Anxiety symptoms. Sleep Anxiety: Diagnosis and Treatment

Anxiety, excitement, anxiety- this is an obsessive feeling of anticipation of something unpleasant, often accompanied by depressed mood, loss of interest or pleasure in previously pleasant activities, as well as often palpitations, headaches, changes in appetite, and sleep disturbance.

Most often, these disorders are based on purely life situations that cause anxiety or are accompanied by uncertainty: experiences in the event of illness or death of relatives, loved ones, personal, family misfortunes; failures, unsettledness, troubles at work, unrequited feelings (love), expectation of an important event (for example, entrance exams, change in marital status), expectation of vital results, decisions, situations.

Anxiety, anxiety accompany some somatic diseases, which can be dealt with by simple means. Among these diseases, the most common are: increased activity of the thyroid gland (thyrotoxicosis), angina pectoris (impaired coronary circulation), low blood sugar (hypoglycemia), excess hormones produced by the adrenal glands, side effects of certain drugs, withdrawal syndrome - abstinence from nicotine, alcohol or drugs, sleeping pills.

The onset of an anxiety state largely depends on the personal qualities of a person, while the degree of mental stability, the form of worldview (optimistic, pessimistic), low self-esteem, loss of self-confidence play a role.

Anxiety- a common symptom of serious mental illness (schizophrenia, manic-depressive psychosis, etc.), but most often it occurs as a manifestation of an anxious and suspicious form of depression.

Symptoms requiring medical attention.

It is very important not to miss a somatic illness accompanied by anxiety; signs of such a disease can be:

1. chest pain, whether it radiates to the arm, neck, jaw; a feeling of constriction, especially in the left side of the chest, uneven or rapid heartbeat;

2. shortness of breath, rapid or difficult breathing;

3. high blood pressure;

4. anxiety occurs on an empty stomach or after a lot of physical activity (this is often with diabetes); nausea, vomiting, belching, indigestion, weight loss;

5. numbness or tingling in the hands, feet, or other parts of the body; muscle weakness, trembling, fainting;

6. constant feeling of heat or warmth, dry mouth, sweating;

7. anxiety occurs before menstruation;

8. anxiety begins after taking a drug or, conversely, when it is canceled; when trying to quit smoking, taking alcohol or drugs.

It is equally important to identify the signs of an anxious and suspicious form of depression, among which deserve mention:

1. recent experience of a tragic event;

2. unreasonable anxiety and fears about at least two life situations within 6 months, accompanied by muscle trembling or tension, dry mouth, hot flashes, difficulty concentrating, irritability, fearfulness;

3. excitement, restlessness, anxiety, interfering with daily activities;

4. anxiety is accompanied by panic moods, fears (for example, fear of leaving the room; fear of being in an awkward position).

The basis of the treatment of anxiety and anxiety is teaching the patient the ability to relax (relaxation), analyze the source of fears and anxiety, as well as psychotherapy. In most cases, these measures are sufficient, possibly with the use of mild sedatives. In the case of anxiety-suspected form of depression by doctor's prescription use antidepressants (imipramine, amitriptyline, etc.), lithium preparations (lithium oxybutyrate), beta-blockers (propranolol); during periods of deterioration, tranquilizers are used - benzodiazepines (for example, Diazepam).

Proper and regular nutrition.

Regular exercise.

A reasonable combination of work and leisure; doing what you love (hobby).

Calm daily routine, warm shower or bath at night.

Watch your breathing (deep breathing helps to relax), breathe slowly.

Communication with people in your circle.

OTC drugs.

Vitamins (especially B, B fi; pantothenic acid; vitamins C, E) and mineral salts (zinc, magnesium, calcium): Vitaspectrum, Vitatress, Duovit.

Valerian root with rhizome (briquettes, tincture, extract in tablets).

Motherwort grass (briquettes, tincture, liquid extract).

Calming collection.

Corvalol, Valocordin, Valoserdin.

Gelarium Hypericum.

Children do not have anxiety states. Teenagers may experience fear and anxiety before exams. In these cases, you should calm the teenager, instill in him a sense of self-confidence, in extreme cases, one of the above sedatives can be given on the eve of the exam.

Anxiety (disorders) is a common phenomenon in our difficult time. Manifested by increased excitability of the nervous system. Characterized by the presence of fears and anxiety, often unfounded.

