Dr Stefan Buttigieg MD MSPH MSc

Overall, the Maltese health system has been making remarkable progress, with improvements in avoidable mortality and low levels of unmet need. Maltese life expectancy continues to be high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private share of expenditure is still higher than in many EU countries.

The… Show more

Overall, the Maltese health system has been making remarkable progress, with improvements in avoidable mortality and low levels of unmet need. Maltese life expectancy continues to be high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private share of expenditure is still higher than in many EU countries.

The health care system offers universal coverage to a comprehensive set of services that are free at the point of use for people entitled to statutory provision although patients often choose to visit private primary care providers. The historical pattern of integrated financing and provision is shifting towards a more pluralist approach and in 2016 a new public-private partnership contract for three existing hospitals was agreed.

The total number of doctors and GPs per capita is at the EU average, the number of specialists remains relatively low; education and training are also being further strengthened in order to retain more specialist skills in Malta.

The main outstanding challenges include:

Adapting the health system to an increasingly diverse population;
Increasing capacity to cope with a growing population;
Redistributing resources and activity from hospitals to primary care and strengthening primary care;
Strengthening the mental health sector;
Building the health information system to support improved monitoring and evaluation;
Ensuring access to expensive new medicines whilst still making efficiency improvements; and
Addressing medium-term financial sustainability and ageing.
Malta is also concerned about, and has designated as its 2017 EU Presidency priorities, childhood obesity and Structured Cooperation (as a way of ensuring access to highly specialized and innovative services, medicines and technologies). Show less

Introduction: The A scan is a method of measurement of the eye length from cornea to retina which is usually coupled with keratometry readings so that by use of formulae like SRK, one can measure the required power of an intraocular lens that would refract sharp images on the retina.

Methods: This is a retrospective audit where notes from post-operative refraction visits were used in order to check the A scan method, ultrasound method vs optical method, the postoperative visual acuity… Show more

Introduction: The A scan is a method of measurement of the eye length from cornea to retina which is usually coupled with keratometry readings so that by use of formulae like SRK, one can measure the required power of an intraocular lens that would refract sharp images on the retina.

Methods: This is a retrospective audit where notes from post-operative refraction visits were used in order to check the A scan method, ultrasound method vs optical method, the postoperative visual acuity and refraction. The notes of post-operative refractions done from November to December 2014 were taken into account.

Results: 55% of the A scans were performed using the Lenstar® while 38% were performed using the ultrasound method. No major difference was noted between the post-operative refraction and resulting visual acuity.

Conclusions: Either method is useful. The advantages of the Lenstar® include that is is less invasive, do! es not transmit infections, more tolerable. The advantages of the ultrasound method include the fact that it can give readings in very dense cataracts and in not so co-operative patients.
Documentation of ophthalmic notes needs improvement. A pre and post op cataract booklet is an idea that emerges from such audit. It could include all pre-operative and intraoperative data and post-operative examination in one booklet that can be easily identified. Show less

This was a literature review to analyze the value of cervical elastography to predict high risk preterm labor in both asymptomatic and symptomatic women.

First Author : Angelika Biernacka-Buttigieg

Results
Elastography allowed for easy correlation between color distribution and the anatomical structures image. Increasing gestational age was accompanied by reduction in internal cervical os stiffness and decrease in cervical length. Elastographic assessment of the internal… Show more

This was a literature review to analyze the value of cervical elastography to predict high risk preterm labor in both asymptomatic and symptomatic women.

First Author : Angelika Biernacka-Buttigieg

Results
Elastography allowed for easy correlation between color distribution and the anatomical structures image. Increasing gestational age was accompanied by reduction in internal cervical os stiffness and decrease in cervical length. Elastographic assessment of the internal cervical os may identify patients with high risk of preterm delivery at the early stage preceding other ultrasound and clinical findings. Show less

This book is intended for web developers of all levels of expertise who want to deep dive into cross-platform mobile application development without going through the pains of understanding the languages and native frameworks that form an integral part of developing for different mobile platforms.

This book is also for you if you are a developer who wants to capitalize on the MobileFirst strategy and so are going to use JavaScript for your complete stack.

An 87 year old fully independent long term care resident at a home for the elderly developed
ductal adenocarcinoma of the breast with diffuse bone metastasis. After a dental check up
the patient was started on pamidronate and later switched to zoledronic acid (Zometa®)
due to multiple skeletal pathological fractures. 7 years later the patient develops a very
loose maxillary incisor abutting a dental bridge. This was deemed non-salvageable and was
therefore extracted. The… Show more

An 87 year old fully independent long term care resident at a home for the elderly developed
ductal adenocarcinoma of the breast with diffuse bone metastasis. After a dental check up
the patient was started on pamidronate and later switched to zoledronic acid (Zometa®)
due to multiple skeletal pathological fractures. 7 years later the patient develops a very
loose maxillary incisor abutting a dental bridge. This was deemed non-salvageable and was
therefore extracted. The patient soon developed ulcers on the alveolar ridge with evident
bone exposure. A diagnosis of bisphosphonate induced ostenecrosis of the jaw was made.

