Portal vein thrombosis : a case report and literature review

A case report of Portal Vein Thrombosis (PVT) as a complication of protein S deficiency. PVT has been increasingly diagnosed over the years, particularly through the use of ultrasound-Doppler equipment. The lifetime risk of getting PVT in the general population has recently reported to be 1%.1 While this condition has traditionally been associated with cirrhosis or liver malignancy, it may also occur without any liver disease. The case report is followed by a discussion of the aetiology and clinical presentations of PVT, as well as a review of the investigations and management proposed in the literature.peer-reviewe

Infectious intestinal disease : do we know it all?

Infectious intestinal disease (IID), with associated high morbidity and considerable mortality worldwide, causes a wide spectrum of illness. This ranges from mild discomfort to illness with severe complications. The economic burden from direct and indirect costs may be high. It is acquired by oral ingestion of micro-organisms which are transmitted from person to person; via food or water or through contact with animals or contaminated objects. Viruses are the commonest cause in developed countries. In Malta, medical practitioners and laboratories are the main source of data on IID. However, under-reporting is a problem. In order to fill in the lacunae in information on the disease burden, population-based-studies are required. Along with other countries, Malta has embarked on a number of studies to describe and quantify under-reporting of IID. This may assist in strengthening the surveillance system which, in combination with other measures, should result in an improvement of the control of IID.peer-reviewe

Laboratory surveillance of communicable diseases : enteric pathogens

Laboratories represent a crucial link in the surveillance chain. Since only a small proportion of cases of enteric infections are asked to submit a stool sample, one needs to assess the practices for testing for enteric pathogens and their notification practices. Five local laboratories participated in this study. This included a description of the laboratory practices; capacity for stool sample analysis; awareness of the notification system and the factors which could improve the system at laboratory level.peer-reviewe

Characterisation of the semi-volatile component of Dissolved Organic Matter by Thermal Desorption – Proton Transfer Reaction – Mass Spectrometry

Proton Transfer Reaction – Mass Spectrometry (PTR-MS) is a sensitive, soft ionisation method suitable for qualitative and quantitative analysis of volatile and semi-volatile organic vapours. PTR-MS is used for various environmental applications including monitoring of volatile organic compounds (VOCs) emitted from natural and anthropogenic sources, chemical composition measurements of aerosols, etc. Here we apply thermal desorption PTR-MS for the frst time to characterise the chemical composition of dissolved organic matter (DOM). We developed a clean, low-pressure evaporation/sublimation system to remove water from samples and coupled it to a custom-made thermal desorption unit to introduce the samples to the PTR-MS. Using this system, we analysed waters from intact and degraded peat swamp forest of Kalimantan, Indonesian Borneo, and an oil palm plantation and natural forest in Sarawak, Malaysian Borneo. We detected more than 200 organic ions from these samples and principal component analysis allowed clear separation of the diferent sample origins based on the composition of organic compounds. The method is sensitive, reproducible, and provides a new and comparatively cheap tool for a rapid characterisation of water and soil DOM

Barriers to implement a smoke free hospital : What action should be taken?

Objective: Tobacco is leading to increased morbidity and mortality. Hospitals have a key role to play in the effective control of tobacco. The aim of this survey was to identify the barriers in implementing a smoke free hospital. Methods: The tool used was a modified Fagerstrom questionnaire. These questionnaires were distributed to all employees at the main state hospital. The data obtained was analysed using SPSS software using frequency tables, univariate and multivariate analysis. Results: The response rate was 55.1%. The findings showed that 27.1% of male staff and 24.8% of female staff are active smokers. 22.2% of smokers refrain from smoking in hospital. The highest percentage of smokers was in the youngest age group (18-25 years). The highest prevalence of smoking was found in nurses (23.6%), followed by doctors (10.4%). A positive finding was that 25.7% of current non-smokers were ex- smokers with the greatest incentive to quit being for health reasons. Most members of staff were aware of the adverse effects of smoking and a number had symptoms suggestive of smoking-related pathology. Conclusion: Hospital staff mirror the general population with respect to smoking prevalence, habits and co morbidities. This indicates that further initiatives are required to decrease the number of health professionals who smoke, as these should ideally be role models for patients, and hence be able to effectively support patients in quitting smoking.peer-reviewe

A survey to assess smoking awareness and attitudes of staff at a local hospital

Rising smoking-related morbidity and mortality would be expected to lead to increased awareness among hospital staff regarding the harmful effects of cigarettes. The aim is to assess the smoking habits of individuals working within a hospital setting who are directly or indirectly exposed to patients with smoking-related illnesses. The survey addresses health issues and attitudes towards smoking. The timing is opportune in that Mater Dei Hospital Malta is to be declared a totally smoke-free hospital.peer-reviewe

