OAR@UM Community:

The COVID 19 vaccine : fear it not!

2021-01-15T11:24:41Z

Title: The COVID 19 vaccine : fear it not! Abstract: As a paediatrician I see children and speak to parents, who frequently recount how the pandemic has adversely affected their lives and livelihood, with many describing ‘hard times’ in relation to their family, job, travel, income, disposable wealth, etc., etc. Invariably, the question “How will it all end?” crops up and directs the discussion toward vaccination. Despite having just described the ‘hit’ that they have sustained, medically or economically or both, and even before any discussion on the rationale and benefits of a vaccine, I am repeatedly surprised by many parents’ immediate comment that “They fear and will not take the vaccine” and, equally concerning, that they “. . . will be reluctant to give the vaccine to their child”. This position is by no means exceptional, and stems from an inherent fear of something new that is relatively untried, and is compounded by misunderstanding from or confusion within the general and social media (less so in the regulated and mainstream channels), as well as unsubstantiated claims from anti-vaxxers.

Analysis of risk factors for Helicobacter pylori infection in the Maltese population

2021-01-15T11:19:55Z

Title: Analysis of risk factors for Helicobacter pylori infection in the Maltese population Authors: Pisani, Darryl; Caruana Dingli, Michael; Axisa, Benedict Abstract: Background: To assess risk factors for H.Pylori Infection in the Maltese population.; Methods: A total of 138 patients undergoing OGD investigation were contacted by telephone and asked a series of questions relating to their H.Pylori status, demographics, and the various risk factors under investigation. The main variables under consideration were as follows; smoking status, alcohol status, and socioeconomical status. Data for H.Pylori positive and negative individuals was analysed for significance using Chi Squared.; Results: From the 138 respondents 50 were found to be CLO positive whilst 83 were found to be negative. From the positive cohort 62% were found to be non-smokers whilst 38% were found to have previously smoked, and 16% were found to be alcohol consumers (>=3 drinks a week), whilst 84% were non-drinkers. The percentages in the negative cohort were as follows; 59.5% non-smokers and 40.5% smokers, whilst 21.4% were alcohol consumers and 78.6% were not. The cohort was divided into six geographic districts (northern harbour, southern harbour, south east, northern, western, and Gozo) with the % of positives being 18%, 30% , 24%, 14%, 14% and 0%, whilst the negatives were 27.4%, 19%, 16.7%, 14.3%, 21.4%, and 1%. Socioeconomic status was assessed based on government pay scales for occupation. Of the positives 79% were >= to grade 10 whilst 21% were < grade 10. For negatives the percentages were 77.8% and 22.2% respectively.; Conclusion: Thus it can be seen that there was no significant difference in the incidence of the aforementioned risk factors in the positive and negative cohorts.

Post-operative nausea and vomiting prophylaxis in adult day case surgery : did it justify a local protocol?

2022-03-10T07:15:33Z

Title: Post-operative nausea and vomiting prophylaxis in adult day case surgery : did it justify a local protocol? Authors: Bellizzi, Muriel; Grech, Nicole; Sciberras, Stephen C. Abstract: Background: Post-operative nausea and vomiting (PONV) is common following surgery and results in complications. The Society of Ambulatory Anaesthesia (SAMBA) published internationally established guidelinesfor its prophylaxis. Our aim was to investigate whether guidelines were being followed locally. We also assessed incidence of PONV, delay in discharge or unplanned admissions in adult surgical cases at Day Care Unit. This study was repeated after five yearsto assess the impact of establishing local guidelines in Mater Dei Hospital in the same year.; Methods: In this retrospective study,we collected information between August and September 2012 and then in 2017. Data regarding vomiting, delayed discharge or unplanned admission due to PONV was documented. Local guidelines were implemented in 2013. Educational measures to raise awareness were carried out, followed by a re-audit in 2017.; Results: 195 patients were eligible in the first study and 173 in the second cycle. No statistically significant decrease was found between patients having PONV (12.4%and 10% in the re-audit - p<0.01). One in ten patients (1%) had an unplanned admission due to PONV during the first audit with no admissions in the second study. Number of risk factors for PONV did not correlate with anti-emetics given.; Conclusion: The incidence of PONV in adult day cases at our day care unit justifies the use of protocol for better prophylaxis. However, local protocols are not being followed. Education and emphasis of local guidelines can improve the compliance rate.

Screening in-patients for risk of malnutrition

2021-01-15T09:56:13Z

Title: Screening in-patients for risk of malnutrition Authors: Hili, Abigail Marie; Ellul, Pierre Abstract: Introduction: Malnutrition is used to define an imbalance in nutrition and is seen in hospitalized patients. The aim of this study was to assess the risk of malnutrition in patients admitted to the acute medical wards. The ‘Malnutrition universal screening tool’, was used as a gold standard.; Material and Methods: Data was collected from adult patients from acute medical wards. The data collected included the identification number, age, gender, reason for admission, comorbidities, weight, height, unplanned weight loss in the last 3-6 months and the number of days of no nutritional intake. By means of the MUST, the overall risk of malnutrition score was obtained and its management was recorded.; Results: Fifty patients were recruited and 18% were found to be at medium risk of malnutrition while 36% were found to be at high risk. Only 2% of such patients had a dietician referral and/or adherence to the guideline. Despite 58% of patients were found to have a Body Mass Index score of 0, 21% of these had a BMI score of >30kg/m 2 , with 14% of which were admitted secondary to a cardiovascular or respiratory cause.; Discussion: Skills and time are required to diagnose a patient with malnutrition. However, the MUST screening tool, enables this to be done quickly and ppropriately. Moreover, implementation of mandatory nutritional screening on admission will allow an increase in dietician referrals and the correct management of this along with the patient’s illness, leading to a faster recovery, shorter hospital stay and better long term prognosis.