Xjenza Online Vol. 11


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Xjenza Online Vol. 11 ISSUE: Xjenza Online Vol. 11



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Editorial
Raising Awareness for Support of Xjenza Online

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Article
Biosensors for Monitoring of Vital Functional Parameters during Medical Emergency
David Zammit, Vincenzo Baylon
Pages: 3 - 9
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Abstract:
The objective of this work concerns the study of biosensors for monitoring of parameters and diagnosis of vital functional during first medical emergency. The study and analysis of vital parameters is extremely important in emergency medicine. The principle is based on the combination of the signals coming from the patient (vital functions), consists of measurement and comparison of the phase of active and reactive components of biologically active points (BAP) the transduction of such acquired signals and the processing of the obtained information. One of the advantages of reflex diagnostic methods is the fact that the response of BAPs to the change in the internal structure of the human body. These signals are proving instantaneous information on the functional state of 20 basic organ and system of the human body. The method will use one input variables (the classic physiological parameters and/or signals detected by using additive sensors) and one output variable which is correlated with the clinical condition of the patient. High information volume, accuracy, reliability, and reproducibility of data are supported in parallel in emergency diagnostics. A model will produce an association between the input variables and the output variable by using a data set established with the medical team. The proposed methodology improves standard systems such as reflex diagnostics, track and trigger and threshold (Early Warning Score). It is shown that good results for the prediction and early diagnosis in first medical emergency, through the adoption of the Fuzzy Set Theory.

Doi: 10.7423/XJENZA.2023.2.01
Article
Playing with Fire - Negative Perceptions against COVID 19 Vaccination
Mary Anne Lauri, Maria Cordina, Maria Grech
Pages: 10 - 19
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Abstract:
Living during a pandemic has a great impact on a person’s health and psychological functioning. While many took the vaccine, others were very skeptical about the intentions and motivations of political and health authorities and the safety of the vaccine. Vaccines may play a role in prevention of disease, however some are against vaccination. This paper will explore the reasons and arguments that people put forward to support their stance against vaccines and the COVID-19 vaccination. This will help in providing a deeper understanding of these participants’ points of view, along with their experiences during this challenging period in time. A mixed methods approach was used. Study one was a quantitative study using online survey methodology to determine the degree of vaccine hesitancy and associated reasons. The most frequently cited reason given for not taking the vaccine were about safety issues. Study two was qualitative and involved interviewing six participants recruited through purposive sampling. The transcripts were analysed by using Thematic Analysis. The three main emerging themes were reasons related to health, others to the socio-political context and the third was the perceived lack of scientific information on COVID-19 vaccine. The results concluded that the participants’ objections to take the COVID-19 vaccine emerged from personal health factors, and was manifested as a form of protest against authorities.


Doi: 10.7423/XJENZA.2023.2.02
Article
Communicating identities: A sociology of house names in Malta
Godfrey Baldacchino, Kylie Aquilina, Enoch John Camilleri, Zindzi De Barra, Amy Galea, Aideen Ledwidge Lanigan, Elaine Sciberras, Gabrielle Spiteri, Rowena Sultana, Diane Zammit
Pages: 20 - 34
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Abstract:
19,683 house names from a convenience sample of ten localities across the island of Malta were collected and analysed in late 2022, with the aim of teasing out how they communicate social identities. Trends in multilingualism and secularisation were particularly explored, from two sets of house names that represent different historical epochs, one dating from 1977 and one from 1977-2022. Results, secured from the ten localities studied, suggest that: (1) English remains by far the preferred language for naming houses, followed by Maltese; (2) house names that involve two or more languages have increased; (3) house names that relate to the religious or sacred have declined (from around 16% to 10%); and (4) in spite of evident secularisation in house-naming practices, the most common house name is ‘St Joseph’.