Each of us has experienced something similar during certain events in life - stress, an exam, a difficult, unpleasant conversation, and so on. The feeling of anxiety and fear lasts, as a rule, not for long and soon passes.

However, for some people, the feeling of anxiety becomes almost the norm, preventing them from living a full life. In addition, it can lead to neurosis and increases the risk of developing serious mental ailments.

How to get rid of anxiety for adults? What pharmacy and folk remedies can be used to eliminate it? Let's talk about it on this "Popular about Health" page today:

signs

Only at first glance, such sensations are without reason. Constant anxiety, nervous tension, fears can be early signs of the development of pathologies of the cardiovascular and nervous systems, various brain lesions.

But most often this phenomenon is closely related to stress. Therefore, the symptoms are expressed in the characteristic signs of stress:

Frequent headache, dizziness, palpitations, lack or deterioration of appetite;

Insomnia and sleep disorders (difficulty falling asleep, superficial sleep, nocturnal awakenings, etc.);

Starting from unexpected sounds, loud voice;

Trembling fingers, frequent urge to urinate;

If the state of anxiety “for no reason” persists for a long time, depression, sadness arise, and negative thoughts are constantly present.

The person feels hopeless and helpless. His self-esteem decreases, he loses interest in his favorite activities, considers himself worthless, and often shows aggression towards loved ones.

If you observe such sensations, what to do with them, you ask ... So the best way out of this situation is to visit a specialist. First, contact a general practitioner who will prescribe an examination. According to its results, it will issue a referral to a narrow specialist who will prescribe treatment individually. Or immediately make an appointment with a neurologist.

If you do this as early as possible, you may not need treatment with serious medications and you can get by with herbal preparations and folk remedies.

How are adults treated??

The treatment of this disorder is always carried out in a complex way: medicines, psychological assistance, lifestyle changes.

If necessary, the patient is prescribed tranquilizers and antidepressants. However, psychotropic drugs only reduce the symptoms, help to alleviate the condition. They don't fix the problem itself. In addition, they have serious side effects and contraindications.
Therefore, if during the diagnostic process the patient does not have a serious illness, in which anxiety is one of the symptoms, methods of cognitive psychotherapy are used, and behavioral treatment is carried out.

With the help of these techniques, the patient is helped to become aware of his condition and learn to cope with feelings of anxiety and fear for no reason.

In addition, patients are advised to take herbal preparations, which can be freely bought at the pharmacy. Compared to synthesized drugs, they are effective, safe, and have far fewer contraindications and side effects.

Pharmacy funds

There are a large number of herbal preparations that are used in the treatment of anxiety for no reason. Let's list some:

Novopassit. Effective for anxiety, nervousness, nervous tension, various sleep disorders, insomnia.

Nervogran. It is used in the complex treatment of neurosis, anxiety, as well as insomnia and headache.

Persen. An effective sedative. Eliminates anxiety, fears, improves sleep quality.

Sanason. It has a positive effect on the central, autonomic nervous system, relaxes, calms, restores mental balance.

How folk remedies relieve anxiety, what to do for this?

Prepare a herbal tincture: pour 2 tbsp dried lemon balm, 1 tsp finely chopped angelica root into a liter jar. Add the zest of one lemon, 0.5 tsp ground nutmeg, a pinch of ground coriander seeds and two cloves. Top up with vodka.

Close the jar and leave it where it is darker and cooler for 2 weeks. Then strain and add to tea: 1 teaspoon per cup.

An infusion of Adonis (Adonis) will help calm the nerves and increase the tone of the body: 1 tbsp of a dry plant per cup of boiling water. Warm with a towel, wait for cooling, strain. Take a sip throughout the day.

Change your lifestyle!

In order for the treatment to benefit, you will have to change the existing way of life:

First of all, you should give up alcohol and smoking, as well as minimize the consumption of invigorating drinks that excite the nervous system: strong coffee, strong tea, various tonics.

Do something interesting for you, find a hobby, go to the gym, attend sports events, sections, etc. This will help you escape from the routine of everyday life, increase your interest in life, and lead to new acquaintances.

However, remember that a constant stay in a state of anxiety, unreasonable fear is a prerequisite for the development of serious nervous disorders and mental illness. Therefore, if you cannot cope on your own, do not wait for it to “pass by itself” and contact a specialist.

