/library/oar/handle/123456789/779 Tue, 11 Nov 2025 19:46:48 GMT 2025-11-11T19:46:48Z /library/oar/handle/123456789/939 Title: History of the development of general anaesthesia in Malta Authors: Azzopardi, Nazzareno Abstract: Anaestheisa (an meaning absence and aesthesia meaning sensation) was a new word coined by Oliver Wendell Holmes, the same doctor who wrote the stories of the detective Sherlock Holmes The science of anaesthesia means the inducement of a state of reversible unconsciousness and analgesia by means of drugs thus enabling the performance of surgery. Before the introduction of the science of anaesthesia the only surgery possible was that which could be done in a few minutes with the patient suffering intense pain and needing physical force to be kept lying down on the operating table. After the start of the anaesthetic process, surgery advanced by leaps and bounds during the last one hundred and sixty years. Really the new science enhanced the full development of surgery. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/939 2009-01-01T00:00:00Z /library/oar/handle/123456789/938 Title: ‘Twiddling’ of the pacemaker resulting in lead dislodgement Authors: Cassar DeMarco, Daniela; Xuereb, Robert G. Abstract: Twiddler’s syndrome is a rare condition in which patient manipulation of the pulse generator within its pocket may result in coiling of the lead and lead dislodgement, thereby causing pacemaker malfunction. Retraction of the electrode may cause phrenic nerve stimulation resulting in diaphragmatic stimulation and a sensation of abdominal pulsations. As the leads are further wrapped around the generator, rhythmic arm twitching may occur as a result of pacing of the brachial plexus.1 Twiddler’s syndrome was first described by Bayliss et al in 1968 as a complication of pacemaker implantation.2 It has also been reported with implantable cardioverter-defibrillators (ICDs)3 and cardiac resynchronisation therapy (CRT).4 This is a case report of an elderly lady with Twiddler’s syndrome resulting in pacemaker malfunction secondary to lead retraction, who emphatically denied any manipulation of her device. She subsequently underwent lead repositioning and appropriate counselling. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/938 2009-01-01T00:00:00Z /library/oar/handle/123456789/937 Title: Le Fort Colpocleisis : re-visited and re-proposed Authors: Formosa, Mark Abstract: A case of an elderly woman suffering from severe genital prolapse is presented. This was so severe that her daily everyday activities became significantly impeded. This was a significant limitation to an individual who could otherwise manage independently of family or institutional help. Major surgical procedures (vaginal hysterectomy) are associated with significant risks in these elderly and frail women.1 Utero-vaginal prolapse is never a life-threatening condition and the surgeon is faced with the dilemma of whether to recommend this procedure, with this risk, to restore her mobility. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/937 2009-01-01T00:00:00Z /library/oar/handle/123456789/936 Title: Recurrence of rectal cancer : a study on patients with rectal cancer referred to Sir Paul Boffa Hospital during 2001-2003 Authors: Brincat, Stephen; von Brockdorff, Luisa; Said, Janabel Abstract: Surgery is the mainstay of treatment of rectal cancer. One third of all treatment failures are secondary to local recurrence usually leading to a painful and distressing death. Radiotherapy has been shown to decrease local recurrence rates and overall survival. The results of a local retrospective study are discussed, identifying and describing the recurrence rates in rectal cancer. Our management pathways are also reviewed and compared to current evidence-based medicine and published clinical trials. Thu, 01 Jan 2009 00:00:00 GMT /library/oar/handle/123456789/936 2009-01-01T00:00:00Z