https://www.um.edu.mt/library/oar/handle/123456789/2441 2026-06-28T02:51:50Z 2026-06-28T02:51:50Z Mercieca, Elyse Zammit, Chantelle Borg, James https://www.um.edu.mt/library/oar/handle/123456789/147697 2026-06-25T09:19:58Z 2025-01-01T00:00:00Z

Title: Pulmonary embolism mimicking congestive heart failure Authors: Mercieca, Elyse; Zammit, Chantelle; Borg, James Abstract: Pulmonary embolism is a life-threatening condition that can present with a wide range of non-specific symptoms, often overlapping with cardiovascular diseases. Here, we report a case of an 83-year-old female with a history of hypertension, rheumatoid arthritis and mild heart failure presenting with signs and symptoms initially suggestive of acute decompensated heart failure. Further diagnostic workup revealed that the true underlying pathology was a bilateral submassive pulmonary embolism. This case highlights the diagnostic challenges and importance of considering pulmonary embolism in patients with seemingly classic signs of congestive heart failure.

2025-01-01T00:00:00Z Micallef, Ismael Gollcher, Alistair Grima, Gabriella Galea, Joseph Abela, Rachel https://www.um.edu.mt/library/oar/handle/123456789/147694 2026-06-25T09:16:05Z 2025-01-01T00:00:00Z

Title: Obturator hernias Authors: Micallef, Ismael; Gollcher, Alistair; Grima, Gabriella; Galea, Joseph; Abela, Rachel Abstract: Obturator hernias are an uncommon type of abdominal hernia, occurring at the pelvic floor. Clinical presentation is vague with symptoms including nausea and vomiting secondary to intestinal obstruction as well as inner thigh pain which can be clinically exacerbated by hip and knee flexion (Howship-Romberg sign). Imaging modalities such as computed tomography and ultrasound allow visualisation of the herniated tissue within the obturator foramen. Surgical reduction of the herniated contents is the standard intervention and can be performed via open or laparoscopic techniques.

2025-01-01T00:00:00Z Gambin, Jeannine Galea, Esther Pace, Doreen https://www.um.edu.mt/library/oar/handle/123456789/147691 2026-06-25T09:10:52Z 2025-01-01T00:00:00Z

Title: Refractory hypoglycaemia in a 45-year-old lady with malignant peritoneal mesothelioma Authors: Gambin, Jeannine; Galea, Esther; Pace, Doreen Abstract: BACKGROUND: Non-islet tumour hypoglycaemia (NICTH) is an uncommon paraneoplastic syndrome characterized by refractory hypoglycaemia potentially impacting quality of life.; CASE PRESENTATION: A 45-year-old lady with peritoneal mesothelioma developed unexplained refractory hypoglycaemia. Investigations supported NICTH. A management plan respecting her preferences and autonomy was made: a combination of high-dose dexamethasone, encouraging oral intake and as-needed intravenous (IV) dextrose. This avoided symptomatic hypoglycaemic episodes.; CONCLUSION: We describe an uncommon clinical manifestation of malignant mesothelioma and a pathophysiology overview. We explore the importance of timely diagnosis and appropriate management of hypoglycaemia in keeping with patients’ preferences and prioritising quality of life at end-of-life.

2025-01-01T00:00:00Z Zrinzo, Sarah Gauci, Carla Bellizzi, Muriel https://www.um.edu.mt/library/oar/handle/123456789/147690 2026-06-25T09:07:44Z 2025-01-01T00:00:00Z

Title: Chronic regional pain syndrome : emerging insights and established concepts Authors: Zrinzo, Sarah; Gauci, Carla; Bellizzi, Muriel Abstract: Complex Regional Pain Syndrome (CRPS) is a chronic and debilitating pain condition primarily affecting the limbs. It is characterized by hyperalgesia (increased sensitivity to pain) and allodynia (pain from non-painful stimuli), often accompanied by sensory, autonomic, motor, and trophic abnormalities. CRPS commonly follows extremity trauma or surgery but remains underreported due to diagnostic challenges and lack of awareness. Misdiagnosis with neuropathic pain syndromes often delays treatment. The introduction of the Budapest Criteria in 2003 has significantly improved diagnostic clarity and remains the gold standard for CRPS diagnosis globally. Patient education plays a crucial role in early identification, adherence to treatment plans, and coping strategies. Empowering patients with knowledge about CRPS may improve outcomes and reduce fear-avoidance behaviours.

2025-01-01T00:00:00Z