Anxiety is a psychological disorder that is associated with stressful influences of varying intensity and duration. It manifests itself in the form of unreasonable excitement. According to psychologists, anxiety after waking up can occur in an absolutely healthy person. But if such a condition periodically repeats without obvious reasons, this indicates the presence of a disease. Let's try to figure out why anxiety occurs after sleep and how to deal with the manifestations of neurosis.

Anxiety neurosis can arise due to the influence of both physiological and psychological factors. Heredity also plays an important role. Therefore, the search for the causes of disorders in children initially begins with the anamnesis of the parents.

Among the psychological factors, the main influence is exerted by:

  1. Emotional experience. For example, anxiety neurosis can be the result of the threat of sudden changes at work, in personal life, as well as deep feelings about this.
  2. Strong emotional attraction of various origins (sexual, aggressive, etc.). Under the influence of certain situations, experiences can be activated.

Physiological factors

Disorders of the endocrine system and the hormonal shift that develops against this background contribute to the alarming state. For example, it manifests itself in the form of organic changes in the adrenal glands or certain areas of the brain that are responsible for the production of hormones. The latter, in turn, control the occurrence of anxiety, fear and regulate mood. Strong physical exertion and severe consequences of the disease can also cause neurosis.

All these reasons can only serve as prerequisites for the appearance of an anxiety syndrome. The development of the disease occurs directly in combination with strong psychological stress.

The use of alcoholic beverages has a particular effect on anxiety. In this case, the feeling of anxiety manifests itself most often in the morning after waking up. The main reason is alcoholism. Similar symptoms of anxiety are associated with hangovers. Consider the main signs of anxiety neurosis.

Signs of anxiety

There are several manifestations of anxiety neurosis. They include mental manifestations, as well as somatic and autonomic disorders.

Mental symptoms

After waking up, there is an unexpected, causeless and inexplicable feeling of anxiety. There may be a seizure. According to the results of research, it was revealed that a person feels an indefinite feeling of an impending disaster. There is a feeling of trembling and severe weakness.

Such an attack can suddenly arise and recede in the same way. The average duration is about twenty minutes. After awakening, there is often a feeling of unreality of the events taking place around. The patient may not be able to navigate in space.

Also, anxiety neurosis is characterized by symptoms of hypochondria (a person is unnecessarily worried about his own health). There is a sleep disorder, sudden mood swings, fatigue. At the initial stage of the disease, anxiety occurs suddenly for no reason. Then, as the disease develops, it becomes chronic.

Somatic and vegetative disorders

Manifestations may be different. There will be dizziness and headache. It is difficult enough to determine its localization. Also, pain can go to the region of the heart. Less commonly, anxiety causes palpitations, shortness of breath, and shortness of breath. The disease may be accompanied by problems with the gastrointestinal tract. There is nausea and upset stool.

Types of anxiety disorder

Even in the last century, scientists as a result of research revealed the phenomenon of paradoxical drowsiness. According to clinical data, patients experienced an unbridled desire to sleep in the evening. But as soon as they got into bed, the drowsiness subsided. Sleep disorder, in turn, affected the state after awakening. Consider the main categories of anxiety states.

Shallow, interrupted sleep with occasional awakening

Most often, a person wakes up abruptly after nightmares. After waking up, there is fear and anxiety. Such affective disorders are usually accompanied by incomplete waking up. The patient inadequately perceives the degree of reality. It's hard enough to fall asleep again. Fatigue builds up. The disturbance may be repeated several times during the night.

There are also cases when nocturnal awakening occurs suddenly, for no reason. Often, sleep is interrupted for about two or four hours. Then anxiety appears, usually associated with the experienced conflict situation. According to the results of the research, it was found that patients after waking up thought about the same things as before going to bed. Repeated sleep does not occur for a long time.

Such violations lead to a sharp change in affect. There is a feeling of fear or anxiety. Experiences can be associated with somatic disorders. Also, anxiety is accompanied by increased aggressiveness towards others. According to the patient, everyone around is guilty of disturbing his sleep. This condition is often observed in patients with hysterical neurosis.

