Biomedical subjects
Publications and source records attributed to A T Abul.
Lobar consolidation in a chest X-ray is often thought to be due to infection. We present the problem of a 66-year-old female with low grade non-Hodgkin's lymphoma of the mucosa associated lymphoid tissue (MALT) type who had features of lobar consolidation that persisted for years. The different causes, both infectious and non-infectious, of this kind of presentation are discussed.
Though common, the exact incidence and clinical pattern of idiopathic pulmonary fibrosis (IPF) in Gulf countries are not known. The results of a four-year prospective study undertaken in two tertiary hospitals in Kuwait are presented. The mean age at diagnosis of the 52 patients studied was 55.40 +/- 11.87 years. Thirty-two (61.5%) patients were male and 22 (42.3%) were smokers. The mean duration of symptoms at diagnosis was 2.1 +/- 0.92 years. Digital clubbing was found in 34 (65%) patients. The mean FVC, TLC and TLCO were 57%, 64.4% and 55% of predicted normal, respectively. The FVC value showed a significant difference between smokers and non-smokers (p < 0.05). HRCT findings were abnormal in all patients. Typical histological and high-resolution computed tomography findings of usual interstitial pneumonia, desquamative interstitial pneumonia and non-specific interstitial pneumonia were observed. This study revealed that IPF is prevalent in Kuwait, with patterns showing some similarities to those established elsewhere. The response to treatment was not encouraging, especially in the usual interstitial pneumonia subtype.
BACKGROUND: The aim of the present study is to compare hospital admissions and death rates from asthma between pre (1987 to 1989)- and post (1992 to 1994)-Gulf War periods. METHODS: Data on annual hospital admissions by nationality and age, per International Statistical Classification of Diseases 493, were collected from the Health Statistics Department, Ministry of Health, Kuwait, and were analyzed with population data from the Annual Statistical Reports, Ministry of Planning, Kuwait. RESULTS: A total of 12,113 patients with asthma were admitted to various hospitals in Kuwait during the pre-Gulf War period compared with 9,771 patients during the post-Gulf War period. The average annual admissions rates per 100,000, people were 205 and 217, respectively, for the pre- and postwar periods. Total number of admissions showed an increase among Kuwaiti nationals during the study period. There were 95 deaths during the prewar period compared with 72 deaths during the postwar period. The mean annual death rates per 100,000 people were 1.60 and 1.59 respectively, for the pre- and post-Gulf War periods. CONCLUSIONS: This study did not show any statistically significant differences in either hospital admissions for or death rates attributable to asthma in the pre- and post-Gulf War periods in Kuwait. However, the number of hospital admissions in young adult Kuwaiti nationals increased. This study suggests hospital admissions and deaths from asthma did not increase after the invasion of Kuwait.
Lung function was studied in 24 patients with advanced mitral stenosis scheduled for mitral valve replacement (MVR), and revealed an obstructive ventilatory pattern. Forty per cent of the patients had a forced expiratory volume in 1 s (FEV1)<60% of that predicted in the preoperative period. Twenty-five per cent of those operated upon showed a similar pattern up to 110 weeks postoperatively. A blind study of the effect of placebo and beta2 agonist (salbutamol) inhalation was performed preoperatively and 6 months postoperatively, to evaluate the reversibility of airflow obstruction in these patients, flow volume curve and body plethysmographic measurement of airway resistance (Rex) and intrathoracic gas volume (VTG). Patients in the pre and postoperative period showed a significant difference between the placebo and the beta2 agonist responses for FEV1, FEV1 as percentage of FVC (FEV1% FVC), peak expiratory flow rate (PEFR), flow rate of 50% of expiratory vital capacity (Vmax50), Rex and VTG (P<0.001). We conclude that salbutamol inhalation improves obstructive impairment in patients with MVR pre- and postoperatively.
The relationship between zinc treatment and interleukin-1 alpha (IL-1 alpha) production by cultured alveolar macrophages (AM) in patients with pulmonary tuberculosis and bacterial pneumonia was investigated. AM (1 x 10(6) cells/ml) from 6 patients with pulmonary tuberculosis, 7 patients with bacterial pneumonia and 4 healthy volunteers were cultured with either two different concentrations of zinc chloride (Znl = 1 microgram/ml and Zn2 = 5 micrograms/ml) or cell culture media alone (control) for an initial period of 6 hours and then stimulated with 3 different immunomodulator agents and reincubated for a further 24 h. IL-1 alpha in culture supernatants was measured by enzyme-linked immunosorbent assay (ELISA). In the absence of Znl or Zn2 Polyinosinic:Polycytidylic acid (Poly I:C 1 microgram/ml), Lipopolysaccharide (LPS 100 ng/ml) and Tumour necrosis factor-alpha (TNF-alpha 10 ng/ml) significantly increased the production of IL-1 alpha from AM in both patients and healthy subjects (p < 0.001) compared to control (media only). Zn1 and Zn2 significantly increased the production of IL-1 alpha (p < 0.001) in culture supernatants in the absence of either Poly I:C, LPS or TNF-alpha in patients but not in healthy group. In contrast, the presence of LPS or TNF-alpha significantly reduced Zn1 or Zn2-stimulated release of IL-1 alpha from AM in patients and healthy subjects (p < 0.01). However, Poly I:C decreased only Zn1-stimulated release of IL-1 alpha. These results suggest that zinc can regulate the production of IL-1 alpha from AM in patients with pulmonary tuberculosis or bacterial pneumonia.