Nasal catheter YAMIK - is a new drug delivery sistem for topical treatment for sinusitis. The introduction of a large volume of the #drugsolution directly into all the paranasal #sinuses - provides new opportunities in the #treatment of #sinusitis! #YamikprocedureNasal catheter YAMIK is a new device for topical sinonasal delivery of medication during rhinosinusitis treatment. Administration of therapeutic solution with YAMIK catheter is called YAMIK procedure. The following features differs YAMIK procedure from all other topical sinonasal delivery techniques: - Medication is delivered into the all paranasal sinuses at one side of nose regardless of their involvement in the inflammatory disease. -Specific position of patient’s head. Patient should lay on the side of of the sinuses, into which solution will be administered. This position is physiological and comfortable for patients, including children and elders. The LHL position was suggested to be the most favorable position for patients to adopt - Therapeutic solutions reliably penetrates into without previous sinus surgery sinuses with natural ostia size. - Paranasal sinuses are filling with medicinal solution by gravity. To accelerate process, it is used small pressure gradient, which created by motion of syringe plunger with amplitude 1 - 2 ml during administration of solution. - It is provided contact of the whole sino-nasal mucosa with medication. - Prolonged time of the contact of sino-nasal mucosa with medicine provides administration of the therapeutically significant dose. Therapeutic solution administered into paranasal sinuses is considered as a STORE. Thanks to affect mucociliary clearance, therapeutic solution is gradually evacuated from sinuses through ostia. Thereby, prolonged nasal irrigation is performed. - Due to extended contact with saline (NaCl 0,9%), viscous colloidal pathological substance filling paranasal sinuses is dissolved. As a result, its viscosity decreases, and substance is removing by mucociliary clearance. Thereby, drainage function of the ostia are returned some time after finish YAMIK method procedure. -The procedure is performing under local anesthesia. - There is no need in active involvement of the patient. Blowing, pronouncing any sounds like “cuckoo”, holding any things and so on is unnecessary. If is performed by a qualified medical professional the procedure is more effective. - Medication contacts only with nasal passages and paranasal sinuses. Thus, it is provided topical drug therapy. - YAMIK procedure is call sinonasal delivery techniques of a therapeutic solution. It differs from nasal techniques, because medicinal solution contacts not only with nasal mucosa, but with mucous membrane of paranasal sinuses. - The only used drug formulation is a solution. - It is possible non-invasive sample extraction from mucosa of paranasal sinuses (for bacteriological, immunological, cytological and a number of others investigation methods).

Ankle Fracture Surgery Video

Diabetic ketoacidosis is an acute complication of uncontrolled hyperglycaemia characterised by high anion gap metabolic acidosis, dehydration and other metabolic abnormalities. Upto half of patients with Type 1 diabetes mellitus may have DKA. The incidence in T2DM is also rising. Precipitants include acute illness such as myocardial infarction, trauma and infection. Paitents of diabetic ketoacidosis may present with vomiting, pain abdomen and lethargy. Mental obtundation may also be present. Management of diabetic ketoacidosis revolves around administration of IV normal saline, insulin, replacement of potassium with frequent monitoring of sugars and electrolytes.

Chronic myeloid leukaemia is a common malignancy worldwide. We have come a long way from the limited treatment options and survival in this condition. Today, CML is a treatable malignancy with more than 80% patients surviving beyond 10 years after diagnosis, in absence of complications. This presentation deals with the definition, diagnostic criteria of chronic phase, accelerated and blastic phase (MD Anderson cancer centre, International bone marrow transplant registry and the WHO for the latter two) and management (first and second generation tyrosine kinase inhibitors) of this condition. Finally, a stepwise approach to chronic myeloid leukaemia is also presented including the definitive modality of treatment, allogeneic stem cell transplantation.

A detailed discussion of the causes, diagnosis and management of the causes of Meningitis and Encephalitis. Includes bacterial, viral, fungal and autoimmune conditions as well as treatment of these conditions. Includes antivirals such as Aciclovir and Ganciclovir as well as IVIG and plasma exchange for autoimmune encephalitis.

A detailed description of the approach to a use of bleeding disorders. This presentation includes the causes, history, clinical features and diagnosis of specific bleeding disorders. These include Haemophilia, DIC, Von Willebrand Disease and others. The final differentiation is often made on the basis of the Prothrombin Time, activated Partial thromboplastin time and platelet count.

A detailed discussion of the pathophysiology, diagnostic criteria, clinical features and management of hepatorenal syndrome.

A step by step approach to Hypokalaemia including causes, diagnosis and management.