Doi: 10.7423/XJENZA.2023.2.03
Article
Ranking of rural localities in Malta and Gozo according to their degree of exposure to traditional locally produced fare
George Attard, Francesco Luca Alexander, Tony Meli
Pages: 35 - 48
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Abstract:
Mediterranean fare originated from regional ethnic groups living in the region, and, other than from external cultural influences, the ingredients used mostly originated from local production. In evaluating the role of tradition in Maltese food culture, three factors, namely part-time farmers, kitchen gardens, and small livestock numbers, appear to have characterised food production within a Mediterranean island agricultural landscape that was dominated by small holdings. This study evaluates Malta's different rural localities, ranked according to evidenced agricultural activities in small farming holdings, which, by their self-sustenance, appear to have retained traditional Maltese rural features. This paper can serve as a guideline for selecting locations to evaluate production and consumption patterns of traditional Maltese food in rural areas.

Doi: 10.7423/XJENZA.2023.2.04
Article
Immature High Grade Teratoma in A 17-Year-Old Lady - a case report
John Thake, Christine Zerafa, Sheriseane Diacono
Pages: 49 - 52
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Abstract:
Introduction
Immature teratomas are uncommon, malignant ovarian neoplasms that make up less than 1% of ovarian germ cell tumours. Immature teratomas are often larger and occur in younger women (in the first three decades of life).
Case summary
A 17-year-old lady was admitted to the emergency department in view of dyspnea, severe abdominal pain, abdominal distension and loss of appetite. On CTPA she had a large pelvic mass, and was referred to gynaecology. She underwent an elective right salpingo oophorectomy and cystectomy. Histology report indicated ovarian immature teratoma (high grade, grade 3) showing extensive neuroectodermal differentiation.
Conclusion
The incidence of immature teratoma is highest in young adults. Most patients present with early-stage disease, are managed with fertility sparing surgery and chemotherapy with an excellent prognosis. Diagnosis requires a combination of clinical, radiological and laboratory findings.


Doi: 10.7423/XJENZA.2023.2.05
Article
A Geological overview of the Maltese Archipelago with reference to the Area of Sliema
Daniele Spatola, Jodie Agius1, Micole Miceli
Pages: 53 - 69
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Abstract:
This study offers an overview and account of the geological and geographical characteristics of the Maltese islands, with a particular emphasis on the Sliema peninsula. The stratigraphic sequence of the geology on the islands, including the lithostratigraphy and sedimentary structure dating back to the Oligo-Miocene Epoch, is described starting from the oldest layer, the Lower Coralline Limestone, up to the most recent rock deposition in the newly discovered quaternary rock deposition. Additionally, the report delves into the general seismic activity on the island that has contributed to the unique geomorphology, hydrology, and hydrogeology that exist on Malta and Gozo. The interrelationship between these geological components is evident on the islands, particularly in the tectonic activity that has resulted in the formation of cliffs and bays throughout. After providing a general geological overview of the islands, the report focuses more specifically on the Sliema area, a town located in the east of the main island of Malta known for its numerous rocky beaches and heavy urbanization.

Doi: 10.7423/XJENZA.2023.2.06
Article
Assessing Current C-reactive Protein Sampling Practices within the Neonatal Intensive Care Unit for Neonates with Suspected Early Onset Sepsis
Nadine Anne De Battista, Michelle Marie Boffa, Jamie Alexander Grech, Pharrah Debono
Pages: 70 - 76
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Abstract:
Background C-reactive protein is synthesized in the liver as part of the acute phase response activated in reaction to acute injury. It has been well established that CRP levels can be used as an acute marker of inflammation making it a useful aid in the diagnosis and management of sepsis. However, its use within the immediate postnatal period presents unique challenges.
Aim This study aimed to elucidate and standardise CRP blood sampling intervals in neonates with suspected early onset sepsis, and to describe the relationship between CRP results and final blood culture results, with the aim of implementing NICE recommendations within the local setting.
Results 316 infants were included in the study. 26.2% of neonates had at least 1 positive CRP value (>10mg/dl) during the first 72 hours of life, with 12.7% resulting in a detectable bacterial growth on blood cultures. The largest percentage of positive CRP levels was obtained when blood was sampled within 18 to 24 hours post birth (30.3%). 40.7% of CRP samples were repeated between 24-48 hours of life. For 27.7% of neonates, a first positive CRP level of more than 10mg/dl was noted after 24 hours of life.

