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B al-Nakib

Publications and source records attributed to B al-Nakib.

8 recordsLinked to original sources
PubMed1998

Findings of colonoscopy in children: experience from Kuwait.

This report summarizes our retrospective analysis of 173 colonoscopic examinations performed on 159 children over a period of 9 years in Kuwait. Ninety-six children were males, with a male to female ratio of 1.5:1. The main indications for colonoscopy were rectal bleeding, polyps, and suspected inflammatory bowel disease. Examination was done under sedation or anaesthesia. One hundred and fifty-one (87 per cent) examinations were complete up to the caecum and 89 (51 per cent) up to the terminal ileum. The most common pathology was polyps in 42 children. All but one polyp were hamartomatous and mainly localized to the rectum and sigmoid colon. The majority had a single polyp. One child had adenomatous polyposis coli. One hundred and forty-two polyps were removed endoscopically with no complications. Inflammatory bowel disease was present in 34 (21 per cent) children (17 Crohn's disease, 11 ulcerative colitis, and 6 indeterminate colitis). Tuberculosis of the ileo-caecal region was diagnosed in two cases. Seven patients had rectal ulcers presenting as rectal bleeding. In 11 (7 per cent), the lesions were limited to the right side of the colon or terminal ileum. These results suggest that colonic pathology is not uncommon in children in Kuwait. The disease pattern is similar to that reported in western countries. As we have observed in adults, inflammatory bowel disease is seen in significant numbers among children in this region. In this survey we have observed a change in the disease frequency, Crohn's disease being more common that ulcerative colitis. Without adequate examination, the existence of inflammatory bowel disease and this possible changing pattern of disease would have gone unrecognized.

Adolescent↗
PubMed1996

Short-term IgM and IgG antibody responses to hepatitis E virus infection.

53 adult patients with acute hepatitis caused by hepatitis E virus were identified by the presence of IgM antibody to hepatitis E virus, and followed for 12 months to evaluate the kinetics of anti-HEV antibodies. All but 1 female Kuwaiti patient were expatriate workers from the Indian subcontinent, temporarily working in Kuwait. Follow-up samples obtained at 1, 3, 6 and 12 months were evaluated for IgM and IgG antibodies to hepatitis E virus. IgM-class antibodies to hepatitis E virus were detectable in 12/27 (44%) patients at 1 months, in 0/26 at 3 months, in 0/8 at 6 months and 0/6 at 12 months. IgG antibodies to hepatitis E virus were detectable in 46/47 (98%) at onset, 26/27 (96%) at 1 month, in 26/29 (90%) at 3 months, 16/16 (100%) at 6 months and 8/8 (100%) at 12 months of follow-up. This study suggests that IgM antibodies to hepatitis E virus decline rapidly after an acute infection but IgG antibodies to hepatitis E virus persists for at least 1 year in many patients.

Acute Disease↗
PubMed1995

Urinary schistosomiasis associated with hepatitis C virus infection.

We studied 26 adult patients referred for cystoscopy: 13 consecutive patients with schistosome ova on bladder biopsy and antibodies to Schistosoma species in serum were classified as having urinary schistosomiasis, while 13 consecutive patients without schistosome ova on bladder biopsy and who were negative for antibodies to Schistosoma species in serum served as controls. Nine of 13 patients (70%) and none of 13 controls (p < 0.0005) had antibodies to hepatitis C virus in serum (anti-hepatitis C virus). All controls and patients who were negative for anti-hepatitis C virus had normal serum alanine aminotransferase levels, while 2 of 9 (22%) positive for anti-hepatitis C virus had elevated levels. Our study shows that patients with urinary schistosomiasis are at high risk for anti-hepatitis C virus positivity and that some of them may have active liver disease. Therefore, it is imperative to screen patients with urinary schistosomiasis for associated hepatitis C virus infection and liver disease.

Adult↗
PubMed1994

Acute sporadic hepatitis E in Kuwait.

