https://www.um.edu.mt/library/oar/handle/123456789/81316 2026-04-23T03:04:04Z https://www.um.edu.mt/library/oar/handle/123456789/91569 Title: Smartphone-mounted infrared thermography to assess success of open lower limb revascularisation Abstract: 40% of major complications after infrainguinal bypass surgery are found to be related to early graft failure. Current available diagnostic tests have a number of limitations in assessing lower limbs postoperatively. Low-cost smartphone-mounted infrared cameras have been recently validated in assessing arterial lower limb blood flow. This study will assess the role of infrared thermography for the early detection of bypass graft thrombosis following open revascularisation surgery of the lower limbs by looking at temperature differences between the feet pre-operatively and post-operatively. A prospective study was carried out on patients undergoing elective open infrainguinal lower limb bypass surgery for peripheral arterial disease (PAD) at Mater Dei Hospital in Malta. Data collection was done in three stages: at time point 0 i.e. pre-operatively, at time point 1 i.e. day one postoperatively, and at time point 2 i.e. between day five and day seven post-operatively. Clinical examination and non-invasive tests (Doppler waveforms, ABPI and toe pressures) were carried out for both the treated leg i.e. the leg undergoing the infrainguinal bypass surgery, and the non-treated leg i.e. the contralateral leg. Thermal images were captured using a smartphone-mounted infrared thermal camera and temperatures at six different region of interest (ROI) in both feet were recorded. A total of 17 patients were eligible for this study. A temperature difference between the feet was noted at all time points. Temperature readings at the six ROI of the treated leg were higher than those of the non-treated leg at all time points, reaching a statistical significance at time point 1 and time point 2 with a p-value <0.005. The mean foot temperature difference between the treated leg and the non-treated leg was found to be 5.99 degrees Celsius and 4.09 degrees Celsius at time point 1 and time point 2 respectively. A low-cost smartphone-mounted infrared thermal camera can be used to assess perfusion of the treated leg following open infrainguinal bypass surgery by looking at temperature differences between the feet post-operatively. This is a non-invasive, non-contact, and user friendly device. Further studies should be considered to standardise thermograms in such patients post-operatively. Description: M.Ch.(Melit.) 2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/81663 Title: The relationship between IBD and gut microbiota Abstract: Background: IBD is a chronic inflammatory bowel disease of unknown aetiology, forming part of a process via which failure in homeostatic interactions between genetic, immune, and environmental factors, triggers immune-mediated inflammation. Aims: The primary aim of the study was to determine the faecal microbiota present in a cohort of newly diagnosed IBD patients who were treatment-naïve and compare them with a cohort of controls. The secondary aim was to determine the clinical characteristics of the newly diagnosed IBD patients. Methodology: An observational, prospective and inception cohort study was carried out between the relationship of IBD and gut microbiota. Via this cohort study, the clinical course, progression, and treatment of all patients diagnosed with IBD between January 2018 and September 2019, in the Maltese Islands, were included. All the recruited patients were asked to answer a set of questions pertaining to their demographic data, daily habits, and particular environmental factors. Results: 100 patients were included in the newly diagnosed IBD group and 97 patients in the control group. From the 100 patients which were newly diagnosed 57 patients accepted to be recruited in this study. From the cohort of CD patients, the majority presented with L1 disease (51%), followed by L3 (26%) and L2 (23%) disease. Our UC cohort were noted to mostly present with E2 disease (50%), followed by E1 (46%) and E3 disease (4%), respectively. Our treatment-naïve CD cohort, was noted to have a predominance of specific bacteria, including Lactobacillus gasseri, ASV 249- Parasutterella unlc., Candidatus-Saccharibacteria and Acteroides clarus. These bacteria were commonly present in various international CD microbiota, therefore associating them with a CD microbiome. The UC cohort was found to have an increase in the number of the bacteria: ASV 6- Escherichia/Shigella Uncl., ASB_41-Sutterella wadsworthensis, ASV 44- Bacteroides faecis and Actinobacteria. These were also commonly found in international studies, and such phyla linked to a UC microbiome. In our control group a predominance of other bacteria was noted: ASV 321 (Clostridia Uncl.), ASV 96 (Rumminococcaceae uncl.), Akkermansia muciniphila (ASV 20) and Alistipes uncl. (ASV 61). All these are proposed as potential biomarkers for healthy gut status. Conclusion: So far, few studies have managed to investigate the microbiome’s effect on the manipulation of the IBD disease activity, therefore such topic generates great interest. The use of beneficial bacteria to yield new treatments for IBD patients is one of the potential new paths, whereby targeted treatment approach using specific bacteria can theoretically be prescribed to IBD patients so to re-establish their normal environment. Description: M.Ch.(Melit.) 2021-01-01T00:00:00Z