https://www.um.edu.mt/library/oar/handle/123456789/1071 2026-04-12T14:54:24Z https://www.um.edu.mt/library/oar/handle/123456789/1121 Title: Blood transfusion and blood banking in Malta : a historical perspective Authors: Balzan, Claudine Abstract: Curiosity and necessity are the main drivers in discoveries and innovations. By researching functions and analysing the human body, man was able to discover important techniques that are still used today in order to minimise pain and prolong life. One of these was the discovery of the composition of blood and its importance in saving lives. This article describes how blood transfusion and blood banking developed throughout the years in Malta. 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/1120 Title: Coeliac crisis with severe hypokalaemia in an adult Authors: Magro, Rosalie; Pullicino, Edgar Abstract: Coeliac crisis is a rare life-threatening presentation of coeliac disease, in which acute dramatic metabolic derangements are present. It is observed mainly in children less than two years of age. In adults, coeliac disease usually has an indolent course and presents with mild gastrointestinal symptoms or may even be asymptomatic and present with long term complications including anaemia, osteoporosis and infertility. This case describes a 38 year old gentleman who presented with acute diarrhoea that led rapidly to severe metabolic disturbances including life threatening hypokalaemia. This case illustrates the heterogeneous clinical course of coeliac disease and the importance of considering it in the differential diagnosis of adult patients presenting with acute diarrhoea and metabolic disturbances. 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/1119 Title: Lateral fixation for bilateral vocal cord paralysis and its social aspects Authors: Jan, Mejzlik; Chircop, Kieran; Borg, Charles Joseph Abstract: Introduction: Different techniques are used to reduce laryngeal obstruction in bilateral vocal cord paralysis. Methods: This article describes one of the simplest and less traumatic techniques that can be used in cases of bilateral vocal cord paralysis. This technique has been previously published, but it is the first time to be used in Malta. No preoperative tracheostomy is needed. This procedure is carried out under general anesthesia where two needles are inserted through the thyroid cartilage. Non-resorbable monofilament sutures are introduced through the needles and the needles are then withdrawn. The fiber thus forms a permanent loop around the vocal cord. Conclusion: Using this new method the patients’ breathing as well as voice quality improves significantly. Apart from being very effective, this technique is also minimally invasive and at the same time doesn’t preclude more extensive surgical procedures from being performed. 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/1118 Title: Cerebral function monitoring in term or near term neonates at MDH : preliminary experience and proposal of a guideline Authors: Attard, Stephen; Soler, Doriette; Soler, Paul Abstract: Introduction: Cerebral function monitoring (CFM) is a simplified EEG device that is used to monitor cerebral function at the cot-side. Various studies have shown its value in detecting neonatal encephalopathy and electrographic seizures, prognostication of neonatal cerebral insults, assessment of response to anticonvulsant therapy and in selecting encephalopathic infants for therapeutic hypothermia. This paper describes our preliminary experience with this monitoring device at Mater Dei Hospital, and a draft of a protocol for its clinical application. Methods: Fourteen recordings were performed on neurologically normal and abnormal term neonates. The quality of the records and their correlation with other imaging and standard EEG findings was assessed. A dataset including technical and clinical particulars of these cases was then compiled, analyzed and discussed. Results: Amplitude aEEG traces were recorded from a total of 14 patients, 4 of whom were normal term or near term infants, and 10 were infants with a neurological abnormality. All records were of satisfactory quality, and all showed very high impedance levels. Five out of 11 neurologically-abnormal patients had signs of seizure activity on CFM. A technical fault caused high impedance level in the first 2 traces. Annotations were generally lacking. Five out of 10 infants with CNS problems had clinical seizures of which 4 had electrographic seizures on CFM, 4 had electrographic seizures on formal EEG, and 3 had abnormal MRI findings. Conclusion: Our local experience has confirmed the usefulness of CFM monitoring in the setting of a neonatal intensive care unit. Despite some initial problems with high impedance levels and electrode attachment, the tracings obtained were reproducible and of good quality. Almost half of the neurologically-abnormal neonates showed signs of seizure activity on CFM with good correlation with clinical and standard EEG. The timely diagnosis enabled the clinicians to confirm seizure activity, initiate anticonvulsant therapy and monitor the response. Staff training is vital in order to improve utilisation of CFM in neonatal practice. 2012-01-01T00:00:00Z