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Biomedical subjects

Dia Shehab

Publications and source records attributed to Dia Shehab.

6 recordsLinked to original sources

Impact of three-phase bone scintigraphy on the diagnosis and treatment of complex regional pain syndrome type I or reflex sympathetic dystrophy.

OBJECTIVE: To determine the impact of three-phase bone scintigraphy (TPBS) on the diagnosis and management of complex regional pain syndrome type I (CRPSI) or reflex sympathetic dystrophy (RSD). SUBJECTS AND METHODS: Twenty consecutive patients with a recent clinical evidence of CRPSI were referred for TPBS as part of their routine management plan. All patients underwent neurological examinations with special attention to the evaluation of clinical features of vasomotor, sudomotor, motor and sensory dysfunction. Patients were followed prospectively. When both the clinical and TPBS results supported the diagnosis of CRPSI, patients were started on treatment. RESULTS: Of the 20 patients, TPBS supported the diagnosis of RSD in 9 who were treated with steroids and physiotherapy. Complete follow-up was available for 7 of them and all had a satisfactory response to treatment. For the remaining 11 patients RSD was diagnosed clinically but not confirmed by TPBS. On follow-up there was no evidence that TPBS failed to identify RSD in these 11 patients. CONCLUSION: The results indicate that TPBS confirmed the clinical diagnosis of RSD, and, more importantly, had a significant impact on its management.

Adult↗

Heterotopic ossification.

Heterotopic ossification (HO) is the presence of bone in soft tissue where bone normally does not exist. The acquired form of HO most frequently is seen with either musculoskeletal trauma, spinal cord injury, or central nervous system injury. For example, patients who have recently undergone total hip arthroplasty or have paraplegia after spinal cord injury are at risk for HO. The fever, swelling, erythema, and occasional joint tenderness seen in early HO can be difficult to distinguish from cellulitis, osteomyelitis, or thrombophlebitis. Bone scanning and other imaging tests frequently are used to distinguish between these diagnostic possibilities. As treatment or prophylaxis for HO, either a nonsteroidal antiinflammatory drug (such as indomethacin), a diphosphonate (such as ethane-1-hydroxy-1,1-diphosphate), or local radiation therapy is recommended. Before therapy begins, bone scanning may be requested to confirm the diagnosis of HO. In addition, surgical resection of HO is used to preserve joint mobility; however, HO is likely to recur and possibly progress if resection is undertaken before the lesion has become mature. With a view toward avoiding recurrent HO and other operative complications, serial quantitative bone scans are used as an aid to time surgical intervention.

Bone and Bones↗

Validation of the Arabic version of the WHO-ILAR COPCORD Core Questionnaire for community screening of rheumatic diseases in Kuwaitis. World Health Organization. International League Against Rheumatism. Community Oriented Program for the Control of Rheumatic Diseases.

OBJECTIVE: (1) To adapt the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) for use as a rheumatic screening instrument among Kuwaitis, including translation, back translation, assessment of cross cultural equivalence, and reliability. (2) To determine the screening characteristics of the Arabic version of the CCQ for detecting rheumatic diseases compared to clinical examination by a rheumatologist. METHODS: Translation and assessment of cross cultural equivalence were undertaken using standard methods. Back translation was done by an Arabic-speaking rheumatologist. Interviewer agreement was assessed using a convenience sample. Sensitivity, specificity, and positive and negative predictive values were assessed first by administering the CCQ followed by full clinical examinations of a randomly selected sample of 359 Kuwaiti persons aged 15 years or older. RESULTS: (1) Cross cultural equivalence and back translation of the translated questionnaire were satisfactory. Interviewer agreement was acceptable. (2) The prevalence of rheumatic diseases based only on CCQ screening was 69% compared to 73% based on clinical examination. The sensitivity and specificity of the Arabic CCQ were 94.4% and 97%, respectively, and the positive and negative predictive values of the instrument were 98.8% and 86.4%, respectively. CONCLUSION: The Arabic version of the CCQ appears promising as a screening tool to detect rheumatic diseases in Arabic speaking communities. The findings suggest that the Arabic CCQ followed by clinical examinations in positive respondents can provide an acceptable estimate of prevalence of rheumatic diseases. We intend to use this instrument to screen for the prevalence of rheumatic diseases among Kuwaiti nationals.

Adult↗

Prevalence of low back pain among physical therapists in Kuwait.

