/library/oar/handle/123456789/497 2025-11-11T17:31:49Z /library/oar/handle/123456789/658 Title: Decline in human sperm counts during the past 50 years? Authors: Jayachandra, Srinivasa; Pinto, Maxim; Souza, Urban JAD Abstract: There is widespread concern that environmental pollutants acting as xenoestrogens may affect human fertility adversely. Whether this has already made an impact on human fertility worldwide remains debatable at the present stage. Ever since Carlsen's analysis reported that sperm concentrations have decreased over the last 50 years there has been renewed attention and curiosity amongst peer groups in different parts of the world. Though Carlsen's mode of data analysis was criticized on many fronts, a number of similar studies that appeared subsequently have contradicted each other. The article has reviewed the literature to determine whether semen counts have indeed changed in the past 50 years. We conclude that sperm counts vary enormously between different countries or regions of the world and also between individual men. There is even marked variation between counts on the same men. It is therefore not surprising that not all analyses of sperm counts find the same patterns. We suggest that a well ­designed prospective study should be performed in several different regions of the world in order to extrapolate the results on sperm counts and to evaluate the potential effect of external factors on male reproductive health. It is hoped that the conclusions from these new studies might put an end to the controversy that surrounds this issue. 2005-01-01T00:00:00Z /library/oar/handle/123456789/657 Title: Obstetrics and gynaecology Authors: Craus, Johann; Muscat Baron, Yves; Brincat, Mark P. Abstract: A review of publications relating to significant advances in the specialty of Obstetrics and Gynaecology over the past four years will be discussed: topics reviewed will have an important impact on reducing maternal/fetal morbidity and mortality and should improve on woman's health care. 2005-01-01T00:00:00Z /library/oar/handle/123456789/656 Title: Emergency medicine and general practice Authors: Abela, Gunther Abstract: Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneumonia, Burns and Controlled Hypotensive Resuscitation. Whenever possible, distinct practical guidelines will be suggested as an aid in the clinical management of emergency situations which the family physician may encounter. This overview of new developments is by no means comprehensive but serves to highlight the increasing importance given to the role of the first-line medical practitioner in the emergency situation. 2005-01-01T00:00:00Z /library/oar/handle/123456789/655 Title: Endoscopy : an evolving speciality Authors: Arebi, Naila; Saunders, Brian P. Abstract: The practice of endoscopy has been rapidly changing due to new emerging technologies and novel techniques. There has been more focus on colonoscopy training with the development of structured programmes including simulators. Chromoendoscopy and magnification endoscopy have enabled improved diagnosis of small neoplastic lesions and will be important for the success of colorectal cancer screening programmes. The small bowel is now accessible to diagnostic modalities like capsule endoscopy and to therapeutic tools through the double balloon enteroscope. Endoscopic therapy has also become more sophisticated with endoscopic therapy of reflux disease now possible. Excision of large colorectal adenomatous polyps by endoscopic mucosal resection and dissection of submucosal tumours may reduce the need for surgical intervention. The practice of endoscopy has rapidly changed over the past few years. What was once a simple diagnostic procedure made possible by the development of fibre optics has become a speciality in its own right. This article will highlight some aspects of endoscopic practice that have undergone major changes over the past few years and that will shape endoscopy practice in the future. 2005-01-01T00:00:00Z