Are our acute coronary syndrome patients achieving better glycaemic control after admission? : a study

BACKGROUND: Diabetes mellitus (DM) is a cardinal cardiovascular risk factor. Tight glycaemic control is advocated as part of primary and secondary cardiovascular disease prevention. The aim of this study was to investigate the impact of acute coronary syndrome (ACS) admission on subsequent glycaemic control in known type I/II DM patients.METHODS: Patients were included if (a) known to have type I/type II DM prior to admission (b) admitted with ACS under the care of a cardiologist between January and December 2020 and (c) in possession of a haemoglobin A1c (HbA1c) result within 6 weeks of index admission (peri-admission) and a repeat result around 6 months thereafter (follow-up). Peri-admission and follow-up HbA1c levels were compared using Wilcoxon signed-rank test.RESULTS: One hundred and seventy patients [124 (72.9%) male; mean age 67.88 ± 10.18 years] were included. During index admission, a change in DM treatment was performed in 80 (47.1%) patients, while a diabetology review was requested for 37 (21.8%) patients. A significant reduction in HbA1c levels was demonstrated following an ACS admission with a peri-admission median level of 7.5% (IQR 2.3%) to a follow-up median of 7.1% (IQR 1.7%) (Z statistic -4.145, p<0.001), although at 6 months 119/170 (70%) patients still had an HbA1c above the 6.5% target.CONCLUSION: Changes in DM treatment and/or advice during ACS admission appear to have an initial beneficial impact on glycaemic control in known diabetics. Aggressive long-term control is necessary to ensure more effective risk reduction.peer-reviewe

A bilingual glossary of mathematics terms : the early and junior years

Includes English translationJinkludi traduzzjoni bl-IngliżF’Malta, il-lingwa akkademika tal-matematika ilha żmien twil bl-Ingliż. It-testi miktuba kollha, bħall-kotba, ix-xogħol miktub fuq il-whiteboard, in-noti tal-istudenti u l-worksheets huma bl-Ingliż. Bl-istess mod, l-assessjar dejjem sar bl-Ingliż. Madankollu, kemm evidenza aneddotali kif ukoll studji ta’ riċerka juru li diversi għalliema jaqilbu bejn il-Malti u l-Ingliż matul l-interazzjoni tagħhom mal-istudenti fil-klassi. Din hija l-iktar evidenti meta l-għalliema u l-istudenti jaqilbu minn interazzjoni orali għall-qari ta’ test matematiku, jew meta jintuża kliem marbut speċifikament mas-suġġett bħal triangle, bar chart u multiplication. Għalhekk, il-prattika li jintużaw żewġ lingwi fit-tagħlim tal-matematika hija prattika lokali komuni. [Silta]peer-reviewe

Knowledge and practices of nurses on prevention of nosocomial infection in emergency care hospitals

OBJECTIVE: Developing countries such as Georgia, face up to Nosocomial infections (Nis) which is a key problem of healthcare system. The main reason for reducing relevance to this practice is the lack of knowledge about infection control practices among healthcare workers. While nurses play a unique role in the hospital infection control processes, the goal of the study is to assess the knowledge and practices of nurses regarding NIs in emergency care hospitals.METHOD: Descriptive, cross-sectional study was conducted. A total of 150 nurses were enrolled through randomized simple selection.RESULTS: Most of the nurses had a sufficient level of knowledge about NIs, but their practices to reduce the spread of infection were not up to a satisfactory level. There was a significant relationship between knowledge and practices, which include attending NIs training courses and practices to gain professional experience (p<0,05). Though, only 53.7% of interviewed nurses consider that they barely take into account the recommendations about reducing NIs. Also, only 54.5% nurses do hand hygiene activities after contacting subjects around the patient. However, there is no significant statistical connection between the knowledge about principles of hand hygiene and demographic indicators of nurses.CONCLUSION: Having adequate education and practice in Nis control and prevention is a must for healthcare workers. The majority of the nurses has sufficient knowledge and practice about NIs control measures. However, possessing adequate knowledge is ineffectual until the proper application of infection control practices. Nurses need further improvement through the regular educational programs.peer-reviewe

An annotated checklist of the Oligo-Miocene cephalopods of the Maltese Islands

A systematic checklist of cephalopod fossils (Phylum Mollusca: Class Cephalopoda) recorded from the Oligo-Miocene sedimentary sequence of the Maltese archipelago is given. It consists of species of the nautilid genera Aturia and Eutrephoceras, next to calcified parts of the nautilid animal’s upper jaw placed under the parataxon Rhyncolites, and of sepiid and spirulid coleoid genera Sepia (Sepiida) and Spirulirostra (Spirulirostrida). Cephalopod fossils from the Maltese archipelago, in particular abundant limonitic or phosphoritic specimens of Aturia and Sepia, have been recorded in scientific literature since the middle part of the 19th Century. The identification of several species of Sepia is hampered by lost type material and taphonomic distortion or loss of diagnostic traits.peer-reviewe