Fifty-seven adult patients with acute hepatitis and 34 comparison patients without liver disease were evaluated using a newly developed Western blot assay for IgM antibody to hepatitis E virus. The mean age of patients with hepatitis was 32 years (range, 18-55 years); 88% were male. Among patients with acute hepatitis, hepatitis A (anti-HAV IgM positive) was diagnosed in two (4%), hepatitis B (anti-HBc IgM positive) in three (5%), and hepatitis E (anti-HEV IgM positive) in 34 (60%). One hepatitis patient had CMV IgM, another had EBV IgM, and 16 others (28%) were negative for all serologic markers of acute viral hepatitis. No patient with acute hepatitis A or B and none of the comparison patients without acute hepatitis had anti-HEV IgM. All but one case of acute hepatitis E were found among expatriates of Asian origin, and acute hepatitis E was associated significantly with recent travel to the Indian subcontinent. These data suggest that acute hepatitis E is common among foreign workers in Kuwait but that little HEV transmission is occurring directly in Kuwait.

Acute Disease↗
PubMed1994

Unusual presentations of abdominal tuberculosis.

OBJECTIVE: To review unusual presenting features and diagnostic difficulties of abdominal tuberculosis in an endemic region. DESIGN: Retrospective clinical study from 1984 to 1989, illustrated by case reports. SETTING: A single hospital in Kuwait. PATIENTS: Fifty patients with abdominal tuberculosis established by the standard histologic and bacteriologic demonstration of acid-fast bacilli or tuberculous granulomas. MAIN OUTCOME MEASURES: Site of disease and unusual features at presentation. RESULTS: Tubercular lesions are most commonly seen in the ileocecal region. They are also common in the ileum but are less common in the appendix and jejunum. Involvement of the ascending colon, rectum and upper gastrointestinal tract is rare. Abdominal tuberculosis presents in many ways depending on the degrees of ulceration, fibrous healing, infection and caseating abscess formation. CONCLUSIONS: Abdominal tuberculosis should be considered in immigrants from regions where this disease is endemic who present with abdominal signs and symptoms. Imaging studies, endoscopy and laparoscopy may preclude laparotomy for the diagnosis of abdominal tuberculosis. Antituberculosis chemotherapy is the mainstay of treatment.

Abdomen↗
PubMed1993

Anti-HCV-positive cirrhosis associated with schistosomiasis.

Hepatosplenic schistosomiasis is occasionally associated with cirrhosis and progressive hepatic decompensation. The aim of the present study was to determine the prevalence of antibody to hepatitis C virus in patients with schistosomiasis and cirrhosis. The prevalence of anti-HCV was studied in 12 consecutive cases of schistosomiasis associated with biopsy proven cirrhosis. All patients had a past history of schistosomiasis and high titers of schistosomal antibodies in serum (1:32 to 1:4096). Five of the 12 patients had hepatic catheterization and were found to have sinusoidal involvement with corrected sinusoidal pressures ranging from 19 to 23 mm Hg. Four had ascites, six had pedal edema, and eight had peripheral signs of chronic liver disease in the form of palmar erythema, spider nevi, and/or gynecomastia. Ten of the 12 cases (83%) were repeatedly positive for anti-HCV/ELISA. These results suggest that when patients with schistosomiasis develop cirrhosis, associated hepatitis C virus infection should be suspected.

Adult↗
PubMed1988

Fulminant viral hepatitis in Kuwait.

This study describes the aetiology and clinical course of fulminant viral hepatitis in 34 patients. Sixteen of 34 (47%) patients presented with serological evidence that indicated that hepatitis B virus (HBV) was the cause of fulminant hepatitis, while in 13 of 34 (38%) non-A, non-B (NANB) virus was implicated as the cause. Further, in three cases (9%) and two cases (6%) the patients' serological data indicated that hepatitis A (HAV) and the delta agent superinfection, respectively, were the cause. Forty-seven per cent of cases with fulminant viral hepatitis were among those aged between 21 and 40 years. Fulminant hepatitis due to HAV was confined to children less than five years of age, while the two patients who had delta infection were 40 years or older. Fulminant hepatitis occurred with equal frequency among males and females, and with the exception of one case, who had a NANB virus infection, the outcome of fulminant viral hepatitis in this study was invariably fatal.

Adolescent↗