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Surgery

Nandrolone decanoato: come funziona, efficacia

Deca Durabolin-descrizione

Uno dei farmaci popolari per aumentare l’efficacia dell’allenamento e aumentare rapidamente la massa muscolare è “Deca”, che è stato ampiamente utilizzato per la maggior parte a causa del suo effetto positivo sul corpo, combinato con una probabilità estremamente bassa di effetti collaterali, nonché una facile tolleranza alle iniezioni. Il corso di Nandrolone decanoato di solito non dura più di 16 settimane, ma molti atleti assumono questo anabolizzante e più a lungo.Sul sito Web Testosteronesteroid è sempre la migliore selezione di steroidi e farmaci per PCT.

Il decanoato di nandrolone è stato creato nel 1960. Due anni dopo, è stato attivamente utilizzato per risolvere problemi medici. Il primo produttore della tavola armonica era la famosa azienda olandese Organon. Molto rapidamente, lo steroide è stato notato dagli atleti e oggi continua ad essere uno degli AAS più popolari utilizzati dagli atleti. Al momento, ogni produttore di sportfarm nella linea di prodotti ha questo farmaco.

I principali vantaggi del decanoato di nandrolone sono:

  • Accelerazione multipla del guadagno muscolare.
  • Rafforzamento dei legamenti e del tessuto osseo
  • Aumentare la resistenza e ridurre il dolore alle articolazioni.
  • Rigenerazione rapida, soprattutto dopo lesioni.

Come funziona la tavola armonica

Deca è una sostanza sintetica derivata dall’ormone maschile. Questo è un anabolizzante prolungato, sotto l’azione di cui il corpo aumenta significativamente la velocità di produzione di composti proteici, nonché l’azoto, il potassio, il calcio e il sodio vengono trattenuti. Tutto ciò contribuisce alla rapida crescita dei tessuti muscolari e al rapido recupero da gravi lesioni.

I bodybuilder usano il nandrolone decanoato (noto anche come Deca) per aumentare la massa muscolare, perché a differenza di altri farmaci, dopo la fine del corso, la massa praticamente non diminuisce e l’effetto complessivo si manifesta dopo diverse settimane di assunzione. E sebbene in rari casi si verifichino effetti collaterali, tutto ciò può essere evitato semplicemente osservando il dosaggio. Altrimenti, potresti iniziare a visitare mal di testa, acne, sbalzi d’umore estremi o Deca-dick.

Durante il corso con la tavola armonica, è necessario assumere testosterone, poiché il nandrolone tende a ridurre il contenuto di questo ormone nel corpo. Oltre al testosterone, ci sono altri farmaci che, se combinati con la tavola armonica, danno un effetto eccellente, come Winstrol e Methandrostenolone.

Profilo steroide

  • Il componente di lavoro del farmaco è attivo per quindici giorni dalla data di somministrazione.
  • Il farmaco ha proprietà anaboliche e androgene in un rapporto di 150 a 30 rispetto al testosterone.
  • Poiché l’attività estrogenica dello steroide è minima, gli effetti collaterali di questo tipo non si manifestano sul corso.
  • Il decanoato di nandrolone ha attività progestinica, che rende necessaria l’introduzione del ciclo di cabergolina.
  • La velocità del processo di aromatizzazione è minima.
  • Non è in grado di convertire in diidrotestosterone.
  • In grado di inibire la produzione di ormone maschile endogeno.
  • I metaboliti dello steroide possono essere rilevati per un periodo compreso tra 22 e 24 mesi.

Nandrolone, Deca, Durabolin nel bodybuilding

Effetto e proprietà di nandrolone decanoato

Il nandrolone, sebbene sia un derivato del testosterone, ma a differenza di esso ha un effetto anabolico più pronunciato a causa della natura androgenica variabile. E allo stesso tempo, è inefficace da solo, il che richiede il tandem con il testosterone, che consente di ottenere un effetto anabolico più equilibrato con meno sviluppo di reazioni negative quando si utilizzano farmaci per separazione. Sul sito Web di Anabolizzanti Naturali è possibile trovare una vasta gamma di preparati di qualità per risultati elevati nello sport.

Farmacocinetica

Il nandrolone è creato sinteticamente, ha una diversa azione anabolica prolungata a seconda del suo estere (decanoato, fenilpropionato). Lo steroide stimola la sintesi, il trasporto e l’accumulo di proteine nei tessuti del corpo, aumentando così la ritenzione di azoto nei muscoli, che porta ad un forte aumento del loro volume del 15% nel primo mese del corso.
Tra le altre cose, l’accumulo di altre sostanze, sia benefiche che dannose, aumenta, quindi il risultato complessivo e gli indicatori di salute dipenderanno direttamente dalla qualità della nutrizione.

