https://www.um.edu.mt/library/oar/handle/123456789/39870 2026-04-05T04:00:48Z 2026-04-05T04:00:48Z Attard, Stephanie Borg, Denise Mamo, John Vella, Sandro https://www.um.edu.mt/library/oar/handle/123456789/25688 2018-01-12T02:18:07Z 2017-01-01T00:00:00Z

Title: Transfusion-related acute lung injury : case report and literature review Authors: Attard, Stephanie; Borg, Denise; Mamo, John; Vella, Sandro Abstract: Blood transfusion is a common procedure that usually goes without complications. However, adverse transfusion reactions should not be overlooked. Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related fatalities and is characterized by the onset of acute respiratory distress in the form of noncardiogenic pulmonary oedema. We hereby report the case of a 28 year old Jamaican lady who developed acute onset dyspnoea, tachycardia and hypoxaemia following transfusion of fresh frozen plasma and red cell concentrates.

2017-01-01T00:00:00Z Zammit, Daniela Xerri, Thelma Ellul, Pierre https://www.um.edu.mt/library/oar/handle/123456789/25685 2019-10-11T07:54:28Z 2017-01-01T00:00:00Z

Title: Rapidity of diagnosis and management of H. Pylori in the endoscopy unit at Mater Dei Hospital Authors: Zammit, Daniela; Xerri, Thelma; Ellul, Pierre Abstract: Introduction: H.pylori infection has been associated with various gastric pathologies and its prevalence varies between different countries. Furthermore, there is an increasing antibiotic resistance and the eradication rates have declined. There is clinical and administrative pressure as to provide the Rapid Urease Test (RUT) result as quickly as possible and ideally prior to discharge from the endoscopy unit. Results: A total of 542 patients fulfilled the inclusion criteria. The patient`s mean age was 54.6 years and 52.4% were female. The main clinical indications for an Oesophago-Gastro-Duodenoscopy (OGD) were dyspepsia (44.7%) and GORD (24.5%). The overall positivity rate was 15% of which 8.7% were early positive and 6.3% were late positive. Analysis of patients’ age with RUT positivity revealed that patients above the age of 60 years were more likely to have a positive result (p=0.013). There was no statistical significance between the H.pylori results and smoking (p= 0.6). In this study, there was a variety of 10 different eradication regimes prescribed, the most popular being the use of a PPI 20mg BD + Amoxicillin 1g BD + Clarithromycin 500mg BD for 10 days (total of 27 cases) versus 14 days (23 cases). Conclusion: This study demonstrates the importance of checking the RUT taken at endoscopy at 24 hours as this has given a 42% increase in the yield for H.pylori. It also demonstrates that various regimens are used in clinical practice. In view of the relatively low prevalence of H.pylori, especially amongst young patients, maybe it is prime time that treatment of H.pylori is specifically managed by culture and sensitivity to avoid worsening clarithromycin-resistance. Description: This article has been reprinted in Malta Medical School Gazette, Volume 2, Issue 1 in 2018.

2017-01-01T00:00:00Z Cardona Attard, Carol https://www.um.edu.mt/library/oar/handle/123456789/25650 2018-01-11T02:28:03Z 2017-01-01T00:00:00Z

Title: The role of kisspeptin signalling in the hypothalamic-pituitary-gonadal axis Authors: Cardona Attard, Carol Abstract: Kisspeptin is a hypothalamic peptide hormone, which plays a crucial role in puberty and fertility control by stimulating the release of gonadotrophin-releasing hormone, which in turn stimulates the release of luteinizing hormone and follicle stimulating hormone. It also interacts with neuropeptides neurokinin B and dynorphin A, and is under negative and positive feedback influences relayed by gonadal sex steroids. Loss of kisspeptin signalling results in hypogonadotrophic hypogonadism and impaired puberty. Kisspeptin expression and secretion is also affected by metabolic status and stress. Several studies have indicated a potential role for kisspeptin in the treatment of disorders causing hypogonadotrophic hypogonadism. This review aims to summarize the importance of kisspeptin and its role in the hypothalamic- pituitary-gonadal axis.

2017-01-01T00:00:00Z Navarro, Andre Sladden, David Casha, Aaron Manche, Alexander https://www.um.edu.mt/library/oar/handle/123456789/25649 2019-10-14T09:13:06Z 2017-01-01T00:00:00Z

Title: The difficulties in identifying and grafting an intramuscular coronary artery Authors: Navarro, Andre; Sladden, David; Casha, Aaron; Manche, Alexander Abstract: Myocardial bridging involves tunnelling of one of the coronary arteries through the myocardium, resulting in what are known as intramyocardial coronaries. While most patients with intramyocardial coronary vessels are asymptomatic, there is evidence that myocardial bridging may be the cause of sudden death. Given the low detection rate on coronary angiography, myocardial bridging may complicate coronary artery bypass grafting (CABG). This case report discusses a 72-year-old gentleman who underwent CABG, during which an undiagnosed intramuscular left anterior descending (LAD) coronary artery was found. With only the tapering end of the LAD visible at the apex of the heart, a small incision was made at this site and a 1mm probe inserted. At the uppermost reach of the probe the tip was felt to point superficial and therefore a second more proximal incision was performed. The left internal thoracic artery (LITA) was than successfully anastomosed with the proximal arteriotomy and a length of saphenous vein was used for anastomosis with the distal arteriotomy where the probe was originally inserted. The patient was discharged home 5 days post operatively.

2017-01-01T00:00:00Z