You can learn how to get rid of anxiety from the video:

Short-term sleep after early awakening

A fairly rare form of the disease. Patients wake up between 4 and 6 am. There is a pronounced feeling of drowsiness, then affective-emotional tension. Anxiety and worries are caused directly by the fact of early awakening. If the patient makes a little effort, he will soon fall asleep. But a few minutes will pass, and again the dream will be interrupted. The cycle can be repeated several times during the night. There is a feeling of lethargy, weakness.

Patients complain about the lack of proper rest. They can fall asleep in the morning and sleep for several hours. After that they feel much better. But since patients have to go to work or fulfill household obligations, extra sleep becomes a luxury. Constant fatigue and a recurring feeling of anxiety causes a psycho-traumatic effect.

In the course of clinical trials and observations of patients with neurosis, a feeling of discomfort, a feeling of lethargy, weakness after waking up, as well as a constant desire to sleep, were attributed to the concept of dyssomnia.

In addition to characteristic disorders, increased anxiety also aggravates the disease. Fear can influence the onset of hypochondria.

borderline stage

During the night, the patient can sleep well. Rest corresponds to the main parameters in terms of depth and duration of sleep phases. But after waking up, the patient doubts whether he slept that night. If the fact of sleep is proved by relatives or a doctor after the study, the patient may doubt the quality of his sleep. As a rule, thoughts about his inferiority and insufficiency visit. Severe drowsiness during the day is not observed. But in the late afternoon, anxiety intensifies as the time of rest approaches.

All the observations carried out proved the connection of anxiety after waking up with gastrointestinal, cardiovascular diseases, as well as sexual disorders.

Diagnostic methods

To establish the correct diagnosis, a person with anxiety symptoms needs to see a psychologist. But in addition, the opinion of other doctors may be needed (for complaints of frequent headaches and other systemic disorders), if a specific pathology is not detected.

Also, the doctor must make sure that there are no signs of psychosis. To determine the condition, the patient is offered to undergo a light test. Patients with neurosis realistically assess their problems. Psychosis causes severe perceptual disturbances. The person does not realize the seriousness of his condition.

Ways to treat anxiety neurosis

It is much easier to get rid of neurosis at the initial stage of the disease. Therefore, it is necessary to seek help from a specialist in a timely manner. The treatment of such symptoms, depending on the complexity and stage, is carried out by psychiatrists and psychologists. Based on the results of the examination, the doctor will prescribe several methods of treatment:

  1. Psychotherapy course.
  2. Medical treatment.
  3. The recovery period in a sanatorium-resort institution.

To relieve the symptoms of anxiety neurosis, first of all, psychotherapy sessions are carried out. The main task of the doctor is to make the patient aware of the causes of vegetative and somatic disorders. The same sessions help to relax and relieve stress. Additionally, a relaxing massage and physiotherapy may be required.

Anxiety is one of the individual psychological characteristics of a person, manifested by an increased tendency of a person to worry, anxiety, fear, which often has no sufficient grounds. This state can also be characterized as an experience of discomfort, a premonition of a certain threat. Anxiety disorder is usually attributed to the group of neurotic disorders, that is, to psychogenic conditioned pathological conditions characterized by a diverse clinical picture and the absence of personality disorders.

Anxiety can manifest itself in people of any age, including young children, however, according to statistics, young women in their twenties and thirties most often suffer from an anxiety disorder. And although everyone can experience anxiety from time to time, being in certain situations, we will talk about an anxiety disorder when this feeling becomes too strong and uncontrollable, which makes it impossible for a person to lead a normal life and engage in habitual activities.

There are a number of disorders whose symptoms include anxiety. This is a phobic, post-traumatic stress or panic disorder. Ordinary anxiety is usually referred to as generalized anxiety disorder. An overly acute sense of anxiety causes a person to worry almost constantly, as well as experience various psychological and physical symptoms.

Reasons for development

The exact reasons contributing to the development of increased anxiety are unknown to science. In some people, the state of anxiety appears for no apparent reason, in others it becomes the result of an experienced psychological trauma. It is believed that the genetic factor may also play a role. So, in the presence of certain genes in the brain, a certain chemical imbalance occurs, which causes a state of mental tension and anxiety.

If we take into account the psychological theory of the causes of an anxiety disorder, then a feeling of anxiety, as well as phobias, may initially occur as a conditioned reflex reaction to any irritating stimuli. In the future, a similar reaction begins to occur even in the absence of such a stimulus. Biological theory suggests that anxiety is the result of some biological anomalies, for example, with an increased level of production of neurotransmitters - conductors of nerve impulses in the brain.

