https://www.um.edu.mt/library/oar/handle/123456789/39724 Wed, 08 Apr 2026 00:27:20 GMT 2026-04-08T00:27:20Z https://www.um.edu.mt/library/oar/handle/123456789/5703 Title: Orbital pseudotumour masquerading as Wegener’s granulomatosis Authors: Fenech, Matthew T.; Fenech, Thomas Abstract: A twenty-two year old female patient presented with new onset bilateral hard orbital masses and progressively worse tear lake problems. Computed tomography of the orbits revealed poorly differentiated bilateral orbital masses. Laboratory investigation revealed ANCA positivity. Routine biochemical investigations were all within normal limits. CXR was also normal. Biopsy of the orbital masses revealed non-specific histological findings. An initial diagnosis of Granulomatosis with Polyangitis (GPA) was postulated. Oral steroids were given followed by a rapid response to steroid therapy. The working diagnosis of GPA was abandoned and a diagnosis of idiopathic orbital inflammation (IOI), or orbital pseudotumour was made owing to the benign, non-infective, inflammatory pathology with no evident systemic or local cause. Tailoring off of steroids resulted in repeated flare ups, resulting in the initiation of methotrexate therapy. The patient is in remission and is currently on combined steroid and methotrexate treatment. IOI is a diagnosis of exclusion and a rapid response to steroids serves as a diagnostic aid but is not in itself diagnostic. Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/5703 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/5702 Title: A large pericardial effusion and bilateral pleural effusions as the initial manifestations of Familial Mediterranean Fever Authors: Schembri, Emma Louise; Mifsud, Simon; Cassar Demarco, Daniela; Coleiro, Bernard; Mallia, Carmel Abstract: Familial Mediterranean Fever (FMF) is a condition characterized by recurrent febrile poly-serositis. Typical presentations of the disease include episodes of fever, abdominal pain and joint pains. Chest pain is a less common presentation. We report a case of FMF which presented with a large pericardial effusion and bilateral pleural effusions in a lady who had no positive family history and negative genetic testing. Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/5702 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/5670 Title: The male to female ratio at birth following the Scottish Independence Referendum, September 2014 Authors: Mamo, Julian; Grech, Victor E. Abstract: Human male live births exceed female live births by approximately 3%. This sex ratio is conventionally expressed as M/F (male divided by total live births). Many factors have been implicated as influencing this ratio, such as stress. This phenomenon occurred following the Quebec sovereignty referendum of 1995. This study was carried out in order to ascertain whether the Scottish referendum of September 2014 had any effect on the M/F ratio in Scotland. Monthly live births by gender for Scotland were obtained from Scottish Office of National Records for the period January 2004 to July 2015. They were analysed for any significant period changes as witnessed in Quebec in 1995. There were 661166 total births (338850 male and 322316 female births), with an overall M/F of 0.5125 (95% CI: 0.5113-0.5137). There were no changes in M/F in the first five months after the referendum. However, there was a non-significant rise in M/F toward the end of 2014 which continued during much of 2015. The rise in M/F reached its peak in May-June 2015, 8-9 months after the referendum (M/F 0.5199 compared to M/F of 0.5124 for aggregated May-June values 2004-14). There was no significant drop in M/F in the Scottish population in relation to the Scottish referendum. This may be due to a type 2 error since this study was less powered (12 times smaller) than the Quebec study. The non-significant rise may have potentially been caused by increased coital rates as observed after the birth of Prince William in 1982 and for Hong Kong in relation to Dragon years. It will be interesting to analyse the rest of the UK data when this becomes officially available. Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/5670 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/5669 Title: The efficacy of lymph node fine needle aspiration cytology Authors: Attard, Jason; Galea, Jonathan; Betts, Alexandra Abstract: Fine needle aspiration cytology (FNAC) of lymph nodes is a safe, easy, cheap and quick diagnostic tool, which involves the examination of a random sample of cells from a lymph node. To assess the distribution of diagnostic categories and the efficacy of lymph node fine needle aspiration cytology at our institution. These were compared to the literature. Methodology: All of lymph node FNAC cases taken between the 1st January 2012 and the 31st December 2013 were retrieved from our Laboratory Information System. A total of 300 cases were retrieved and then placed into one of six categories; Category 1: Non-diagnostic, 2: Reactive, 3: Probably reactive but lymphoma cannot be excluded, 4: Non-Hodgkin lymphoma, 5: Hodgkin lymphoma, and 6: Metastasis. These were then correlated with the histology of the lymph node excision specimens. The proportion of diagnoses placed under categories 1, 2, 3, 4, 5 and 6 represent 14%, 53%, 4.3%, 5.7%, 1.7% and 21.3% of the total respectively. The overall efficacy of FNAC showed a sensitivity of 84.5%, specificity of 99.3%, a false negative rate of 10%, a false positive rate of 0.7%, accuracy of 93.1%, positive predictive value of 98.8% and negative predictive value of 89.9%. FNAC of lymph nodes is a very useful and effective tool in triaging patients with lymphadenopathy. Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/5669 2015-01-01T00:00:00Z