/library/oar/handle/123456789/119131 2025-12-28T12:55:49Z /library/oar/handle/123456789/104914 Title: Journal of the Malta College of Family Doctors : volume 11 : issue 1 Editors: Sammut, Mario R.; Bugeja, Anton Abstract: Table of contents:; 1/ BUGEJA, A. - Novelty beyond the novel coronavirus; 2/ CAMILLERI, L., & FARRUGIA, M. - Deterioration in general condition secondary to polyarthritis in an elderly patient : a case report; 3/ ZERAFA, N. M., MICALLEF STAFRACE, K. - Patellar dislocation : an algorithm for management within primary care; 4/ SAMMUT, M. R., ABELA, G., ABELA, S. PULLICINO, G., & SCERRI, A. M. - A review of GP trainees’ evaluations of placements in hospital and community medicine during 2020-21 within Malta’s Specialist Training Programme in Family Medicine; 5/ SULTANA, G., & SCIBERRAS, C. - A study analysing the new Rapid Access Chest Pain Clinic at Mater Dei Hospital, Malta; 6/ VIDAL, T. L., SPITERI MEILAK, B. P., HARNEY, M., BONELLO, D., & LE BRUN, D. - An evaluation of the use of paediatric X-ray imaging in public health centres within Primary Health Care in Malta 2022-12-01T00:00:00Z /library/oar/handle/123456789/104869 Title: Novelty beyond the novel coronavirus Abstract: Around three years have passed since the first case of novel coronavirus was detected in China. A few weeks later the World Health Organisation declared a pandemic. The creation and dissemination of a vaccine has since brought a slow return to normality. There is no doubt that the pandemic changed certain aspects of our lives. For weeks on end social encounters were curtailed while our plans for trips abroad were shelved or modified. Our personal activities were adapted to an online dimension with all the benefits and challenges this brings with it. Our professional life also changed. Many of us have had to restructure their practice and reorganise patient encounters. Dealing with respiratory cases changed drastically and new ways of practicing medicine, such as telemedicine, were embraced. General practitioner (GP) trainees saw their training programme suspended temporarily, then change with their summative assessment modified in ways unthinkable a few months back. Beyond online lectures, meeting colleagues in a venue for a continuing professional development evening now has competing alternatives. [excerpt] 2022-12-01T00:00:00Z /library/oar/handle/123456789/104867 Title: Deterioration in general condition secondary to polyarthritis in an elderly patient : a case report Authors: Camilleri, Lara; Farrugia, Mark Abstract: INTRODUCTION: Deterioration in general condition is a common presentation in elderly patients. However, it is often a sign of an underlying potentially reversable pathology. As a result, a thorough assessment is often required since it can prove detrimental if left untreated. The following case report gives a clear example of this.; CASE SUMMARY: An 83 year old lady was admitted to the acute hospital in view of speech disturbances and lower limb weakness. Her daughter noted an acute on chronic deterioration in general health over the previous weeks. She was found to be hypothermic. The underlying cause was not identified from initial investigations, so she was transferred to a rehab hospital once the hypothermia resolved. She then developed an asymmetrical migrating polyarthropathy involving medium and large joints of the right side of her body. She had a history of gout, so a trial of colchicine was given until blood results were available. She responded significantly and a diagnosis of pseudogout was made.; CONCLUSION: This is an unusual presentation of pseudogout which often manifests as a monoarticular arthritis. However, multimorbidity and polypharmacy associated with ageing, predispose to atypical presentations of common diseases. In turn, there may be delayed or misdiagnosis leading to inadequate treatment with consequent ‘deterioration in general condition’. As a result, a comprehensive geriatric assessment often involving a multidisciplinary team approach is the gold standard management in geriatric medicine. 2022-12-01T00:00:00Z /library/oar/handle/123456789/104866 Title: Patellar dislocation : an algorithm for management within primary care Authors: Zerafa, Nicole M.; Micallef Stafrace, Kirill Abstract: BACKGROUND: Patellar dislocation is a common condition which may present to primary care. The literature available on this condition discusses evaluation, assessment of risk factors for recurrence, and non-surgical versus surgical management. Literature detailing its management specifically within primary care is lacking.; OBJECTIVES: The purpose of this review paper is to review and discuss the steps in evaluation and management of this condition and formulate an algorithm summary particular to a primary care setting.; METHOD: A database search was carried out using specific keywords and terms. The authors’ initial selection of 12 articles were subsequently reduced to 8 after review of their relevance to a primary care setting, and these were subjected to in-depth analysis. The information gathered was detailed and discussed, and a subsequent algorithm was formulated.; RESULTS: Patellar dislocation is a common injury, which may have long-lasting consequences to knee stability if not initially managed appropriately. There is inconclusive evidence to favour a surgical versus non-surgical approach. Evaluation of an individual’s risk factors and whether referral to secondary care is required are crucial steps in management of this condition.; CONCLUSION: Primary care physicians may play a key role in appropriate management of an individual’s first presentation of patellar dislocation, as well as assessment on the need for secondary care referral. The algorithm proposed by the authors may assist primary care physicians in improving management of patellar dislocation within a primary care context. 2022-12-01T00:00:00Z