https://www.um.edu.mt/library/oar/handle/123456789/9705 2026-04-05T10:59:51Z https://www.um.edu.mt/library/oar/handle/123456789/9733 Title: Clinicians’ adherence to local antibiotic guidelines for upper respiratory tract infections in the ear, nose & throat casualty department of a public general hospital Authors: Fsadni, Clayton John; Caruana Galizia, Sarah Abstract: Background: In Malta, resistance to antibiotics constitutes a major threat to public health. This study aims to assess clinicians’ adherence to local antibiotic guidelines when treating cases of acute otitis media, acute tonsillitis and rhinosinusitis, that present to the ear, nose and throat (ENT) casualty department in Malta’s public general hospital, as well as to recommend methods for improving adherence and minimising overprescribing. Methodology: Data on first line antibiotic prescribing regimens was retrieved from ENT casualty sheets between February and March 2015 for adult patients (>12years) diagnosed with acute otitis media, acute tonsillitis and persistent rhinosinusitis. On an audit form, aspects of the prescribed antibiotic were benchmarked to local infection control antibiotic guidelines of 2011 to evaluate adherence. Results: From 1010 casualty records, 188 were antibiotic prescriptions, of which 93 (49.4%) were correctly indicated as per guidelines. From the indicated prescriptions 81 (87%) were assessable, out of which full adherence was only observed in 6 (7%) of prescriptions. All of these were for rhinosinusitis. Full adherence in rhinosinusitis was found to be 43%, whilst no adherence was found in the other infections. The most prescribed antibacterial for all three infections was co-amoxiclav. Conclusion: The current antibiotic guidelines have not been adequately implemented as adherence to antibiotic choice alone was low in all infections. This may have an impact on antibiotic-resistant rates and infection incident rates. Hence to improve adherence to local antibiotic guidelines, it is recommended that these should be clear, regularly updated, well disseminated and reinforced. The addition of a care pathway may further improve appropriate antibiotic use. 2016-04-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/9732 Title: An evaluation of referral tickets for acute psychiatric admissions Authors: Baldacchino, Ian; Sciberras, Edith; Micallef, Simon Abstract: Background Tickets of referral assist in clerking and the enforcement of the Mental Health Act. Initial reviewers of the patient who may be more aware of his/her background may provide this information when transferring a patient to Mount Carmel Hospital, Malta’s psychiatric hospital. Objectives The aims of this study were to assess whether key information on referral tickets was lacking as well as to justify the importance of such information when referring a new case and raise awareness on appropriate referral. Methods Permission to review the tickets of referral for new admissions from the community to Mount Carmel Hospital during the month of June 2015 was obtained from the Chairman of Psychiatry. The files of new admissions were assessed to see if the following were present: official referral ticket; drug history; next of kin details; handover to staff at Mount Carmel Hospital. The place of initial assessment was also noted. All data was anonymised and data input was done using a prepared proforma. Patients referred from the civil prison and by the caring consultant’s firm were not included. Results Seventy admissions were assessed. Eighty-nine per cent (n=62) of these admissions included an official ticket of referral. Most referrals came from health centres: 31% (n=22). Seventy-four per cent (n=51) had a drug history present. Seventy-six per cent (n=53) were lacking next of kin details. Forty per cent (n=28) of the cases had documentation of a handover to a senior on call. Conclusions Poor quality referral tickets with missing information are often present which makes it difficult for the on-call staff at Mount Carmel Hospital to clerk the patient and come up with a provisional treatment plan. 2016-04-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/9731 Title: The management of nocturnal enuresis in children Authors: Galea, Marthese; Sciberras, Christopher; Galea, Keith Abstract: Introduction : Nocturnal enuresis is more prevalent in the male gender. Studies such as that by Butler & McKenna (2002) show how nocturnal enuresis is hereditary, with approximately 50% of the children affected if one parent has suffered from it. The main cause for nocturnal enuresis can be drinking late in the evening or not passing urine before going to sleep, resulting in excessive urine volume. A detailed history needs to be taken, eating and drinking habits should also be assessed, and any drinks or food that can increase the chances of bedwetting should be removed or reduced. Management: Management has to be adapted to the child and his/her family requirements. Prescribing the right medication and ensuring compliance is important but is only part of the management plan. Lifestyle changes should be advised. A very simple bedwetting vibrating alarm can be considered. If symptoms persist, pharmacological treatment should be prescribed together with the bedwetting alarm. Conclusion: Nocturnal enuresis is a common condition in a young child, however it requires a careful assessment and management in cooperation with the child’s parent or carer. Physicians need to be aware of when the child needs to be referred. 2016-04-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/9729 Title: Journal of the Malta College of Family Doctors : volume 5 : issue 1 Authors: Mallia, Pierre Abstract: The mission of the Journal of the Malta College of Family Doctors (JMCFD) is to deliver accurate, relevant and inspiring research, continued medical education and debate in family medicine with the aim of encouraging improved patient care through academic development of the discipline. The JMCFD strives to achieve its role to disseminate information on the objectives and activities of the College. Description: Contents: Summative assessment and the new council - Pierre Mallia 2016-04-01T00:00:00Z