Also, increased anxiety can be the result of insufficient physical activity and poor nutrition. It is known that in order to maintain physical and mental health, the correct regimen, vitamins and trace elements, as well as regular physical activity are necessary. Their absence negatively affects the entire human body and can cause an anxiety disorder.

For some people, anxiety may be associated with a new, unfamiliar environment that seems dangerous, their own life experiences in which unpleasant events and psychological traumas have taken place, as well as character traits.

In addition, such a mental state as anxiety can accompany many somatic diseases. First of all, this can include any endocrine disorders, including hormonal failure in women with menopause. A sudden feeling of anxiety sometimes becomes a harbinger of a heart attack, and may also indicate a drop in blood sugar levels. Mental illness is also very often accompanied by anxiety. In particular, anxiety is one of the symptoms of schizophrenia, various neuroses, alcoholism, and so on.

Kinds

Among the existing types of anxiety disorder, the most common in medical practice is adaptive and generalized anxiety disorder. In the first case, a person experiences uncontrollable anxiety combined with other negative emotions when adapting to a stressful situation. In generalized anxiety disorder, the feeling of anxiety persists permanently and can be directed to a variety of objects.

There are several types of anxiety, the most studied and most common of them are:


In some people, anxiety is a character trait when a state of mental tension is always present, regardless of specific circumstances. In other cases, anxiety becomes a kind of means of avoiding conflict situations. In this case, emotional stress gradually accumulates and can lead to the emergence of phobias.

For other people, anxiety becomes the flip side of control. As a rule, the state of anxiety is typical for people striving for impeccability, having increased emotional excitability, intolerance for mistakes, worrying about their own health.

In addition to various types of anxiety, its main forms can be distinguished: open and closed. A person experiences open anxiety consciously, while such a state can be acute and unregulated or compensated and controlled. Anxiety that is conscious and significant for a particular person is called “implanted” or “cultivated”. In this case, anxiety acts as a kind of regulator of human activity.

Latent anxiety disorder is much less common than open anxiety disorder. Such anxiety is unconscious to varying degrees and can manifest itself in human behavior, excessive external calmness, etc. In psychology, this state is sometimes called "inadequate calm."

Clinical picture

Anxiety, like any other mental state, can be expressed at various levels of human organization. So, on a physiological level, anxiety can cause the following symptoms:


At the emotional and cognitive level, anxiety manifests itself in constant mental tension, a feeling of helplessness and insecurity, fear and anxiety, decreased concentration, irritability and intolerance, and the inability to focus on a specific task. These manifestations often cause people to avoid social interactions, look for reasons not to attend school or work, etc. As a result, the state of anxiety only intensifies, and the self-esteem of the patient also suffers. By focusing too much on one's own shortcomings, a person may begin to feel self-loathing and avoid all interpersonal relationships and physical contact. Loneliness and a feeling of "second-class" inevitably lead to problems in professional activities.

If we consider the manifestations of anxiety at the behavioral level, then they can consist in nervous, senseless walking around the room, swinging in a chair, tapping fingers on the table, pulling one's own strand of hair or foreign objects. Nail biting can also be a sign of increased anxiety.

With anxiety disorders of adaptation, a person may experience signs of panic disorder: sudden attacks of fear with the manifestation of somatic symptoms (shortness of breath, heart palpitations, etc.). With obsessive-compulsive disorder, obsessive disturbing thoughts and ideas come to the fore in the clinical picture, forcing a person to constantly repeat the same actions.

Diagnostics

Diagnosis of anxiety should be made by a qualified psychiatrist based on the patient's symptoms, which should be observed for several weeks. As a rule, identifying an anxiety disorder is not difficult, but it can be difficult to determine its specific type, since many forms have the same clinical features, but differ in time and place of onset.

First of all, suspecting an anxiety disorder, the specialist pays attention to several important aspects. Firstly, the presence of signs of increased anxiety, which may include sleep disturbances, anxiety, phobias, etc. Secondly, the duration of the course of the existing clinical picture is taken into account. Thirdly, it is necessary to make sure that all the symptoms present do not represent a reaction to stress, and are not associated with pathological conditions and lesions of the internal organs and body systems.