Conclusion The results show the importance of maintaining adequate timing intervals between serial CRP levels, which should be taken as a baseline on admission and then repeated not before 12 hours of age, to achieve optimal sensitivity. Our current sampling practice might lead to falsely reassuring negative CRP values, affecting outcomes in sepsis management.


Doi: 10.7423/XJENZA.2023.2.07
Article
Serum Prolactin Monitoring in Patients on Risperidone admitted to the acute wards at Mount Carmel Hospital
Rachel Gambin, Sheriseane Diacono, Therese Ann Mizzi, Rachel Taylor East
Pages: 77 - 80
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Abstract:
First-generation antipsychotics have been shown to increase prolactin levels in the body. Atypical antipsychotics have a lower tendency to produce hyperprolactinaemia due to a weaker and transient dopamine antagonistic effect. Despite being an atypical antipsychotic, Risperidone, tends to cause a higher increase in prolactin due to a stronger and more prolonged blockade on dopamine receptors.

The purpose of this audit is to assess current practices at Mount Carmel Hospital (MCH) with regards to serum prolactin monitoring in patients taking Risperidone when compared to Maudsley Prescribing Guidelines in Psychiatry, 14th Edition (2021). The audit was based on patients acutely admitted between June and December 2021. Focus was placed on prolactin levels checked during admission in patients previously on Risperidone, prolactin levels checked in the preceding six months if no prolactin level was checked during admission and the appropriate action taken in cases where the serum Prolactin was noted to be high.

From this audit it was concluded that there is inadequate monitoring of serum prolactin levels in patients prescribed Risperidone at MCH. Increased awareness of Risperidone-induced hyperprolactinemia and associated guidelines are required to improve clinical practice.

The recommendations suggested from this audit were to increase awareness of serum prolactin monitoring guidelines amongst all medical and nursing staff at MCH and to create a simple flow-chart outlining the appropriate serum prolactin monitoring guidelines and distribute this to MCH wards.


Doi: 10.7423/XJENZA.2023.2.08
Article
An earthquake swarm on the Malta Graben, Central Mediterranean, September – November 2020
Pauline Galea, Matthew Agius, Daniela Farrugia, Sebastiano D'Amico
Pages: 81 - 88
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Abstract:
The seafloor of the Sicily Channel is characteristized by an extensional regime, governed by a network of normal and strike-slip fault systems. These faults generate a background level of seismicity that rarely exceeds magnitude 5.0. A number of these faults pass close to the Maltese islands. In particular the Malta graben lies less than 15 km to the south of Malta at its closest point, and the islands have been shaken a number of times by earthquakes originating on this, and other fault systems. In this study we describe the occurrence of a seismic sequence, that started in September 2020 and lasted for several weeks, the largest event having a local magnitude of 4.5 and being strongly felt throughout the archipelago. The sequence was located at a distance of around 23km south of the eastern tip of Malta. We have used single-station polarization analysis at seismic station WDD to estimate epicentral location for all events, down to magnitude 1.2. For the largest events, we have also used conventional network location, utilising phase picks at stations of the Malta Seismic Network and in Southern Sicily. We describe the time evolution of the sequence, felt effects, the public response and the implications for seismic hazard.

Doi: 10.7423/XJENZA.2023.2.09
Article
The 2022 COPCA Conference in Valletta
Duncan Mifsud, Rebekah Attard-Trevisan, Nigel Mason
Pages: 89 - 92
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