This later extended into the palate, the zygomatic bone and maxillary sinus. Despite good
multidisciplinary efforts between geriatricians, oncologists, ENT, dental surgeons and
speech language pathologists the quality of life of the patient was markedly reduced due to
the continuous oral pain, halitosis, orofacial disfigurement and difficulty with speech and
eating. Show less

Trial without catheter (TWOC) is a procedure that is regularly undertaken in geriatric
hospitals and long term care facilities. However, there are no established local or international
guidelines about the procedure save for recommendations made by a Cochrane review in 2009 and
an occasional standard operating procedure used by UK NHS trusts.

The aim of this audit was to assess retrospectively the documentation of the various steps involved in this procedure as outlined in… Show more

Trial without catheter (TWOC) is a procedure that is regularly undertaken in geriatric
hospitals and long term care facilities. However, there are no established local or international
guidelines about the procedure save for recommendations made by a Cochrane review in 2009 and
an occasional standard operating procedure used by UK NHS trusts.

The aim of this audit was to assess retrospectively the documentation of the various steps involved in this procedure as outlined in forms issued by the local continence nursing team, compare the local practice to the 2009 Cochrane recommendations and to use the data to establish a local standard operating procedure. Show less

Arduino Android Blueprints, co-authored by Marco Schwartz and Stefan Buttigieg is a book about the power of combining the efforts of Arduino and Android platforms bring about incredibly implemented practical projects that enhance daily life.

This book is a "recipe-book" where each project is explained in a step-by-step fashion, always starting with the choice of components and the assembly of the hardware.This process is complemented by learning how to code and implement the Android… Show more

Arduino Android Blueprints, co-authored by Marco Schwartz and Stefan Buttigieg is a book about the power of combining the efforts of Arduino and Android platforms bring about incredibly implemented practical projects that enhance daily life.

This book is a "recipe-book" where each project is explained in a step-by-step fashion, always starting with the choice of components and the assembly of the hardware.This process is complemented by learning how to code and implement the Android mobile application onto your personal Android Smartphone and truly understanding what each part of code stands for. Show less

Case Report on a hospital admission of 38-year-old pregnant female in her 8th week of gestation presented with a suspicion of caesarean scar pregnancy (CSP).

A case report on a 54-year-old woman with history of allogenic kidney transplantation one year before was admitted to the hospital presenting with severe graft pain, oliguria, microscopic hematuria and fever up to 39 degrees celsius despite intensive antibiotic therapy.

Medical Education is being innovated rapidly on an exponential scale globally and the convenience of being able to undergo a learning experience through a mobile device has been noted and acknowledged in worldwide research institutions and is being taken advantage of. It has been projected that by the year 2015, the number of mobile phones will reach the 10 billion mark of which 2 billion are smartphones. A smartphone is defined as a phone with more advanced computing capability and… Show more

Medical Education is being innovated rapidly on an exponential scale globally and the convenience of being able to undergo a learning experience through a mobile device has been noted and acknowledged in worldwide research institutions and is being taken advantage of. It has been projected that by the year 2015, the number of mobile phones will reach the 10 billion mark of which 2 billion are smartphones. A smartphone is defined as a phone with more advanced computing capability and connectivity than basic feature phones and with the basic ability of installing advanced applications which are capable of taking advantage of advanced hardware. Through this poster we analyzed mobile applications related to radiology education. Show less

Health care has been deeply transformed by the Digital Revolution at every level and many new paradigms allowed by
the application of information and Communication Technologies in medicine are already mainstreamed in everyday
medical practice.e-Health allows a more patients centred, data driven, delivery of care, with big economical and
efficiency improvements, for both high- and low income countries.
It is fundamental that awareness about the changes introduced by e-Health and… Show more

Health care has been deeply transformed by the Digital Revolution at every level and many new paradigms allowed by
the application of information and Communication Technologies in medicine are already mainstreamed in everyday
medical practice.e-Health allows a more patients centred, data driven, delivery of care, with big economical and
efficiency improvements, for both high- and low income countries.
It is fundamental that awareness about the changes introduced by e-Health and its ethical and practical consequences
raise among medical students, as the following generation of health professionals.
IFMSA represents the biggest medical students
association in the world and its aim is to arrange debates and discussions among medical students all over the world
about the impact of ICTs over Health Care, another great importance is to educate a generation towards professional
health awareness and confidence about the radical changes carried on by the correct usage of these technologies.
During the 63rd General Assembly, in Hammamet, Tunisia, the Federation has started a long term effort to advocate
about e-Health with specific initiatives. Health 2.0 Workshop was organized to give the participants a background on
the several innovations introduced by ICTs. The workshop themes spanning from relationship between patients, doctors
and technology, devices and software, movements like Quantified Self, including medical education and research. Other
topics were also low-income backgrounds, and examples such as virtual simulation and Open Access platforms, Big
Data, Digital Epidemiology and the effects on Public Health and many others. The IFMSA enables a student movement
of passionate future health leaders and emphasizes the role of youth in the global mobilizing for health in the post-2015
development agenda, the theme of the General Assembly. IFMSA strongly believes that this contribution to promo Show less