https://www.um.edu.mt/library/oar/handle/123456789/39422 Wed, 08 Apr 2026 02:55:36 GMT 2026-04-08T02:55:36Z https://www.um.edu.mt/library/oar/handle/123456789/891 Title: Benign recurrent intrahepatic cholestasis : report of two local cases Authors: Vella, Cecil; Ellul, Marthese; Andrejevic, Hermoine Abstract: Benign Recurrent Intrahepatic Cholestasis (BRIC) is a rare disorder characterized by recurrent episodes of cholestasis without permanent liver damage. Familial and sporadic cases have been reported and both autosomal recessive and autosomal dominant inheritance described. We report two children with BRIC without any previous family history. Tue, 01 Jan 2008 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/891 2008-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/890 Title: An evaluation of type 2 diabetes care in the primary care setting Authors: Cutajar, Josianne Abstract: Objectives: To assess the clinical outcome of type 2 diabetes care currently provided at the primary healthcare centres. Method: A clinical audit was performed among 110 type 2 diabetes patients in the two major primary healthcare centres. The measurements of fasting blood glucose, HbA1c, serum lipid profile, blood pressure, serum creatinine, body mass index and waist circumference were carried out during a clinical examination. Knowledge, behaviour and attitude among the participants were assessed via a questionnaire composed of four sections concerning diabetes and its complications, physical activity, nutrition and smoking. Results: The ideal standards recommended by the International Diabetes Federation were employed for data analysis. HbA1c level was controlled in 37. 3%, systolic blood pressure was controlled in 44. 5%, cholesterol was controlled in 30% while LDL was controlled in 10.9 % of patients. Body Mass Index was above the normal threshold in 72.7% of participants while waist circumference was abnormally high in 96.3% of females and 64.7% of males. Serum creatinine level was controlled in 60% of patients. Significant correlations with HbA1c were registered for BMI (p-value 0.038) and serum creatinine (p-value 0.04). Patients showed limited knowledge on diabetes, its complications and exercise but were better informed on nutrition and smoking. Inappropriate eating habits were evident among participants while better behaviour was demonstrated in relation to the adherence to medication, physical activity and smoking. Conclusion: The framework for structured care is in place at the primary healthcare centres and compliance with process measures was confirmed. The present local care is based on good practice and is compatible with that provided in developed countries. However the health status of these patients is under imminent threat by a cluster of risk factors. This necessitates improvement in all components of present care while additional efforts must address the inadequacies in cardiovascular risk and lifestyle management. Tue, 01 Jan 2008 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/890 2008-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/889 Title: Charcot neuroarthropathy : pathogenesis, diagnosis and medical management Authors: Vella, Sandro; Cachia, Mario J. Abstract: Charcot neuroarthropathy (CN) is a progressive degenerative arthropathy which rarely complicates diabetes mellitus. Most commonly, though not exclusively affecting the foot, it seems to be determined by the interaction of neuropathy, osteopaenia and proinflammatory cytokines on a calcified peripheral vasculature that maintains its ability to vasodilate despite widespread arteriosclerosis. Although often unrecalled, this arthropathy is probably triggered by trauma. Diagnosis is essentially clinical, given the paucity and non-specificity of radiological and biochemical findings at the acute stage. CN should be considered in the differential diagnosis of any diabetic patient presenting with a warm swollen lower extremity. Bone turnover markers, magnetic resonance imaging and radioisotope scanning may be useful diagnostic aids. Offloading is essential and improves limb survival. There is considerable interest, though limited data, on the benefits of bisphosphonates and calcitonin. The possible roles of ultrasound and radiotherapy need to be assessed in larger trials. Failure to institute corrective measures at an early stage results in a foot that is prone to deformity, ulceration, amputation and loss of function. It is hoped that a better understanding of the aetiopathogenesis at a cytokine level will allow the targeting of new effective agents. Tue, 01 Jan 2008 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/889 2008-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/888 Title: Review of Varicella zoster virus : from epidemiology to prevention Authors: Pace, David Abstract: The Varicella zoster virus is a human pathogen which causes Varicella after primary infection and herpes zoster after secondary reactivation. Both disease manifestations can occur at any age; however, Varicella is seen more commonly in children whilst herpes zoster is mainly observed in the elderly. Although uncommon, disease complications secondary to Varicella may be severe and life-threatening especially at the extremes of age, during pregnancy and in the immunocompromised. Attenuated Varicella vaccines have been successfully formulated to prevent Varicella and its complications and are part of the routine childhood immunisation programmes in several countries including the US, Canada, Germany and Australia. This review discusses the epidemiology of Varicella, the clinical presentation and management of Varicella zoster virus infections and the potential of preventing Varicella and herpes zoster through immunisation. Tue, 01 Jan 2008 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/888 2008-01-01T00:00:00Z