https://www.um.edu.mt/library/oar/handle/123456789/32503 2026-04-04T03:10:10Z https://www.um.edu.mt/library/oar/handle/123456789/50756 Title: Management of hypertension in primary care Authors: Schembri, Kirsten Abstract: Background: The European Society of Cardiology and the European Society of Hypertension define hypertension as systolic blood pressure ≥140 mmHg Hg, or diastolic blood pressure ≥90 mmHg Hg, or both. Hypertension is a challenging condition in view of it being asymptomatic, highly prevalent and requiring continuous follow-up by the family physician. Objective: To implement the available guidelines into clinical practice for better patient health.Method Multiple databases were used to perform the literature search including PubMed, National Institute of Clinical Excellence, Scottish Intercollegiate Guidelines Network, and the Turning Research Into Practice database. The following keywords were applied: hypertension, blood pressure, and primary care. Results: Blood pressure needs to be measured by a device which is regularly calibrated. This could be a traditional mercury sphygmomanometer, aneroid sphygmomanometer or the automated sphygmomanometer. The cuff size should be adjusted according to the patient’s arm circumference and the patient should be seated comfortably with the arm rested such that the cuff is at the same level as the heart. During the initial assessment, the blood pressure should be measured in both arms and then the arm with the highest reading is used for subsequent measurements. Ambulatory blood pressure monitoring should be offered if the blood pressure is found to be over 140/90mmHg (measured at least twice) during the initial assessment. Conclusion: Appropriate management of hypertension will contribute significantly towards an improvement in overall patient health. 2018-12-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/50753 Title: An evaluation of the conservative management of fractures with plaster in a Maltese primary health centre Authors: Grima, Martha; Abela, Jurgen Abstract: Introduction: Fracture management still remains a grey area in primary care internationally. In Malta, conservative fracture management operates as the Plaster Slab Service, a service which has never been evaluated. The purpose of this study is to assess this service in Mosta Health Centre (MHC) – the only health centre with a 24/7 X-ray service. The objective is to find common trends and to increase primary care awareness on conservative fracture management. Method: In this cross-sectional study, all patients who had a plaster cast done at MHC between August and December 2017 were included. Retrospective data was collected including demographic data (age, gender, locality), time of application, type of injury and plaster, problems related to the slab and wound healing as well as whether a repeat X-ray was taken. Results: Most plaster casts were required for the younger age group with another peak in the 60s-70s age group. Younger patients showed a significantly increased risk of sustaining a scaphoid or radial fracture. There was a significant link between patients’ locality and time of presentation. Only 44.6% of scaphoid fractures had a repeat X-ray done as follow up. Complications to fracture healing amounted to 1% whilst 5% had problems with the cast. Conclusion: At primary care level, a wide range of fractures can be successfully managed with a very low rate of complications. Possible areas for improvement include guideline adherence in the follow-up of fractures. 2018-12-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/50752 Title: A study on the attitudes of foundation doctors in Malta towards general practice and their experience while working in the specialty Authors: Baldacchino, Marilyn; Abela, Jurgen Abstract: Introduction: A substantial number of Foundation year (FY) doctors have a three month rotation in family medicine at the health centres in Malta. The aim of the study was to understand the factors that influence FY doctors’ attitudes towards general practice (GP) and the potential reasons why these doctors would choose a career in GP. Method: This consisted of a cross-sectional questionnaire study carried out with FY doctors in Malta. The online server Google Forms was used to collect data and manage the questionnaires. Data was extracted to Excel 2010 with which it was analysed. Results: Over the one-year study period 61 FY doctors had a GP rotation. The questionnaire response rate was 54%. For 72.7% of respondents, choosing a rotation in GP had been a priority; of these, 88% would consider a career in GP but it was the preferred career choice for only 50%. Sixty-nine point six per cent of doctors gave a very positive rating (more than 7 out of 10) of their experience at health centres, and 78.8% experienced a positive change in attitude towards the specialty of family medicine after this rotation. The rotation was rated as having the greatest influence on career choice. Quality of life was the most popular factor attracting doctors to GP. Lack of respect towards general practitioners and the challenge of managing clinical uncertainty with patients in family medicine were the two main factors which discouraged doctors from such a career. Conclusion: General practice is a popular specialty in Malta and the Foundation rotation in GP was found to be one of the main factors influencing career choice. In view of this, it should be ensured that during the rotation doctors get a complete experience of general practice, which is a true reflection of what the specialty entails. 2018-12-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/50751 Title: MCFD president’s report : December 2017 - November 2018 Abstract: As you know this is my last year as President of the MCFD as I have served two terms. I had recommended myself that the statute be amended so that a President cannot serve more than two consecutive terms, in line with many international standards. Following last years’ election of Dr. Philip Sciortino as President-Elect, Dr Sciortino found it necessary not to fulfill this position and therefore another election was called in which Dr Edward Zammit was elected. The purpose of having an election for President-Elect one year before is for the person to gradually learn what is going on in council and therefore to have a smooth transition. We were lucky that Dr Zammit has been on Council for several years. I would like to publicly acknowledge the hard work that Dr Sciortino has done over the years, especially with running the Continuing Medical Education (CME) programme which many members attend and, whilst wishing him well, would hope that he continues to give support to the College when necessary. Dr Zammit is well placed to take over. He is experienced in one of the most important ventures of the College – that of the Summative Assessment for specialist trainees. He has been examination lead for the past few years. Good luck and I give him my full support. 2018-12-01T00:00:00Z