/library/oar/handle/123456789/65501 2025-11-10T10:37:21Z /library/oar/handle/123456789/65365 Title: Acquired unilateral Brown Syndrome in newly diagnosed Systemic Lupus Erythematosus Authors: Coppini, Jessica; Aquilina, Annelise; Farrugia, Ruth; Muscat, Jessica; Attard Montalto, Simon Abstract: Brown Syndrome is a congenital or acquired ocular movement disorder that is known to be a rare complication of Systemic Lupus Erythematosus (SLE). We report a case of acquired Brown Syndrome in an adolescent girl with newly diagnosed SLE which responded well to oral prednisolone. 2020-10-01T00:00:00Z /library/oar/handle/123456789/65363 Title: Abdominal X-ray use in Mater Dei hospital, Malta Authors: Nyame, Sandra Asi; Ajewole, Oluwatosin; Giordimaina, Christopher Abstract: Aim: To examine a sample of patients who underwent Plain Abdominal X-Rays (AXR) in Mater Dei Hospital (MDH) Emergency Department, Malta and assess if indications for AXR requests met current Hospital Guidelines, relevance of findings in clinical management and if further imaging was required to confirm diagnosis. --- Method: Retrospective review of 550 plain AXR taken between January 2016 till June 2016.The data collected from the MDH PACS System included patient age, gender, AXR indication and findings, follow-up CT abdomen. Guidelines from the Royal College of Radiology were used to confirm if an AXR was indicated or not. Data was then analysed using Microsoft Excel formulas. --- Results: Of 550 plain AXR reviewed, 62.6% were inappropriately requested with indications which did not meet the guidelines. Only 204 requests had a valid indication for plain abdominal x-ray as the initial modality of choice. 2020-10-01T00:00:00Z /library/oar/handle/123456789/65359 Title: Extrinsic compression of an anomalous left main coronary artery in a patient with pulmonary arterial hypertension presenting with myocardial injury Authors: Bonello, Maria; Bonello, John; Felice, Tiziana; Caruana, Maryanne Abstract: Extrinsic compression of the left main coronary artery (LMCA) caused by severe pulmonary arterial dilatation in the setting of pulmonary arterial hypertension (PAH) is a recognised entity. This can present with angina, cardiogenic shock, malignant arrhythmias or sudden cardiac death. We report the case of a 17-year-old female with a history of primary PAH who presented with acute chest discomfort, elevated biomarkers and ECG changes. Invasive and non-invasive imaging confirmed her diagnosis and identified an anomalous origin of the left main coronary artery and significant LMCA extrinsic compression by an enlarged main pulmonary artery (MPA). The abnormal anatomical location of the LMCA resulting from its anomalous origin could have further contributedto the risk of compression. 2020-10-01T00:00:00Z /library/oar/handle/123456789/65358 Title: Management of pregnant women living with type one diabetes mellitus during Ramadan : a theoretical case-presentation discussion Authors: Vella, Amy Abstract: The Ramadan period is highly significant in the Muslim religion which is characterised by fasting from dawn until dusk. In this case scenario, a 23-year old Muslim woman from Somalia expressed her wishes to fast even though this poses a high risk due to the presence of both type one diabetes mellitus and pregnancy. A management plan was devised to fast safely for optimal wellbeing of her foetus and herself. This consisted of carrying out a thorough assessment and identifying her current needs. Dietary pattern was the major feature of the care plan due to its sudden changes in Ramadan. A modified nutrition plan was advised in this scenario, allowing for a balanced diet in iftar and sahur with adequate caloric intake. No additional plans for physical exercise were sought as physical exertions associated with Tarawih prayers were considered sufficient. Insulin management is important since this accompanies meals and adjustments may need to be made. Therefore, providing education in self-monitoring of blood glucose and injecting insulin is paramount. Follow-up by an obstetric care provider during Ramadan is essential. 2020-10-01T00:00:00Z