A livello molecolare, la struttura del nandrolone è identica al testosterone, l’unica differenza è la mancanza di un gruppo metilico 19, che ha causato il suo nome aggiuntivo «19 – nortestosterone». Questa caratteristica della struttura ha permesso di migliorare la stabilizzazione dei recettori, che ha permesso loro di rimanere nelle cellule nella fase attiva molto più a lungo e quindi di mantenere l’effetto anabolico stesso più a lungo (la funzione della sintesi e dell’accumulo di proteine nelle cellule).

In realtà, tutto ciò rende nandrolone un anabolizzante molto migliore del testosterone. Se si confrontano nandrolone e testosterone somministrato in proporzione uguale, la quantità di nandrolone somministrato si lega meglio ai recettori degli androgeni rispetto a una quantità simile di testosterone. Ma le caratteristiche di tale connessione hanno i loro svantaggi se si usa il nandrolone solo da solo.

Proprietà di irrigazione

Le proprietà positive del nandrolone includono un’attività completamente diversa degli androgeni, a differenza del testosterone e dei derivati del DHT, che a sua volta riduce l’aggressività alla prostata, meno spesso ci sono problemi con la pelle e i capelli. Pertanto, gli utenti di questo farmaco sono meno inclini allo sviluppo di ipertrofia prostatica, acne e perdita di capelli.

Tuttavia, allo stesso tempo, ci sono svantaggi in termini di libido e stimolazione neuromuscolare, in seguito alla quale anche l’uso del nandrolone da solo non è un’opzione e quindi non si può fare a meno di una combinazione competente di sostanze e alcuni trucchi.

Il profilo steroide di nandrolone decanoato è il seguente:

  • Attività anabolica-150%.
  • Attività androgenica-30%.
  • L’attività progestinica è lì.
  • La capacità di aromatizzare è minima.
  • Il derivato deidrotestosterone (DHT) non lo è.
  • La ritenzione idrica è media.
  • L’impatto sul fegato è molto basso.
  • La pressione sanguigna è Nella media.
  • Acne-sotto la media.
  • Forma di rilascio-iniezioni.
  • L’emivita è fino a 7 giorni.
  • Sfondo attivo – fino a 2 settimane.
  • Ritardo nel corpo (sfondo generale) – da 5 a 6 settimane. Il tempo di rilevamento per il controllo antidoping è di almeno
  • 2 anni.
Upper and Lower Jaw Advancement with Special Surgery for Sleep Apnea and Snoring

Upper and Lower Jaw Advancement with Special Surgery for Sleep Apnea and Snoring

Mechanism and Causes for Obstructive Sleep Apnea

Obstructive sleep apnea is the condition where breathing is interrupted during sleep. This is caused by insufficient space for the tongue in a retruded lower jaw. The tongue falls back into the throat during sleep and obstructs the airway. This results in a pause in breathing followed by a brief awakening with a popping sound.

The resultant hypoxemia causes frequent arousals throughout the night. These episodes of periodic wakefulness stimulate the sympathetic nervous system. This results in vasoconstriction and reduced peripheral blood flow. There is an associated increase in heart rate and blood pressure due to this.

This is an extremely disruptive condition that leads to snoring and interrupted sleep. The person feels sleep deprived even after a full eight hours of sleep. It is usually the person’s sleeping partner who first notices this condition. There is also excessive daytime somnolence due to the poor quality of sleep caused by sleep apnea.

Restless legs syndrome can also be a result of obstructive sleep apnea. Wearing oral appliances during sleep can help with obstructive sleep apnea. This helps maintain constant positive airway pressure. Risk factors for complications are minimal through these appliances can be cumbersome.

Sleep labs conduct studies to diagnose sleep disorders. There is often blockage of the upper airway in sleep disorders. Management of obstructive sleep apnea can both be done through medical and surgical means. Both are equally effective at correcting sleep-disordered breathing. These disorders can also cause loud snoring.

Prolonged sleep disorders can lead to high blood pressure and heart disease. This increases your risk for life-threatening events. Oxygen level drops drastically in obstructive sleep apnea. Tongue and soft palate fall back obstructing the throat and breathing. The patient needs to stay overnight during a sleep study.

Need to Undergo Sleep Study for Confirmation of Obstructive Sleep Apnea

A sleep study, which is known as polysomnography in medical parlance, is a test to diagnose sleep apnea. This is conducted in a sleep lab. The patient is hooked up to several monitors during sleep. These record the brain waves, level of blood oxygen, eye movements, heart rate, breathing and movement of extremities.