OBJECTIVE: To determine the life and point prevalence rates and study the characteristics of work-related and non-work-related low back pain (LBP) among physical therapists in Kuwait and its effect on their regular activities. SUBJECTS AND METHODS: A specially designed self-administered questionnaire was distributed to 143 physical therapists in Kuwait. The questionnaire included demographic data, history and characteristics of LBP before and after working as a physical therapist, the effect of LBP on regular activities and current LBP. A visual analogue scale was used to score the intensity of the pain. RESULTS: One hundred (70%) of the 143 physical therapists completed the questionnaire; mean age and standard deviation of the respondents were 35.9 +/- 8.45 years. The lifetime prevalence of work-related LBP was 70% (61.8% in males and 74.2% in females) and the point (current) prevalence rate was 57% (31.6% in males and 68.4% in females). All the 100 therapists were college graduates who worked full-time and 82% were employed in general hospitals and rehabilitation centers. The most common areas of specialty were orthopedics (32%) and neurology (23%). Fifty percent reported that LBP affected their regular activities, 28.6% reported limitation due to pain and 11.4% changed their work settings because of LBP. The main site of pain was at low back and buttocks. Pain intensity was scored similarly among male and female physical therapists. CONCLUSION: Work-related and point prevalence rates of LBP among physical therapists in Kuwait are high and affect their daily activities, necessitating changes in work settings.

Adult↗

Is low-back pain prevalent among Kuwaiti children and adolescents? A governorate-based study.

OBJECTIVE: To measure the magnitude of the problem of low-back pain among 10- to 18-year-old Kuwaiti schoolchildren in Hawalli Governorate. SUBJECTS AND METHODS: A cross-sectional multistage stratified random sample of 400 schoolchildren (199 males and 201 females) of ages 10-18 years were selected from two junior and two high schools in Hawalli Governorate, Kuwait. Data on age, gender and characteristics of low-back pain such as duration, location and frequency were collected through personal interviews using a questionnaire. Low-back pain was defined as pain in the back from the 12th rib to the buttock area. RESULTS: According to our definition, reported lifetime prevalence of low-back pain was found to be 57.8% (50.8% in male and 64.7% in female students), while the point prevalence was 35% (20.6% in male and 39.3% in female students). More female students reported low-back pain than male students, and the prevalence of low-back pain was found to increase with age in both sexes. The age of onset of low-back pain was 14 years in males and 13 years in females. The majority of students (92.1% in males, 84.6% in females) reported pain in the low back. Almost 46% of students related their low-back pain to accidents. A significantly higher proportion of male students (58.4%, compared to females 36.2%) reported low-back pain caused by accident or with duration of recovery less than a week (21.8% for males as compared to 16.2% for female students). Female students reported more recurrent or continual low-back pain. CONCLUSION: Low-back pain is common among Kuwaiti students in Hawalli Governorate. Prevalence of low-back pain increased with age in both sexes. Female students reported more frequent low-back pain than male students.

Adolescent↗

Incidence of musculoskeletal pain in adult Kuwaitis using the validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire.

BACKGROUND: The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We estimated the incidence of musculoskeletal pain in the first community-based COPCORD study in Kuwait SUBJECTS AND METHODS: The validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire was used in a survey of 2500 randomly selected Kuwaiti households to assess the frequency of musculoskeletal pain, disability, and health-seeking behavior in adult Kuwaitis. Those subjects reporting no musculoskeletal pain were identified and followed-up for a period of one year by contacting them every 2 weeks. Once a respondent reported pain, an appointment to report to hospital was offered and the subject was examined by a rheumatologist using American College of Rheumatology (ACR) criteria. RESULTS: Of 5159 adults who were non-complainers in an earlier prevalence phase of the study, 3341 responded to phone calls (response rate of 65%). The incidence of musculoskeletal pain was 6.6% (95% CI, 3.4%-9.7%) Age- and sex-adjusted incidence rates were 7.2% (95% CI, 3.4%-10.5%) for females and 6.1% (95% CI, 3.1%-9.2%) for males. The incidence rate increased with increasing age, body mass index, and with being married. The common sites of pain were knee, low back and shoulder. CONCLUSION: The incidence of musculoskeletal pain among Kuwaiti adults is reported for the first time. Further studies adopting the same instrument in other communities are warranted to compare with our findings.

Adolescent↗