note any other concerns/issues you may have: __________________________________________
General Health Information
Do you have any medical complaints or conditions? Please explain ___________________ _________________________________________________________________________ r Y r N
Are you currently taking any medications? Please list ______________________________
_________________________________________________________________________
Please circle all of the following conditions which you have had:
Other ________________________________________________________________________________ r Y r N
Are there any of the preceding conditions after which you have never been totally well again, or which have been more severe than usual? Explain? ________________________
r Y r N
Have you had any operations? Which __________________________________________
Have you lost any weight recently? How many pounds? ____________________________
Do you exercise? How often? ________________________________________________
Have you had any major injuries? Explain _______________________________________
Are you taking any of the following substances? How much? Tobacco: _____________________
Alcohol: ___________________________________
“Recreational Drugs” _________________________
Have any of the following ailments affected your relatives? Alcoholism
FAMILY HISTORY Age if Alive Age at Death AILMENTS
Mother: Father: Brothers: Sisters: Children: Maternal Grandmother: Maternal Grandfather: Paternal Grandmother: Paternal Grandfather:
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HERBAL MEDICINE AND ANXIETY DISORERS Khan Usmanghani *,Abdul Hannan, Ejaz Mohiuddin, Muhammad Sakhi Sarwar *Department of Basic Clinical Sciences, Faculty of Eastern Medicine, Hamdard University, Sharah-e-Mohammad Bin Qasim, Karachi-74600, Pakistan Department of Pharmacognosy, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan. Mental disorders are on the rise throughout