Patient Referred to our Hospital Following Sleep Study

The patient is a 21-year-old male from Secunderabad in Telangana, India. He stated that he has been plagued with disturbed sleep since he can remember. There were frequent episodes of interrupted sleep throughout the night. These episodes were accompanied by an audible popping sound.

He was also a heavy snorer. There was excessive daytime somnolence despite a full night’s sleep. He also complained of always feeling tired.

His parents had consulted a doctor in their hometown who had referred them for a sleep study. The results of the study came back indicative of obstructive sleep apnea. They were referred to our hospital for management since they requested the best surgical care.

Specialty Center for Jaw Correction Surgery

We have been performing jaw correction surgery for over 30 years now. Mandibular advancement with a bilateral sagittal split osteotomy (BSSO) is a specialty surgery performed at our center. Patients regularly undergo BSSO for asymmetry correction of the mandible. We use advanced digital facial biometric studies to ensure the best cosmetic and functional results.

Initial Consultation at our Hospital for Management of Sleep Apnea

Dr. SM Balaji, a Sleep Apnea specialist, examined the patient and ordered imaging studies. He analyzed the results of the sleep study in detail. The patient had a retruded mandible.

A treatment plan was formulated and presented to the patient and his parents. They were in full agreement with the treatment plan and consented to surgery.

Genial Tubercle Advancement and BSSO Advancement of Lower Jaw

Genial tubercles are bony protuberances that are situated on the lingual side of the anterior mandible. They are located bilaterally in the region of the lingual foramen. Two muscles are attached to the genial tubercle. These muscles play a very important role in the mechanism of sleep apnea.

They are the geniohyoid and genioglossus with the former pulling the hyoid bone forwards and upward. The genioglossus helps protrude the tongue and pull it to the opposite side.

In a retruded mandible, the pull from these muscles is not sufficient to keep the tongue from falling backward during sleep. Surgical forward positioning of the genial tubercle will help address this issue. The tongue also does not have sufficient space in a retruded mandible.

Successful Completion of BSSO and Genial Tubercle Advancement

The genial tubercle was advanced and stabilized anteriorly using plates and screws. This was followed by BSSO with the advancement of the mandible by 12 mm. The inferior alveolar nerve was mobilized with the proximal segment. Care was taken to ensure that there was no injury to the nerve throughout the surgery.

A Le Fort I maxillary osteotomy was next performed to ensure correction occlusion with the mandible. Occlusion was checked before stabilization with plates and screws. This also resulted in a dramatic improvement of the patient’s facial esthetics.

Resolution of Sleep Apnea with Normal Postsurgical Sleep Study

The patient subsequently underwent a sleep study in his hometown. All parameters were normal in this sleep study.

His obstructive sleep apnea symptoms had completely resolved. He had also stopped snoring during sleep. Oxygen saturation levels were normal.

His parents reported that he slept fitfully throughout the night. The patient also reported that he felt refreshed upon waking up. Daytime somnolence had also completely resolved.

Complete Patient Satisfaction with Treatment at our Hospital

The patient and his parents were delighted with the results of the surgery. His parents stated that he seemed like a new person with a lot of energy and focus. He too stated that there was a greatly improved overall quality of life.

They expressed their gratitude to the hospital staff for the care and attention rendered during their hospital stay.

Surgery Video

Open Rhinoplasty with reconstruction of philtrum

Open Rhinoplasty with reconstruction of philtrum

Patient born with bilateral cleft lip and palate deformity

The patient is a 7-1/2-year-old girl from Sadurangapattinam in Tamil Nadu, India. She was born with a bilateral cleft lip and palate defect. It was very severe. Her parents were extremely distressed upon seeing the degree of her facial deformity. They were reassured at the hospital that this could be surgically managed.

The incidence of cleft deformities among newborns is higher in the Sadras region than the national average. Many infants born with this deformity have been successfully rehabilitated in our hospital. Some of the patients who were operated on over 20 years ago are now happily married with children of their own.

The patient and her parents were referred to our hospital for surgical management of her cleft defects. It was explained to them that the road to total cleft rehabilitation was a long one. They stated a complete understanding of this. Plastic surgeons also perform this procedure in western countries.

She first underwent bilateral cleft lip repair at the age of 3 months. This was followed by cleft palate repair at 11 months of age. The premaxillary setback with bone grafts to the region of the cleft alveolus was also performed for the patient.

