/library/oar/handle/123456789/51031 2025-12-31T23:20:03Z /library/oar/handle/123456789/51002 Title: An evaluation of the use of nasal bones imaging in primary care in Malta Authors: Harney, Marilyn; Barbara, Maria; Abela, Jurgen Abstract: Introduction: Fractures of the nasal bones are one of the commonest injuries sustained in facial trauma. The purpose of this study was to evaluate the use of nasal bone x-rays in the public primary care department in Malta and whether this has an impact on subsequent follow-up of patients presenting with nasal trauma. --Method: This was a retrospective cross-sectional observational study. Data of all nasal x-rays requested in primary health care during the year 2018 was gathered. Data input and analysis was carried out using Microsoft Excel®2016. -- Results: A total of 212 nasal bone x-rays were taken in primary care over the one-year study period, amounting to 65% of the total number of nasal x-rays taken in the public health sector in Malta. The majority of the patients were males. The most frequent age group was 21 to 30 years. The highest number of nasal bone x-ray requests (37.7%) was for unspecified trauma, followed by trauma secondary to a fall (25.9%), and trauma secondary to fights or assaults (16.5%). The majority(67%) of x-rays were reported as normal. Thirty point two per cent of all patients who had a nasal bone x-ray taken were referred to the Accident and Emergency (A&E) Department on the same day and 28.3% had Ear, Nose & Throat (END Outpatients follow-up. -- Conclusion: A substantial number of nasal bone x-rays are performed in the primary health care department in Malta on a yearly basis. Only a slight majority of those referred to ENT had an abnormal x-ray report, in keeping with data from previous studies highlighting the limitations of nasal x-rays in planning further management. 2019-06-01T00:00:00Z /library/oar/handle/123456789/51000 Title: Depression in patients with Type 2 Diabetes in Maltese primary care Authors: Cardona, Tania; Pullicino, Glorianne Abstract: Background: Type 2 diabetes and depression are two common chronic conditions affecting the Maltese population with significant and costly effects on health. Multiple studies have demonstrated a higher prevalence of depression in diabetic patients and a link with uncontrolled diabetes; however, despite this, depression is still not considered as important to chronic conditions in terms of the effects it has on health. -- Objectives: This study was conducted to estimate the prevalence of depression in type 2 diabetic patients in primary care and to study their associated risk factors. -- Method: A quantitative, cross-sectional, retrospective, descriptive study was performed among 400 participants with type 2 diabetes attending diabetes clinics within the public health centres in Malta. Patients completed a self-administered questionnaire to quantify depressive symptoms and to study patient and disease characteristics. Convenience sampling was used to collect the data. -- Results: Data analysis showed that the prevalence of depression is around 29.7% among type 2 diabetic patients. Younger diabetics, women, lower educational levels, unemployment, obesity, a family history of depression and uncontrolled diabetes were found to be associated with a higher risk of developing depressive symptoms. -- Conclusions: Screening for depression in type 2 diabetic patients is important due to the high prevalence and significant impact on health. Appropriate management can significantly improve the outcome of both conditions and consequently improve both health and quality of life. 2019-06-01T00:00:00Z /library/oar/handle/123456789/50895 Title: An analysis of referrals to social services in state primary care in Malta Authors: Micallef, Elizabeth; Mifsud, James; Scerri Harney, Alexandra Abstract: Background: Involvement of the social worker in patient management leads to better holistic care. A better understanding of the service offered is needed. -- Objectives: The aim is to review the referrals made to the social worker in Primary HealthCare in Malta since the introduction of the service. Other objectives include increasing the awareness of this service, and improving community care. -- Method: A retrospective analysis of the data obtained by the social worker was carried out by examining all the referrals to the social worker between the 17th August 2015 and the 30th September 2018. Data collection included the total number of referrals, age, nationality, locality, source of referral, time from referral to first contact, reason for referral and co-morbidities. -- Results: The majority of subjects (n=52) were 65 years or older. There were 56.4%, 16.8% and 25.7% of cases from the North, Central and South catchment areas respectively. The majority of patients (n=69) were referred by GPs (67.6%). The others were referred by other healthcare professionals or they were self-referred. The average waiting time from the date of referral to the initial contact with the social worker was 18 days. Most referrals were due to social problems (52%) whilst 38 clients (37%) suffered from mental health illness and 37 clients (36%) suffered from cardiac diseases mainly hypertension and ischaemic heart disease. -- Conclusion: Recommendations for increasing awareness which will lead to better community care were put forward in the discussion, including implications for policy making and making good use of the service. 2019-06-01T00:00:00Z /library/oar/handle/123456789/50894 Title: Family medicine and the specialist register Abstract: It has indeed been an honour to serve again as MCFD President for two consecutive terms. When one thinks that one has spent nine years in all as President of the College one cannot but think humbly about members who have entrusted you to do so and I hope that I have satisfied them somewhat in what we have achieved -things which were mentioned in other editorials. Today I wish to speak about an ongoing issue which started during my tenure but which remain unresolved, although we have given our recommendations to issue a change in the law. We have spoken about this issue during several AGMs and also in this editorial but it is worth explaining the issue again as the law become clearer as we go along. 2019-06-01T00:00:00Z