Vibration welding of PLA/PHBV blend composites with nanocrystalline cellulose

Thermoplastic composites have garnered significant attention in various industries due to their exceptional properties, such as recyclability and ease of molding. In particular, biocomposites, which combine biopolymers with natural fibers, represent a promising alternative to petroleum-based materials, offering biodegradability and reduced environmental impact. However, there is limited knowledge regarding the efficacy of joining PLA/PHBV-based biocomposites modified with nanocrystalline cellulose (NCC) using vibration welding, which restricts their potential applications. This study demonstrates that vibration welding enables efficient bonding of PLA/PHBV composites with NCC, resulting in strong, biodegradable, and environmentally friendly materials. The investigation revealed that the addition of nanocrystalline cellulose (NCC) at 5, 10, and 15 wt.% significantly enhanced the strength of welded joints, with the highest strength achieved at 15% NCC content. Microstructural analysis using scanning electron microscopy (SEM) and deformation studies with digital image correlation (DIC) indicated that a higher NCC content led to greater local deformation, reducing the risk of brittle fracture. Mechanical hysteresis tests confirmed the composites’ favorable resistance to variable loads, highlighting their stability and energy dissipation capabilities. Optimization of welding parameters, such as vibration amplitude, welding time, and pressure, is crucial for achieving optimal mechanical performance. These findings suggest that PLA/PHBV composites modified with NCC can be utilized as durable and eco-friendly materials in various industries, including automotive and packaging. This research presents new opportunities for the development of biodegradable high-strength materials that can serve as alternatives to traditional plastics.peer-reviewe

Green public procurement in public administration : perceptions and challenges in practice

The implementation of green public procurement (GPP) in the Maltese public administration wasperceived as an important step that supports the achievement of environmental policies. Institutionsare in place for the application of GPP. However, there are difficulties in practice, and more needs tobe done in terms of training and capacity development. This study concludes that managerialdecisions are taken to legitimize actions, so that the administrator appears to be doing the rightthing in the eyes of the stakeholders. Institutions intentionally adopt GPP to adhere to the norms andvalues of society. Whether GPP has a positive effect on the environment is a secondary objective.peer-reviewe

Pharmacist-led ambulatory blood pressure monitoring in community pharmacy

Ambulatory blood pressure monitoring (ABPM) compliments home blood pressure monitoring by assessing white-coat hypertension, diagnosing masked hypertension, and providing information on night-time dip and morning surge.peer-reviewe

Time to fluid administration in paediatric diabetic ketoacidosis

BACKGROUND: Diabetic ketoacidosis is a medical emergency and merits prompt fluid therapy. Our aim is to evaluate whether fluids are started within one hour of presentation to hospital for children with diabetic ketoacidosis.METHODS: This is a retrospective study involving patients with diabetic ketoacidosis presenting to paediatric emergency department at Mater Dei Hospital between 2008 to 2017. Diabetic ketoacidosis was defined as per local protocol. Times at hospital presentation, medical visits in emergency department and wards and at start of fluid administration were recorded. Clinical and biochemical parameters for patients with start of fluids within one hour (Immediate Fluid Treatment) were compared to those with delayed fluid treatment; T-test was used for significance.RESULTS: Sixty episodes were included, with 34 males (60.7%) and mean age 7.42 years. Fluids were started at a median of 95.5 (IQR: 70.5 - 128.3) minutes following presentation and were mainly started in the admitting ward. Only 18% of patients received fluids within one hour of presentation (n = 11). Bicarbonate and pH levels were significantly lower in these patients, at 7.87 vs 11.48 mmol/l (p = 0.027) and 7.07 vs 7.21 (p = 0.002) respectively, when compared to those with delayed fluid treatment. Significantly more patients in the immediate fluid treatment group needed fluid boluses (73% vs 29%, p = 0.0006).CONCLUSION: Fluids were delayed more than one hour from presentation in most paediatric diabetic ketoacidosis patients. Consideration should be given to commencing fluids in the paediatric emergency department or expediting their ward transfer, to decrease this delay in starting treatment.peer-reviewe

Burkitt’s Lymphoma in 3 years-old boy with craniofacial presentation

BACKGROUND: Burkitt’s lymphoma (BL) is an aggressive non-Hodgkin B-cell lymphoma with rapid growth. The majority of endemic BL occurs in children aged 5-12 years old with mandibular involvement.CASE: We presented a rare case of BL in 3 years-old boy with craniofacial involvement in Indonesia. A boy came to the emergency department with a massive mass in the upper-left facial area. The mass was 10 x 5 x 5 cm with eye and maxillary infiltration. Three months before, the patient came to the outpatient clinic with a slightly-visible and painless mass in the left cheek without any lymph node enlargement. The blood examination revealed no abnormalities, yet the LDH level was 1.260 U/L. The histopathological examination supported the diagnosis of Burkitt’s lymphoma. No leukemic cells or metastases were found in bone marrow aspiration. The patient received Cyclophosphamide, Vincristine, Methotrexate, and oral prednisone. The patient responded well and the mass was completely resolved in 3 weeks with no complications.peer-reviewe

Piloting extended services in community pharmacy practice

Community pharmacists can support patient management by offering extended services tailored to patient needs. Studies in Malta reported that community pharmacists are in favour of expanding their roles and consumers are in agreement with extended services provided by community pharmacists. A framework consisting of standard operating procedures (SOPs) for the provision of extended services in community pharmacy practice, including medicine use review, patient review and advice and treatment services, was proposed in a previous study.peer-reviewe