Continuation of the rehabilitation process at our hospital for the patient

Orthodontic consultation was also initiated for the patient. Our hospital is a super-specialty center for cleft orthodontics in India. She will need extensive orthodontic intervention in later years.

Her teeth are malaligned due to her cleft deformity. She also has a few congenitally missing teeth. The remaining teeth will need to be brought into perfect alignment. Dental implant surgery would ensure the replacement of her missing teeth. This final step would complete her rehabilitation. Soft tissue molding would also be perfect following this step.

She still had nasal deformities that needed to be corrected. There was a collapsed columella. This caused extreme flattening of her nose. She also had a very blunt nasal tip. Some patients also have asymmetry of the alar bases.

There was also stunting of the prolabium with a resultant short upper lip. The patient was instructed to present for correction of these deformities.

Surgical planning for correction of her collapsed columella and stunted prolabium

Dr. SM Balaji, cleft nose correction surgeon, examined the patient and obtained pertinent studies. The patient would require an open rhinoplasty with the reconstruction of philtrum. It was decided to reconstruct her collapsed columella with a flap dissected from the prolabium. The resultant prolabium defect would be reconstructed using a lower lip Abbe flap.

It was explained to the patient that she would not be able to open her mouth for two weeks following surgery. This period would enable revascularization of the Abbe flap from the upper lip tissue. They were in agreement with the treatment plan and consented to surgery.

Cosmetic and functional rehabilitation of her cleft related deformities

Under general anesthesia, markings were made on the prolabium. This was followed by a dissection of the prolabium and the columella. The lower lateral cartilages were identified, dissected and separated.

Medial crura were sutured together as well as to the nasal septum. This would ensure a sharp alar dome. Prolabium was then utilized to reconstruct and lengthen the columella.

A full-thickness Abbe flap was then raised from the lower lip to reconstruct the prolabium. Extreme care was taken to ensure patency of the inferior labial artery in the flap tissue. The flap was then sutured to the region of the upper lip defect.

Blood supply would be from the inferior labial artery until the establishment of supply from the upper lip. The inferior labial artery is a branch of the facial artery. This arises near the angle of the mouth, at the region of the edge of the lower lip

Separation of the lower lip flap from the upper lip with good flap vascularity

Abbe flap was separated after a period of two weeks. There was good perfusion of blood within the upper lip flap. She now had a sharp nose with a long columella. Her nose now had a straight profile.

The upper lip also had adequate length due to the lengthened prolabium. This provided increased lip tissue for her to appose her lips together. Visible scar tissue was also negligible following the surgery. She expressed her satisfaction with the cosmetic results from the surgery. Her parents too were very happy with the results of the surgery.

Surgery Video

Jaw Reduction Surgery with Wisdom Tooth Surgery

Jaw Reduction Surgery with Wisdom Tooth Surgery

Patient with a Hereditary Tendency for a Large Lower Jaw Running Through his Family

The patient is a 24-year-old male from Ludhiana in Punjab, India. He has always had a large lower jaw. This caused an unattractive facial structure. The scientific term for this is mandibular prognathism. Many members of his family also have a large lower jaw.

Functional and Esthetic Difficulties Caused by Mandibular Prognathism

This has caused him to have problems with eating and speech. He has also felt very self-conscious because of the cosmetic compromise from the large jaw. Desiring to get this corrected, he and his parents made inquiries with many surgeons including dentists and oral surgeons. They had been referred to our hospital for surgical correction.

Certain syndromes have been associated with a large lower jaw. Acromegaly, which is a condition caused by excess growth hormone in adults results in mandibular prognathism. A percentage of these patients also have gum disease due to chronic mouth breathing.

Specialty Procedures performed in our hospital

A common term for a very large lower jaw is lantern jaw. The chin is extremely prominent and forwardly positioned. Mastication and speech are rendered very difficult in these cases. Patients undergoing facial feminization also undergo jaw reduction procedures.

Our hospital is a specialty center for jaw reconstruction surgery. Le Fort I surgery is performed for retrusion or advancement of the upper jaw. Distraction osteogenesis is also used for the advancement of the retruded maxillaLower Jaw Protrusion – Bilateral Sagittal Split Osteotomy Reduction and retrognathic mandible.

Jaw reduction surgery is routinely performed in our hospital. All these surgeries are performed under general anesthesia in our state of art operating theatres.

Initial Consultation and Examination at our Hospital

Dr. SM Balaji, Specialist in Jaw Surgery, examined the patient. A detailed history was also obtained. He then ordered imaging studies including a 3D CT scan. These are mandatory for patients undergoing jaw surgery.

This showed that the patient had a skeletal overbite of 12 mm. There was also a horizontally impacted right third molar. He had bilateral impacted wisdom teeth. These were also indicated for removal.