Vaccine hesitancy among Maltese healthcare workers vis-à-vis influenza and COVID-19 vaccination

INTRODUCTION: Vaccine hesitancy is a chronic public health threat. This study was carried out to ascertain Maltese healthcare workers’ hesitancy to COVID-19 vaccination and correlate this with influenza vaccine uptake.METHODS: A short, anonymous questionnaire was sent out to all of Malta’s government sector healthcare workers via the service’s standard email services (11-19/09/2020). A total of 9,681 questionnaires were posted electronically, with 10.4% response.RESULTS: The proportion of Maltese healthcare workers who “will take” the influenza vaccine increased significantly. Doctors had the highest baseline uptake and highest likely influenza vaccine uptake next winter. The likely/undecided/unlikely to take a COVID-19 vaccine were 52/22/26% respectively. Males were likelier to take the vaccine. Doctors had the highest projected likelihood to take vaccines. Likelihood of taking COVID-19 vaccine was directly related to the likelihood of influenza vaccination. Concerns raised were related to insufficient knowledge about such a novel vaccine, especially unknown long term side effects.DISCUSSION: The anticipated increased uptake of influenza vaccine is probably due to increased awareness of respiratory viral illness. Doctors may have higher vaccine uptakes due to greater awareness and knowledge of vaccine safety. The proportions of who are likely/undecided/unlikely (half, quarter, quarter respectively) to take a COVID-19 are similar to rates reported in other countries. The higher male inclination to take the vaccine may be due the innate male propensity for perceived risk taking. Shared COVID-19 with influenza vaccine hesitancy implies an innate degree of vaccine reluctance/hesitancy and not merely reluctance based on novel vaccine knowledge gap.peer-reviewe

Vaccine hesitancy among Maltese healthcare workers vis-à-vis influenza and COVID-19 vaccination

INTRODUCTION: Vaccine hesitancy is a chronic public health threat. This study was carried out to ascertain Maltese healthcare workers’ hesitancy to COVID-19 vaccination and correlate this with influenza vaccine uptake. METHODS: A short, anonymous questionnaire was sent out to all of Malta’s government sector healthcare workers via the service’s standard email services (11- 19/09/2020). A total of 9,681 questionnaires were posted electronically, with 10.4% response. RESULTS: The proportion of Maltese healthcare workers who “will take” the influenza vaccine increased significantly. Doctors had the highest baseline uptake and highest likely influenza vaccine uptake next winter. The likely/undecided/unlikely to take a COVID-19 vaccine were 52/22/26% respectively. Males were likelier to take the vaccine. Doctors had the highest projected likelihood to take vaccines. Likelihood of taking COVID-19 vaccine was directly related to the likelihood of influenza vaccination. Concerns raised were related to insufficient knowledge about such a novel vaccine, especially unknown long term side effects. DISCUSSION: The anticipated increased uptake of influenza vaccine is probably due to increased awareness of respiratory viral illness. Doctors may have higher vaccine uptakes due to greater awareness and knowledge of vaccine safety. The proportions of who are likely/undecided/unlikely (half, quarter, quarter respectively) to take a COVID-19 are similar to rates reported in other countries. The higher male inclination to take the vaccine may be due the innate male propensity for perceived risk taking. Shared COVID-19 with influenza vaccine hesitancy implies an innate degree of vaccine reluctance/hesitancy and not merely reluctance based on novel vaccine knowledge gap.peer-reviewe

Quantifying tropical peatland dissolved organic carbon (DOC) using UV-visible spectroscopy

UV–visible spectroscopy has been shown to be a useful technique for determining dissolved organic carbon (DOC) concentrations. However, at present we are unaware of any studies in the literature that have investigated the suitability of this approach for tropical DOC water samples from any tropical peatlands, although some work has been performed in other tropical environments. We used water samples from two oil palm estates in Sarawak, Malaysia to: i) investigate the suitability of both single and two-wavelength proxies for tropical DOC determination; ii) develop a calibration dataset and set of parameters to calculate DOC concentrations indirectly; iii) provide tropical researchers with guidance on the best spectrophotometric approaches to use in future analyses of DOC. Both single and two-wavelength model approaches performed well with no one model significantly outperforming the other. The predictive ability of the models suggests that UV–visible spectroscopy is both a viable and low cost method for rapidly analyzing DOC in water samples immediately post-collection, which can be important when working at remote field sites with access to only basic laboratory facilities

The Role of Accidental and Therapeutic Hypothermia in Non-Fatal Drowning

A case of non-fatal drowning with a successful outcome despite a submersion time of 25 min is described. Our case report emphasizes the role of accidental hypothermia in the survival of drowning victims with hypoxic brain injury, and supports the use of therapeutic hypothermia in the resuscitation of these patients