Biomedical subjects

A M Bilal

Publications and source records attributed to A M Bilal.

10 recordsLinked to original sources

PubMed1992

Evaluation of outpatient prescribing for substance misusers in Kuwait: the need for a rational approach.

The outpatient follow-up care of 140 substance misusers in Kuwait was evaluated. Treatment has been traditionally based on substitution pharmacotherapy with no set objectives or criteria for outcome evaluation. Patients' structural characteristics, mode of referral, clinical diagnoses, medication prescribed and screening urine samples for drugs were examined for meaningful associations between these variables. Benzodiazepines were by far the most prescribed (94%) medication. Only 40% of the urine test results were positive for drugs containing different combinations of medications and street drugs. Unlike patients who received benzodiazepine, those who received tricyclic antidepressant medication were significantly more likely to associate with predictors of improvement. There is a need for better training of doctors and careful selection of patients in order to implement treatment strategies based on good doctor-patient relationships and well defined objectives for treatment and clear criteria of outcome.

Adolescent↗

PubMed1992

Psychosocial and toxicological profile of drug misuse in male army conscripts in Kuwait.

The pattern of drug use among 2183 young Kuwaiti conscripts was studied using the Drug Abuse Screening Test (DAST) and urine analysis. Drug misuse rates were low, compared with similar set-ups elsewhere as independently confirmed by urine test (0.7% amphetamine and 2.8% other street drugs; alcohol was not detected in this sample) and self-report (7.9% on DAST). This may be attributed to the influence of the Islamic traditions on lifestyles. Significant correlations were seen between self-report of multiple drug use and positive urine results for both amphetamine and other street drugs, while positive urine amphetamine was associated with families seeking help for treatment, problems with family and/or work and having or being hospitalized for drug-related medical problems. Amphetamine as the major identified individual misused drug was significantly associated with older age group but negatively correlated with marital status, higher education and employment. The discrepancy between self-report of drug misuse-related problems and objective proof of this may reflect the inappropriateness of some of DAST items to this sample, culturally desired responses or both.

Adolescent↗

PubMed1990

Attitudes of a sector of the Arab-Muslim population in Kuwait towards alcohol and drug misuse: an objective appraisal.

The attitude of a sample of 1001 Arab Muslims living in Kuwait towards alcohol and drug misuse was examined by using a 30-item questionnaire. Eighty percent condemned drug misuse, 93.6% thought it was a contravention of Muslim religious teachings, yet 90% held an enlightened attitude compared to only 26% that chose the punitive attitude. The older generation, the less educated, females and Non-Kuwaiti Arabs were less likely to be sympathetic towards substance misusers. These findings while indicating the sample's strong religious condemnation of substance misuse demonstrated the adoption of Western concepts of care especially by the younger educated Kuwaiti males. Indirect evidence of drug misuse and smoking in the sample may be inferred from the low rates of denunciation of such behaviours.

Alcohol Drinking↗

PubMed1989

Prospective study of alcoholism treatment in Kuwait: a 5-year follow-up report.

The outcome of a 5-year prospective follow-up study of 100 patients treated in the Kuwait Hospital for alcohol-related problems is reported using two parameters computed from weighted follow-up variables, i.e., Offset Score measuring patients' initial follow-up status and Direction of Slope summarizing consequent follow-up scores. Nineteen patients had died representing 14 times the age-corrected national rate. Univariate and multivariate analyses of outcome measures against prefollow-up patients' characteristics revealed that variables indicating heavy alcohol use independent of each other predicted negative outcome and mortality. The tendency of the group score distribution towards normalization uninfluenced by treatment is demonstrated. The pertinence of these findings to the medical profession in Kuwait is stressed.

Alcoholism↗

PubMed1989

Kuwait drug addiction scene: a changing pattern?

Sociocultural considerations and persistence of indiscriminate prescription habits for addicts may have contributed in shifting the pattern of misused drugs from traditional alcohol and illicit drugs to predominantly iatrogenic dependence on benzodiazepines. The clinical profile and the rationale for the long-adopted detoxification treatment of 120 patients were studied. Multiple-drug misusers were found to suffer significantly more anxiety-type symptoms suggestive of benzodiazepine withdrawal. Poor correlation of detoxification medication with patient variables suggests that such treatment lacks the rationale for its continuation and should be replaced by treatments based on proper physical and psychiatric evaluation. Benzodiazepine dependence should be recognized as a clinical entity requiring relevant treatment strategies.

Alcoholism↗

PubMed1988

Correlates of addiction-related problems in Kuwait: a cross-cultural view.

