Primary hyperparathyroidism : a diagnostic and operative problem

Early diagnosis and early surgery for primary hyperparathyroidism are of paramount importance. Various aids are available for both and have been discussed. Clinical features including nephrolithiasis and peptic ulceration are also described. Furthermore, bone pain is a relatively common symptom. Progression of the disease leads to progressive deformity, like kyphosis, bowing of the limbs. Whatever the presenting feature or features of primary hyperparathyroidism, the adenoma or adenomata must be removed. Parathyroid adenoma will eventually cripple the patient and kill him. An endeavour has been made to show pitfalls and disagreements in the laborious progression from clinical suspicion, biochemical confirmation of the diagnosis to surgical extirpation.peer-reviewe

Upper abdominal injuries

The incidence of upper abdominal injuries is not confined to automobile users, but with the great increase in road traffic, the majority of these injuries result from road traffic accidents. There are various mechanisms by which this particular type of trauma may be produced; as a result, more than one internal organ may be involved. One must beware of associated injuries to the chest, skull and skeleton. Six cases of severe upper abdominal injury have been reported. Their immediate and subsequent management has been discussed. It is obvious from the case histories and a review of the relevant literature that awareness of the various possibilities is the first prerequisite for a proper assessment and treatment of the patient. One must also beware of the presence of associated injuries which may be masked by the severity of trauma to one or other viscus.peer-reviewe

SIDS and infant sleeping position : audit on the advisory campaign in Malta

Background: The baby’s sleeping position is the most important modifiable risk factor in Sudden Infant Death Syndrome (SIDS). The “back to sleep” position is safer than side or prone position. Objectives: To determine what advice midwives and nurses at St Luke’s Hospital give to new mothers about the baby’s sleeping position; and whether the practice has changed following a series of lectures on SIDS and a focused circular issued by the Department of Health in February 2007. Methods: A questionnaire-based, descriptive, and crosssectional before-after trial. Results: In 2007, 81% of midwives/nurses advised exclusive back sleeping position, compared to 38% in 2006 (p<0.0001). Conclusion: The audit demonstrates a notable increase in the number of midwives/nurses giving correct advice to the new mothers.peer-reviewe

The Gozo stone circle re-discovered

Every summer between 1987 and 1994 excavations were carried out on an archaeological site on the outskirts of Xaghra in Gozo, about half way between the important prehistoric remains at Santa Verna and the Ggantija Temples. The project involved the Universities of Malta, Cambridge and later Bristol, in conjunction with the Malta Museum of Archaeology. This site has long been known as the Gozo Stone Circle. It was given the name Brocktorff Circle in 1972 by Dr. David Trump, a former Curator of Archaeology in Malta, in commemoration of Charles Frederick Brocktorff, the German artist who painted the Circle in the 1820s .. Earlier in archaeological and historical literature, it has been referred to variously as Un Edifice Antique de Forme Circulaire, A Circle of Cyclopean Walls or simply as the Gozo Stone Circle. But the earliest reference to this site is found in an old manuscript in Italian, in which it is described as Un Recinto in Forma di Torneo, i.e. a circular enclosure (M.C.A. Mise. 55: 144).peer-reviewe

A case of a large, painless retroperitoneal mass causing hydronephrosis and biliary obstruction

A 56-year-old man presented with abdominal distention over a few months. He was otherwise well and routine blood tests were normal. Examination of the abdomen revealed a firm swelling. CT scan was performed for further evaluation.peer-reviewe

Physicochemical characterization of Gozitan honey

Honey quality is clearly defined in the EU Directive 2001/110/EC, and by Codex Alimentarius (Codex Stan 12-1981) and the International Honey Commission (International Honey Commission, 2002). Our investigation aimed to characterize the physicochemical properties of honey produced on a small island, Gozo which is situated near Malta. Ten randomly collected honey samples were analysed for moisture content, pH, free acidity, water insoluble content, hydroxymethylfurfural (HMF) content and total phenolic compounds. Moisture content, pH, free acidity, water insoluble content, and HMF content were within the range specified in standards but the electrical conductivity was generally higher than 0.800 mS cm−1. This may be the result of the relatively high atmospheric and soil salinity on this small island. All the samples analysed were within the 40 mg kg−1 HMF limit, which is an indicator of honey quality. The total phenolic compounds, which represent some of the constituents derived from the nectar and pollen obtained during foraging, ranged between 236.555 and 294.209 GAE kg−1 honey. Principal Component Analysis showed the properties of polyfloral honey samples obtained from the southern part of the island to be different from those obtained from the northern part.peer-reviewe

Incidence of acoustic neuroma in Malta

Objective: Establishing the incidence of acoustic neuroma in Malta over the last 17 years. Methods: A retrospective study whereby records of patients referred for treatment abroad were reviewed along with the Magnetic Resosnance Images of the Internal Auditory Meatus (MRIAMs) performed from 2009 until 2016. All new cases of acoustic neuroma were included in the study. Results: 76 new cases of acoustic neuroma were discovered over the 17 years, resulting in an incidence of 1.1 per 100000. Conclusion: This is the first study trying to establish the incidence and epidemiology of acoustic neuroma in Malta.peer-reviewe

An evaluation of in-patient respite care at St. Vincent de Paul Residence

Aim: To identify the multi-dimensional characteristics and need for inter-disciplinary input associated with in-patient respite care. Methods: During the period January-December 2007, 91 in-patient respite users, aged ≥60 years, were assessed on admission for respite care at St. Vincent de Paule Residence. Assessment instruments used included the Barthel Index, the Mini-Mental State Examination, a Caregiver Strain Index, the Functional Oral Intake Scale and the Communicative Effectiveness Index. Findings: Of the study group (n=91), 65% of respite users were found to be suffering from moderate to severe dementia (Mini-Mental State Examination score 0-20). High dependency on the Barthel Index (0-7/20) was found in 52% of cases whilst 45% had low dependency (13-20/20). Carer strain was reported in 60% of care-givers (carers). Interdisciplinary input requirements in the group studied included nursing in 85%, dental (83%), speech language pathology (70%), physiotherapy (39%), occupational therapy (38%), medical (33%) and social worker assistance (24%). Conclusion: Elderly respite users are a mixed group with multiple and diverse needs. In their own homes, these care needs are principally met by informal helpers who are frequently under stress. The expansion of in-patient respite services will reinforce the informal community care network and will help avoid or postpone long-term institutionalisation.peer-reviewedpeer-reviewe

Health and the Economy : a statement of concern

The relationship between health and the economy is an intimate and complex one. The economy of health and the apportioning of funds to different medical services and health care programs are issues that depend on the health profile of a given community as well as the expectations of its members. Decisions ultimately depend on available resources and political priorities. Health and the economy cannot be isolated and contrasted, as the integrity of a given economic system clearly depends on the state of health of the community both at an individual level as well as at a population level.peer-reviewe