https://www.um.edu.mt/library/oar/handle/123456789/38142 2026-06-27T16:56:47Z https://www.um.edu.mt/library/oar/handle/123456789/10142 Title: Septic emboli secondary to Infective Endocarditis Authors: Paris, Timothy; Padovani, Luisa; Pavia, Jessica Abstract: A 31 year old lady was brought to casualty by a friend, unconscious and incontinent of urine and faeces. She was responsive to verbal stimuli with a Glasgow Come Scale (GCS) of 10 and noted to have a fever of 39.6oC. She had a blood pressure (BP) of 116/65 mmHg and a pulse rate of 160 bpm. She was allegedly unresponsive for two days prior to admission. She is a known intravenous drug user (IVDU). Physical examination revealed bilateral puncture wounds in the groin. In view of her poor general condition she was admitted to the intensive therapy unit (ITU). She was started in empirical antibiotics which included both G+ and G- coverage. Blood culture eventually grew a methicillin sensitive staphylococcus areus (MSSA), and the antibiotics were eventually downgraded to flucloxacillin. A transoesophageal echocardiogram (TOE) showed a massive infective endocarditis of the mitral valve, which was rendered incompetent. An MRI scan of the brain revealed multiple septic emboli resulting in several cerebral infarcts. 2016-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/10141 Title: Pemphigus Vulgaris : case report Authors: Cassar, David; Cauchi, Suzanne Editors: Boffa, Michael J.; Mercieca, Liam Abstract: Case report on a 53yr old gentleman who initially presented to his family doctor with mouth ulcers, hoarseness and odynophagia. He was given various treatments including antibiotics, anti-virals, non-steroidal anti-inflammatory drugs (NSAIDs) and oral steroids with no effect. His condition worsened and was associated with a 5kg weight loss. He subsequently developed skin blisters and erosions and was referred to the dermatology department. A clinical diagnosis of pemphigus vulgaris was made and he was started on high dose oral steroids. A skin biopsy sent for histology and immunofluorescence confirmed the diagnosis. On confirmation he was admitted for rituximab therapy and started on azathioprine. 2016-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/10140 Title: Becker’s Muscular Dystrophy : case report Authors: Grech, Neil; Degiorgio, Sophie Editors: Aquilina, Josianne Abstract: Case report regarding a 23 year old gentleman, presented with difficulty climbing stairs, changes in posture and toe walking. Significant calf hypertrophy was seen on examination. A muscular dystrophy was the probable diagnosis and to confirm, this various investigations were carried out, including: genetic testing, electromyography (EMG), and creatinine kinase (CK) levels. The doctors’ suspicions were confirmed and the patient was diagnosed with a de novo mutation of Becker’s Muscular Dystrophy (BMD). A cardiac work up followed to assess for dilated cardiomyopathy which is associated with BMD, although Mr. K.B. was still asymptomatic. BMD is a very rare disease with an incidence in males as low as 1 in 30,000 people. The prevalence in females is extremely low, as BMD is an X linked disorder. Apart from this, Mr. K.B’s case is particularly more rare due to the fact that genetic studies have shown a de novo mutation, furthermore no other family member is affected by the disease, nor is a carrier. Under Dr. Aquilina’s care, only one other family has been reported in Malta. 2016-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/10139 Title: Phantom pain Authors: Duca, Kristina Editors: Muscat, Richard Abstract: Almost anyone with a limb amputation experiences phantom sensations. Moreover, the majority of amputees experience pain. This phenomenon is known as ‘Phantom pain’ and is described as the pain felt from a body part, usually a limb, which is no longer present. Several mechanisms have been proposed in attempt to explain this phenomenon with some being more prevalent than others. Cortical remapping seems to explain a substantial part of the occurrence of phantom pain and will be focused upon throughout this review. Since the exact mechanism underlying phantom limb pain is unknown, treatment for this condition is still quite primitive and is mostly by trial and error. However, ‘Mirror Therapy’ has recently been suggested which seems to show promising results for the effective treatment of phantom pain. 2016-01-01T00:00:00Z