The diagnostic examination itself takes place in several stages and, in addition to a detailed survey of the patient, includes an assessment of his mental state, as well as a physical examination. An anxiety disorder must be distinguished from the anxiety that often accompanies alcohol dependence, as it requires a completely different medical intervention. Based on the results of the performed physical examination, diseases of a somatic nature are also excluded.

As a rule, anxiety is a condition that can be corrected. The method of treatment is selected by the doctor depending on the prevailing clinical picture and the alleged cause of the disorder. Today, the most commonly used drug therapy using drugs that act on the biological causes of anxiety and regulate the production of neurotransmitters in the brain, as well as psychotherapy aimed at the behavioral mechanisms of anxiety.

Anxiety disorders are disorders in which a person experiences severe, most often unreasonable anxiety or fear. This condition is characterized by increased excitability of the nervous system, manifested by symptoms resembling signs of certain diseases. Diagnosis and treatment of anxiety disorders are handled by neuropathologists.

What is the treatment of anxiety, symptoms, treatment, why does anxiety occur? We will talk about all this today with you.

Symptoms of an Anxiety Disorder

The main symptom, of course, is constant anxiety, the experience is sometimes fear. These feelings are most often unfounded and have no explainable reason. Periodically, they intensify, causing a panic attack.

All this is accompanied by characteristic physiological symptoms arising from the autonomic nervous system. There are signs that usually accompany diseases of the internal organs: cough, pain behind the sternum, or abdomen. Patients often complain of shortness of breath, sensation of a lump in the throat.

Other symptoms of anxiety disorder include:

Feeling the unreality of what is happening;
- Disorientation, dizziness, blurred vision;
- Hypochondria - a state of excessive concern for one's health. Tearfulness, turning into irritability;
- Attacks of increased heartbeat, a feeling of lack of air, as well as fainting and shortness of breath at rest. Frequent mood swings, increased fatigue.

Often, people with this pathology are observed (fear of certain situations, objects). The most common are: agoraphobia, claustrophobia, nosophobia, social phobia, as well as fear of insects, snakes, heights, etc.

Quite often, the symptoms that accompany anxiety are often found in other diseases. For this reason, patients are often unsuccessfully treated by other specialists.

Why does anxiety occur? Causes of pathology

Doctors attribute anxiety to neuroses, mental disorders that develop against the background of short or long-term stress. The cause may be emotional shock, nervous overwork, as well as excessive physical or mental stress.

Often the cause is hereditary predisposition. In the presence of close relatives with a similar diagnosis, the likelihood of developing this syndrome is doubled.

Anxiety can occur due to hormonal failure, or due to dysfunction of the endocrine system.

Experts note that with the latent course of this pathology, an exacerbation caused by some kind of shock is possible (loss of a loved one, news of a serious illness, moving to another city, etc.).

How is anxiety corrected? Treatment of the condition

Therapy of this pathology depends on its degree and severity of the course. For example, mild manifestations of anxiety are eliminated with the help of a massage session, physiotherapy procedures and acupuncture. They conduct psychotherapy sessions aimed at making a person aware of his painful condition and mastering the skills to get out of it.

In more complex cases, as well as exacerbation of an anxiety disorder, the patient is prescribed tranquilizers, necessary psychotropic drugs and antidepressants. If necessary, the doctor will prescribe sleeping pills. In addition to drug treatment, the patient is prescribed psychotherapeutic treatment.

The composition of drug therapy also includes homeopathic preparations, using traditional medicine with the use of plants that have a calming, mild hypnotic effect.

Folk remedies for the treatment of anxiety

To reduce the intensity of anxiety symptoms, to eliminate insomnia, drink a decoction of peppermint. To prepare, pour 1 tbsp. l. dried herb. Mint pour 200 ml of boiling water. Boil, simmer on low heat for 10 minutes. Remove from heat, wait, let it cool down. Strained warm broth drink at night, before going to bed and in the morning, after waking up. Recommended intake: half a glass of broth.

Finely chop the fresh borage grass (it grows in the plots of many summer residents). Pour 1 tbsp. l. herbs in a glass of boiling water. The infusion will be ready in half an hour. Strain it, drink half a glass before meals. This tool will help to calm down, reduce anxiety, improve mood. You can not only prepare infusions, but also add fresh borage to vegetable salads. Be healthy!

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