Child abuse in Malta : a review

Child abuse constitutes one of the most difficult areas of paediatric practice in Malta and, sadly, non accidental injury (NAI) is not only relatively common but is also increasing in incidence. The multi-factorial and socially complex aetiology of child abuse makes its eradication at source very difficult indeed. Nevertheless, the significant negative impact of this diagnosis on the affected child, both in the immediacy as well as in the long term, dictates damage-limitation through early identification and appropriate management. To this end, local awareness of the magnitude of the problem has galvanized the relevant authorities who have now established efficient tracking and processing protocols for cases of NAI, covering medical, social, legal and police aspects.peer-reviewe

Good parenting

Doctors need to realize that when one of their patients becomes a parent all of a sudden, everyone around them becomes an expert on parenting. They will start getting plenty of advice which will not always be the right one. That is where we, as doctors need to be vigilant. Parenthood can be very difficult. There is no right or wrong way of bringing up a child. This article is intended to give you the tools so you can give your patients the best advice based on the latest scientific evidence. Keep in mind that the evidence suggests that parents are happier than non-parents regardless of how tired they might feel at the end of the day. As Nelson et al. (2013) suggested, parents feel most fulfilled when they raise their children, as compared to the fulfillment they obtain from doing other things.peer-reviewe

The role of the A C395 IFNGR1 mutation in determining susceptibility to intracellular infection in Malta

Background: The first human mycobacterial susceptibility gene was identified amongst four children on the island of Malta in 1995. All affected children were homozygous for a nonsense mutation at position 395 of the interferon gamma receptor 1 (IFNGR1) gene, and all but one died of overwhelming mycobacterial infection. The population of Malta has high rates of infection with intracellular pathogens; leishmania, brucellosis and tuberculosis are all endemic, while leprosy, which was previously endemic, has only recently been eradicated. We hypothesised that heterozygous carriers of the IFNGR1 gene mutation, while resistant to infection with poorly pathogenic organisms, may have increased susceptibility to infection with more virulent pathogens. Methodology and Result: Screening patients with a past history of intracellular infection and healthy newborns for the presence of the IFNGR1 A->C395 mutation, using sequence specific primer PCR, did not identify any carriers of the mutation. Conclusion: These results suggest that the IFNGR1 mutation is unlikely to be of public health significance on Malta.peer-reviewe