Treatment Planning Explained in Detail to Patient and his Parents

Treatment planning was modified as the patient wanted to undergo both procedures at the same time. The mandibular setback is usually performed six months after wisdom tooth extraction, but an exception was allowed in this patient.

The patient will first undergo presurgical fixed orthodontics to decompensate the arch. This would be followed by surgery and postsurgical orthodontics. The last stage of orthodontics would be fine-tuning his dental occlusion. They then consented to surgery.

Wisdom Tooth Surgery Followed by Mandibular Setback

Under general anesthesia, both impacted third molars were extracted. Sectioning of the left third molar was performed to enable easy wisdom tooth extraction. Attention was turned to the bilateral sagittal split osteotomy (BSSO) following wisdom teeth extraction. The bilateral sagittal split osteotomy would enable backward positioning of the lower jaw to achieve good alignment with the upper jaw.

Preservation of Inferior Alveolar Nerve throughout Surgery

Bilateral sagittal split osteotomies were made. The inferior alveolar nerve was mobilized with the proximal segment. This allowed for mobilization of the distal segment. A slice of bone 14 mm was removed from the site of the osteotomy.

The mandible was then set back and occlusion was checked. Stabilization of the mandibular segments was performed with plates and screws. Care was taken to ensure that the inferior alveolar nerve remained safe throughout the procedure.

Complete Patient Satisfaction with Results of Surgery

There was a tremendous immediate improvement in facial esthetics. The patient and his family were very happy with the results of the surgery. They expressed their satisfaction before their final discharge from the hospital.

Surgery Video

Lower Incisor Over Show Recorrection Genioplasty

Lower Incisor Over Show Recorrection Genioplasty

A patient opts for surgical creation of a more prominent chin

The patient is a 45-year-old male from Bhopal in Madhya Pradesh, India. Ever since he was a young man, he had always felt that he had a very small chin. He had always been dissatisfied with the shape of his chin. His desire was to have a prominent chin, which he felt would be more masculine looking.

Around a year ago, he finally decided to undergo chin enhancement surgery. He, therefore, got in touch with a facial cosmetic surgeon. Without any presurgical planning, the surgery had been performed on the very same day.

Dissatisfaction with the results of the surgery

A genioplasty had been performed with osteotomy of the chin. To his dismay, the patient realized that he could not close his lips fully. There was an unsightly excessive lower incisor overshow. He could not appose his lips.

Feeling distressed by this, he realized that his surgery needed to be redone. He began an exhaustive search for the best surgical facility to address his issue. His search repeatedly led him to our hospital.

Our hospital is a specialty surgical center for cosmetic resurgery. Many patients with botched cosmetic surgery elsewhere have undergone surgery with us with the optimal restoration of esthetics. Cosmetic lip surgery and redo rhinoplasty (revision rhinoplasty or nose job) are specialty procedures performed at our hospital.

Facelift surgery is routinely performed in our hospital. Facial plastic surgery procedures have helped many people lead fulfilling lives. Facial implants are used for correcting bony defects by plastic surgeons. Chin implant surgery is performed for enhancing retruded chins. This results in optimal chin augmentation.

Our hospital follows all the protocols laid down by the American Society of Plastic Surgeons. Head and neck surgery had rigorous guidelines that need to be followed for optimal results.

Treatment planning explained to the patient in detail

Dr SM Balaji, facial cosmetic surgery specialist, examined the patient and obtained imaging studies including a 3D CT scan. This revealed an enormous gap between the osteotomized chin and the mandible. It was explained to the patient that this gap needed to be closed as there was no new bone formation.

Care was taken to explain to him that the best course of treatment would be to reverse the previous surgery. The patient contemplated the findings presented to him and consented to surgery.

Successful reversal of his previous advancement genioplasty surgery

Under general anesthesia, a vestibular incision was made in the anterior mandibular region. The previous chin surgery with the titanium plates was exposed. There was extensive granulation tissue formation at the site of the bony gap in the chin.

The granulation tissue was carefully debrided. The titanium plates and screws holding the chin were removed and the chin was placed back into its original position. There was a good approximation of the osteotomized segment with the mandible. The incision was then closed and the patient was taken to the recovery room.

Patient happy with regaining previous facial dimensions after reversal of chin surgery

The patient’s chin had been placed back in its original position. Overshow of lower incisors was completely eliminated. He was extremely happy with the results of the surgery and thanked the surgical team before being discharged from the hospital.

Surgery Video

 

We are dedicated to giving each of our patients the healthy smile they deserve!