Factors determining gender ratio in the Maltese population

Introduction: The Male/Female ratio at birth has been described to favour the male conceptus, a situation that persists throughout most of childhood and into the reproductive phase of life. The reasons behind this preferential male-favouring remain elusive. Methodology: The various relevant obstetric and population national registers kept by the Department of Health information and the National Statistics Office of the Maltese Islands were reviewed to elucidate the age-related M/F ratios differences in the population starting with the third trimester of the antenatal period. In addition, third trimester M/F ratios in women with specific metabolic-related disorders were assessed and compared to the on-affected individuals. The role of foetal congenital malformations was also investigated. Results: It would appear that the M/F ratio starts favouring the male conceptus as early as the third trimester of the antenatal period. It remains favoured right through the reproductive age reaching par after the age of 45 years when it shifts to favour the female. This relationship was significantly altered during the 1930s as a result of the emigration patters prevalent during that period. The results further show that the maternal nutritional and biochemical milieu may influence the M/F ratio at the beginning of the third trimester with women suffering from adiposity, diabetes and thyroid disease having higher M/R ratios. In spite of this preference to the male conceptus, malts have a higher mortality throughout life with mortality rates being higher for males from the third trimester up to the age of 75 years. On the other hand, female foetuses with malformations appear to have a higher mortality during intrauterine life than corresponding male foetuses. Conclusion: The M/F ratio appears to favour the male conceptus during antenatal life and is definitely evident by the beginning of the third trimester of pregnancy, the selection mechanism possibly being a greater predisposition of female foetal loss in the presence of malformations. These biological observations may present advantages within the breath of human reproductive ecology, ensuring a healthy reproductive female individual who has the option of choosing her mate from a competing male community.peer-reviewe

Hospitaller activities in medieval Malta

The Medieval Period in the Mediterranean World is generaly considered to cover a period of about a thousand years, and is considered to initiate with the end of the Roman era heralded by the division of the Roman Empure into two parts between the sons of Theodosius in AD 395. It ended with the advent of the Renaissance movement of the fifteenth century. This period in Malta was to see the Islands come under the influence of the Byzantine Empire encompassing the period prior to the ninth century; the Arab dominance starting in AD 870 and lasting until their formal expulsion in the mid-13th century; and the Latin phase of the late 13th century to the early 16th century when the islands were ceded to the Order of St. John of Jerusalem. The documentary sources dated to before the 14th century are rather scanty and often limited to ecclesiastical and political matters. A number of extant documents relate to medical matters, particularly with the setting up and management of hospital services and with matters relating to the affairs of hospitaller orders having links to the Maltese Islands.peer-reviewe

A maternity unit in Gozo a hundred years ago

The present paper reviews the hospital confinements which occurred at Victoria Hospital in Gozo during the period 1876-1893. These hospital confinements are shown to have been generally restricted to needy women from the lower socio-economic strata. The lower socio-economic status of these mothers, together with the fact that these mothers were more likely to have significant medical and/or obstetric problems, resulted in higher perinatal and maternal mortality rates than those reported for the general population in Gozo and Malta. These observations are in conformity with the maternity care situation in European establishments.peer-reviewe

Nineteenth-century disciplinary enquiry at Victoria Hospital, Gozo

In this article the author presents a report which describes an enquiry into the actions of a junior medical practitioner employed with the public sector in the late nineteenth century, wherein the final intention was in disciplining the officer without attempting to correct the circumstances which led to the incident. An account of the case which provoked the disciplinary enquiry is described in the article.peer-reviewe

Dr. James Barry : an enigmatic army medical doctor

In spite of marked eccentricity, Dr. Barry became notorious only after dying on 25th July 1865. The Irish newspaper Saunders’s News Letter on 14th August 1865 reported Dr. Barry’s death and revealed that the doctor was in fact a female who had masqueraded as a male throughout her life. Dr. Barry had served as a principal medical officer with the British Military in Malta for about four and a half years. An eccentric but very professionally able person, Dr. Barry joined the Army Medical Department as a hospital assistant on 5th July 1813 and subsequently practiced for the benefit of soldiers in Plymouth, South Africa, Jamaica, St. Helena and Barbados before being posted to Malta on 2nd November 1846. Through her subterfuge, Dr. James Barry had made history by being the first woman in Britain to graduate as a medical doctor and to fulfil an active army career dedicated to Medicine and the amelioration of human suffering. Whatever the reasons for the subterfuge, Barry, during her forty-six years service showed herself to be a successful doctor and administrator.peer-reviewe

King George V Hospital in Malta : Sacra Infermeria for the Order of St. Lazarus of Jerusalem

King George V Hospital, originally commissioned in 1922, saw its closure in 1967. It was eventually reopened under the management of the Department of Health as Boffa Hospital in 1970. In the interim years, the budding Maltese jurisdiction of the Military and Hospitaller Order of Saint Lazarus of Jerusalem made serious bids to assume the management of the hospital hoping to set up a service for public and private-paying patients.peer-reviewe

War and population change in the Maltese context

Warfare is associated with marked social consequences that directly and indirectly will influence the reproductive patterns of the population. The present analysis looks at the population changes that occurred during the three of the four major conflicts where the Maltese population was directly involved. The study confirms that one of the consequence of warfare in the Maltese context during the centuries was a reduction in birth rates that picked up again in the post-war period.peer-reviewe

Fenugreek : a natural prototype oral hypoglycaemic agent used in Malta

Before the discovery of insulin therapy in 1921 and the development of effective oral hypoglycaemic therapy in 1926, pharmacological management of diabetes mellitus was restricted to empirical treatment often based on plant products and relegated to folklore medicine. One therapy reputed in Malta as useful for the management of diabetes mellitus in 1927 was Fenugreek. This has now been shown to have definite pharmacological properties that controls blood glucose levels in diabetic subjects.peer-reviewe

Contraception use in Malta

Temporal surveys of family control methods being used within the Maltese setting carried out in the 1970's and 1990's had shown a definite shift towards the more effective methods of contraception. The present study was carried out on a mixed gender population of 211 individuals with a strong bias towards the highly educated sector of the population. The respondents reported a higher rate of family control that in previous studies with a greater reliance on the effective methods particularly the barrier method, hormonal manipulation, and sterilisation. The latter appeared to be an option limited to the older age groups rather than in the young. There has been a further significant decrease in reliance to the natural methods of contraception including the rhythm method supported by the Roman Catholic Church and coitus interruptus. The study further confirms the increasing secularisation and distancing from traditional values that is occurring in the Maltese population.peer-reviewe

Past Influenza pandemics and their effect in Malta

The influenza virus type A has caused repeated pandemics throughout the 19th and 20 th century causing significant morbidity and mortality on a worldwide scale. The worst pandemic on record during the 20th century was that which occurred during 1917-19, the virus being assisted in its spread by the massive movement of persons brought on by World War I. The present increasing international travel has led to increasing alarm of the possible effects of an emerging pandemic with the WHO issuing guidelines to ensure the preparedness of health authorities. The various Influenza Type A pandemics of the late 19th and 20th century have had a varying effect on the Maltese community with influenza reaching epidemic proportions during the 1889-90 Asiatic Flu, 1917-19 Spanish Flu, 1957-58 Asian Flu pandemics, and 1968-69 Hong Kong flu, but no apparent effect during the 1977-78 Russian Flu pandemic.peer-reviewe