The promise of adopting a valid and reliable tool for diagnosing addiction-related problems is offered by the Addiction Severity Index (ASI). Socially determined admissions and poor treatment facilities may have biased the representativeness of our sample, though methodological difficulties were minimal. The ASI was used to evaluate 120 hospitalized addicts in Kuwait's only addiction unit, categorized according to their primary drug of abuse: 61% were alcoholics and 39% drug addicts. Examination of ASI composite scores showed no difference between the two patient groups except in their corresponding problem area of substance abuse. ASI composite scores were similar to the interviewer's severity ratings. Intercorrelations between scores for different problem areas were low. The validity of ASI in diagnosing these problems was unquestionable, but the cross-cultural significance of some problem areas is doubtful.

Alcoholism↗

PubMed1988

Correlates of alcohol-related casualty in Kuwait.

This paper reports the extent to which alcohol consumption is associated with casualties in a country in which alcohol is prohibited religiously and culturally. Selective screening of particular casualty groups by blood test established qualitative evidence of alcohol use in 107 out of 1058 patients (10%) examined at a general hospital and a traumatology hospital in Kuwait. The rate of alcohol-associated casualty was significantly higher in traumatology hospital patients (15%) than in general hospital (7%), stressing the association between alcohol and trauma. Absence of differences by place of casualty disproves lay beliefs that motor vehicle casualty is the major alcohol-associated risk in Kuwait. Other casualties, particularly work and domestic injuries, should be regarded as being affected by alcohol consumption. Statistically significant high alcohol-associated casualty rates characterized Kuwaitis (14%), the unemployed/retired (20%) and coma cases (22%) suggesting that these categories may suffer from serious alcohol problems.

Alcohol Withdrawal Delirium↗

PubMed1987

A cross-cultural application of a drinking behaviour questionnaire.

A British Questionnaire for Drinking Behaviour (HDBQ) measuring the severity of alcoholism was applied cross-culturally to 96 Arab-Muslim alcoholics while receiving treatment in Kuwait Psychiatric hospital. Though HDBQ proved valid in differentiating Arab alcoholics drinking categories, it gave significantly lower scores for the Arab sample when compared to scores of a British sample. Statistical analysis of the responses of various categories showed that Arab patients tended to respond in absolute negatives significantly more than the British sample did. Cultural factors underlying this tendency were discussed. Suggestions are offered for improvements of this and similar diagnostic instruments to make them more usable transculturally.

Alcoholism↗

PubMed1987

Treatment of alcoholism in Kuwait: a prospective follow-up study.

The outcome of routine drug-supportive psychotherapy treatment of 100 patients with alcohol-related problem in Kuwait's only psychiatric hospital was evaluated in four 6 month's intervals. Patients were assessed on 9 post-treatment questions reflecting improvement or deterioration. Correlation of follow-up changes to pre-treatment data shows that non-Kuwaitis do better than Kuwaitis in resuming employment and social reintegration. Patients on chronic benzodiazepine prescription were less likely to become abstinent, had poor social re-integration and more re-admissions. Good relationships with the family were clearly associated with a better treatment outcome. Scores of weighted follow-up findings were calculated to assess patients' status at each follow-up. Progress during the whole follow-up period was measured by the direction of slope calculated from linear regression model for individual scores. The relationship between pre-treatment conditions and patterns of follow-up was evaluated cross-sectionally (answers distribution) and longitudinally (direction of slope). A pattern of shift emerged where different patient groups crossed over to the opposite end of the score scale. Kuwait society's indulgent attitudes towards Kuwaiti patients with alcohol-related problems in employment have to be changed and utilization of the role of the Arab extended family in therapy is stressed.

Adult↗

PubMed1985

Some clinical and behavioural aspects of patients with alcohol dependence problems in Kuwait psychiatric hospital.

One hundred patients undergoing treatment for alcohol-related problems in Kuwait's only psychiatric hospital were studied. Eighty-three Kuwaitis and 17 non-Kuwaitis (78 inpatients and 22 outpatients) were compared on two variables, i.e. nationality and drinking category. Kuwaiti patients were more likely to be violent while drunk and to receive benzodiazepine prescriptions while non-Kuwaiti patients were better educated and suffered more alcohol withdrawal seizures. Heavy drinkers were prescribed more benzodiazepines. Light drinkers were involved in more road accidents and were more likely to be prescribed major tranquillizers. The relationship between benzodiazepines use and alcohol withdrawal symptoms is discussed and its implications in patient care in Kuwait are stressed.

Alcohol Drinking↗