https://www.um.edu.mt/library/oar/handle/123456789/414 Fri, 10 Apr 2026 12:44:56 GMT 2026-04-10T12:44:56Z https://www.um.edu.mt/library/oar/handle/123456789/145424 Title: Could the Omicron variant be the last variant of concern of the COVID-19 pandemic? Global immunity is key Authors: Muscat Baron, Yves Abstract: The Omicron variant was designated a Variant of Concern (VoC) due to its increased transmissibility and antibody evasion. Data from several countries however suggested a milder clinical outcome for the Omicron variant compared to the previous VoCs. The clinical outcome in the coming year (2023) is however uncertain due to Omicron’s persistent evolution, developing variants with increased immune escape attributes in the presence of populations that may not possess adequate immunological defences.; The Omicron variant utilizes the endosomal route of cell entry unlike previous VoCs. This may be due to Omicron’s superior spike protein receptor binding domain (RBD)’s adhesion to the host cell’s angiotensin converting enzyme II (ACE2) receptor. Efficient cell entry may have increased Omicron’s tropism to rapidly infect the extensive surface area of the nasopharyngeal mucosa and its adjacent sinuses. The endocytic mode of cell invasion may result in a more efficient recruitment of several contemporaneous RBD-ACE2 complexes of the same virus and other viruses to the attached host cell, suggesting a correlation between viralhost cell binding and transmissibility and a negative correlation with clinical severity. The nasopharyngeal region acting as a buffer, would have gained time with the initial containment of the Omicron infection providing immunological protection, preceding significant seeding into the lungs.; The combination of previous waves of natural infection, uneven global vaccination efforts and widespread Omicron infection and its most recent sub-variants (BF7 and XXB), may elude worldwide immunity, exacerbating the pathogenic effects of future SARS-CoV-2 outbreaks. Emulating the pattern of waves of infection during the devastating 1918 Spanish influenza, the current COVID-19 Pandemic may have approached an upended immunological equilibrium, due to adverse immunological, anthropogenic and environmental factors, swaying in favour of a more virulent subvariants. Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145424 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145423 Title: Synergistic effect on the treatment of menorrhagia by endometrial biopsy followed by contemporaneous insertion of the levonorgestrel intrauterine system Authors: Muscat Baron, Yves; Craus, Johann; Camilleri Agius, Rodianne; Brincat, Mark Abstract: Objective: To evaluate the efficacy of endometrial biopsy followed by intrauterine system-releasing levonorgestrel (LNG-IUS) insertion in the treatment of women with menorrhagia. Method: This was a retrospective, non-comparative study. Ninety-two patients who had menorrhagia due to non-malignant causes were sequentially recruited into the study over a 3-year period (age range 29–51 years). Patients with a uterine size more than 12 weeks were not included. A LNG-releasing intrauterine system was inserted during the mid-cycle immediately after an endometrial biopsy was taken. One year after the closure of the study period, the women recruited were then contacted by telephone or by direct questioning at the outpatient clinic as to the outcome of the above treatment. Results: The most common (15%) complaint regarding bleeding patterns at 3–6 months after insertion was spotting and intermenstrual bleeding. Following the introduction of the LNG-IUS, six women required a hysterectomy for various reasons. The remaining 86 women (93.5%) continued the use of LNG-IUS. Conclusion: LNG-IUS following an endometrial biopsy is an effective treatment for menorrhagia due to benign causes and could be an alternative to other forms of medical and surgical treatments. Sun, 01 Jan 2012 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145423 2012-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145422 Title: The diagnosis and management of ectopic pregnancy presenting to Mater Dei Hospital between June 2019 and June 2020 Authors: Hackenbruch, Sophie Noelle; Meli, Nicole; Felice, Nicholas; Formosa, Mark; Muscat Baron, Yves Abstract: The incidence of ectopic pregnancies has steadily increased over recent years and despite advances in treatment it still remains a major cause of maternal morbidity and mortality. The objective of this audit was to assess whether diagnosis and management is occurring as per international suggested guidance and practice. This study is a retrospective one using data collected from June 2019 to June 2020. All data were password protected and kept anonymous. No patient contact occurred. The standard cross referenced was the 'April 2019 NICE Guideline on the Management of Ectopic Pregnancy'. Thirty-one ectopic pregnancies occurred between June 2019 and June 2020. Twenty-nine underwent surgical management and two medical. Six out of the 29 surgically managed patients were managed incorrectly. Twenty-four of the surgical cases were managed laparoscopically. Presence of a foetal heart rate remained undocumented in 21 out of 31 of cases. The results highlight the ease of access to emergency gynaecological services at Malta's national hospital. However, this audit did highlight the discrepancy that can occur in examination in association with ectopic pregnancy. An inconsistency was noted in documentation. Additionally, a number of cases could have been offered and benefitted from different modes of management. Description: Supplemental material available in this record. Sat, 01 Jan 2022 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145422 2022-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145291 Title: Does the 10-15% caesarean section rate threshold endorsed by the World Health Organization in 1985 still apply to modern obstetrics in developed countries? The “ideal” caesarean section rate and the stillbirth and neonatal death perspective Authors: Muscat Baron, Yves Abstract: In 1985 the World Health Organization stated “there is no justification for Caesarean Section Rates in any region to be higher than 10-15%”. The World Health Organization expert group drew its conclusions from a review of the limited data available from European countries that indicated good maternal and perinatal outcomes with the rate of Caesarean Sections of between 10-15%. Since then recent publications from the same organization have continued to re-iterate this statement. [excerpt] Fri, 01 Jan 2016 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145291 2016-01-01T00:00:00Z