https://www.um.edu.mt/library/oar/handle/123456789/148 2026-06-03T22:48:04Z 2026-06-03T22:48:04Z https://www.um.edu.mt/library/oar/handle/123456789/146232 2026-05-07T13:12:50Z 2026-01-01T00:00:00Z

Title: The MMSC XI : a postscript Abstract: The XIth Malta Medical School Conference, organised at the Mediterranean Conference Centre in Valletta on the 4-6th December 2025, has come to pass. Incredibly, despite the challenges faced including but not restricted to often unreasonable bureaucracy, apathy, an almost two-year delay and of course spiralling expenses, the Conference was a success. The Malta Mediterranean Conference Centre (MCC) in Valletta is, undoubtedly, an amazing location and elevates ‘the whole’ by its inherent grandeur and historical splendour. Staff at the MCC, the Conference caterers, as well as the outside support for audiovisual aids for the Republic Hall, our website host, and other farmed-in miscellanea that a conference of this size necessitates, all ‘came good’ on the day(s)! Certainly, costings were at a premium, but we were not disappointed for having had to pay for quality.

2026-01-01T00:00:00Z Hoo, Fan Kee Ching, Siew Mooi Khan, Abdul Hanif Khan Yusof Loh, Wei Chao Rashid, Anna Misya'il Abdul https://www.um.edu.mt/library/oar/handle/123456789/146214 2026-05-07T08:23:01Z 2026-01-01T00:00:00Z

Title: Treatment of symptomatic intracranial atherosclerotic stenosis : a review Authors: Hoo, Fan Kee; Ching, Siew Mooi; Khan, Abdul Hanif Khan Yusof; Loh, Wei Chao; Rashid, Anna Misya'il Abdul Abstract: Intracranial atherosclerotic stenosis (ICAS) is an important cause of ischemic stroke worldwide, accounting for 8-10% of strokes in North America and Europe and up to 50% in some Asian populations. Patients with symptomatic ICAS are at high risk of recurrent stroke, with rates up to 18% at 1 year despite medical therapy. This review discusses current evidence on prognosis, risk factors, and optimal medical and endovascular treatment for symptomatic ICAS. All patients should receive intensive medical therapy focused on antiplatelet agents, blood pressure control, cholesterol management, and lifestyle changes. Short-term dual antiplatelet therapy provides additional benefit for some patients. Endovascular stenting has not shown benefit over medical therapy in clinical trials and is not routinely recommended. However, selected patients who fail medical management may be considered for stenting or alternate endovascular approaches on an individual basis. Further research is critically needed to identify patients at highest risk of recurrence and evaluate novel therapies to improve outcomes. This review provides a framework for prognosis and management of symptomatic ICAS based on current evidence.

2026-01-01T00:00:00Z Darmanin, Julia Zarb, Maria Galea, Ruth Vella, Malcolm https://www.um.edu.mt/library/oar/handle/123456789/146212 2026-05-07T08:11:37Z 2026-01-01T00:00:00Z

Title: Utilisation of cardiac holter monitoring and echocardiography following acute ischemic stroke or transient ischemic attack Authors: Darmanin, Julia; Zarb, Maria; Galea, Ruth; Vella, Malcolm Abstract: BACKGROUND: The audit was conducted at Mater Dei Hospital in Malta, assessing the adherence to guidelines and the effectiveness of current practices. The audit aimed to evaluate the time interval between stroke events and outpatient cardiac holter monitoring and transthoracic echocardiography (TTE), as well as scrutinize the detection of subclinical atrial fibrillation (AF) in secondary stroke prevention, as per European Stroke Organisation (ESO) recommendations.; METHODOLOGY: Retrospective data was obtained from patient records, documenting the number of patients with an ordered outpatient cardiac holter and/or outpatient TTE following an ischaemic stroke or TIA.; RESULTS: The findings reveal that a significant number of patients are experiencing prolonged waiting times. Of the 63 scheduled holters, 71% of patients waited for over 200 days. This delay is concerning, especially considering the high contribution of AF to stroke-related morbidity and mortality. Of the 71 scheduled TTEs, 53.5% of patients waited over 100 days. The audit discovered that, from the 54 performed outpatient cardiac holters, no patients were identified with previously undiagnosed AF during monitoring and from the 71 performed outpatient TTEs 1 identified new onset AF. This emphasizes the potential benefits of extended monitoring durations.; CONCLUSION: This audit highlights the necessity for enhanced strategies in outpatient cardiac monitoring and echocardiography following ischemic stroke or TIA. Implementing the provided recommendations can significantly enhance AF detection, mitigate the risk of recurrent strokes, and ultimately lead to improved patient outcomes.

2026-01-01T00:00:00Z Alhassawi, Abdulrahman Busuttil, Gerald Bedz, Darya Cordina, Anthony Demicoli, Pierre Farrugia, David https://www.um.edu.mt/library/oar/handle/123456789/146211 2026-05-07T08:07:38Z 2026-01-01T00:00:00Z

Title: Stone-free rate post extracorporeal shock wave lithotripsy (ESWL) in the management of adult renal stones Authors: Alhassawi, Abdulrahman; Busuttil, Gerald; Bedz, Darya; Cordina, Anthony; Demicoli, Pierre; Farrugia, David Abstract: BACKGROUND: Extracorporeal Shock Wave Lithotripsy (ESWL) has been, and still is, one of the main kidney stone treatments available at Mater Dei Hospital in Malta and worldwide. This audit is aimed at identifying stone free rates (SFR) and stone factors that influence treatment outcomes.; METHODS: Retrospective data collection was conducted by collating stone density, size and type, skin to stone distance and stone free rates for all ESWL treatment sessions performed over a 14-year period between 2008 and 2022. Statistical analysis was performed to identify stone free rates after treatment and stone factors which were shown to be significant in influencing outcome.; RESULTS: The overall SFR was calculated as 30.1% from the 719 ESWL sessions included in this audit. Stone density in Hounsfield Unit (HU) was significantly associated with stone free status after treatment (p=0.0001). Stone size was also associated with SFR (p=0.001). Skin to stone distance, presenting and stone position were not significantly related to SFR.; CONCLUSION: The overall SFR was found to be lower than that quoted in most studies, even when accounting for the strict definition of complete clearance of the treated stone used. This audit should hopefully lead to development of treatment protocols in terms of multiple sessions and power ramping, as well as stricter follow-up and continuous re-audit to improve future outcomes.

2026-01-01T00:00:00Z