Biomedical subjects
Publications and source records attributed to M A Moussa.
A total of 5,007 Kuwaitis were ascertained to study the incidence of consanguineous marriages during 1983. The rate of consanguineous mating was found to be 54.3% with estimated population incidence rates 52.9 to 55.7%. First cousin marriages were the most frequent type. The average inbreeding coefficient was 0.0219 which could be considered high.
Little is known about congenital viral and toxoplasmal infections in the developing countries. This study attempts to provide preliminary data on such infections among Arab mothers and infants in Kuwait. Babies born with an elevated IgM in cord blood were selected at birth and then studied prospectively during the first year of life for serological and clinical evidence of viral and toxoplasmal infections. There appeared to be a significant association between the elevation of total cord blood IgM and the selection of cases with cytomegalovirus infection. Demonstration of specific IgM in cord sera was attempted, whenever possible, to provide further evidence of congenital infection and to exclude early postnatal infections. In 18.5% of cases there was an association between serological evidence of infection and certain clinical abnormalities. Apart from cytomegalovirus and rubella virus, no evidence was found for congenital infection by other viruses or toxoplasma in this study.
A national cross-sectional survey of the heights and weights of Kuwaiti preschool-age children of 0-5 years was conducted on a stratified multistage sample of 2554 subjects from high and low socioeconomic levels. The collected data were used to compare the nutritional status of these children with their American counterparts using the NCHS/CDC reference population. The basic indices for comparison were height for age and weight for height, each considered in terms of centiles and standard deviation (SD) scores and cross-classified using the SD scores. The results indicated that Kuwaiti children in the studied age groups were shorter than American children, 47.7% falling below the 30th centile of the reference population. Conversely, the weights of Kuwaiti children aged 0-5 years were much closer to their American counterparts, 51.8% falling above the 50th centile of the reference population.
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For quantification of glycated hemoglobin (HbA1c), we compared an automated system (Pharmacia Fast Protein Liquid Chromatography), which separates and determines HbA1c, with a commercial disposable-minicolumn kit (Boehringer-Mannheim), which separates total HbA1. We studied 41 diabetic women and 79 apparently normal women on their first postparturition day. The automated method was more precise (within-run CV 0.98-4.16%) than the kit method (within-run CV 3.67-7.77%). Results by the two methods correlated well for both control (p less than 0.001) and diabetic (p less than 0.05) groups. Values for HbA1c correlated significantly with fasting blood-glucose concentrations in controls and diabetics (intraclass correlation coefficient rI = 0.822 and 0.851, respectively, p less than 0.001) as well as with 1- and 2-h values for glucose after a 75-g glucose load in the control group (rI = 0.649 and 0.846, respectively, p less than 0.001). For HbA1 no such significant correlation was found except with values for fasting blood glucose in diabetics (rI = 0.745, p less than 0.001). Evaluation of HbA1c was a more sensitive index of glycemic status. The automated system is convenient, reliable, and easily operated.
This paper deals with: (1) estimation of the optimum clinical trial size minimizing the total cost, given types I and II errors, alpha, beta and response rate difference, delta; (2) studying the test performance by calculating the operating characteristic curve in case of available fixed total cost; (3) mapping the future course of the patient recruitment plan by estimating recruitment rate and final intake based on enrollment to date; (4) projecting the recruitment duration and probability of achieving the contracted goal in case the recruitment rate is well established.
The annual incidence of diabetes mellitus among Kuwaiti subjects 0-29 years of age during 1980-1981 was found to be 22.09 per 100,000. There was a very low incidence in the 0-14 and 0-19 year age groups (3.96 per 100,000 and 5.61 per 100,000, respectively). The age distribution at onset shows an increase in incidence with age without exhibiting any remarkable peaks. The total number of female diabetic patients exceeded the number of males by 32%, the male/female sex ratio being found to be 0.68, which is significantly less than that of the same age group in the general population.
This paper deals with the problem of identifying and testing a number of extreme sample elements (t = 1, 2, 3 and 4) as significant outliers in a sample of size n from a K-dimensional normal distribution with unknown parameters. Accommodation of detected outliers is effected through outlier-robust estimation of multivariate location (mean vector) and dispersion (variance-covariance matrix).
Five hundred and seventy three of 606 (94.6%), 583 of 604 (96.5%) and 575 of 595 (96.6%) women were found to have antibody to rubella virus, cytomegalovirus and herpes simplex virus, respectively. The Geometric Mean Titre (GMT) of haemagglutination-inhibition antibody to rubella virus was 60.97, while the GMT of complement-fixation antibody to cytomegalovirus and herpes simplex virus were 28.49 and 25.01, respectively. Furthermore, 301 of 517 (58.2%) women were also found to possess antibody to toxoplasma (GMT = 10.12) as detected by the passive-haemagglutination test. No significant differences in antibody prevalence or GMT could be found among the various nationalities studied except among Bedouins who showed a significantly higher rate and GMT of antibody to rubella virus and for the Mediterranean Arabs who showed significantly higher rate of immunity to and GMT of toxoplasma antibody when compared to other nationalities. Finally, no significant differences in antibody prevalence or GMT could be found among the various age groups.
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In this study to determine the harmful effect of abnormal pregnancy outcome on the immediately following pregnancy, 573 recently delivered women (with 2347 pregnancies) were interviewed. Data were recorded on their pregnancy outcomes (normal, abortion, stillbirth and congenital malformation), as well as on their interpregnancy intervals. A significant difference was found between the chances of having a spontaneous abortion following a normal outcome (5.5%) against that following a spontaneous abortion (31.1%). Also, the chances of a normal outcome following a normal outcome were 92.4%, compared with 63.9% following a spontaneous abortion. The delivery of a malformed baby is associated with a larger proportion of abortion and congenital malformation in the subsequent pregnancy, while stillbirth was followed by a larger proportion of abortion and stillbirth. A longer interpregnancy interval did not appear to have any protective effect on the subsequent pregnancy.
The antistreptococcal immune responses in 130 children with Acute Rheumatic Fever (ARF), seen in Kuwait, over a period of three years, are presented. The ages of children ranged between three to 13 years. One hundred and three presented in initial attacks while 27 presented in recurrences. The geometric mean of antistreptolysin 'O' (ASO) and antihyalurodinase (AH) titres for all patients were 488 Todd Units and 595 units, respectively. In children under the age of eight years, but not above this age, the geometric mean of ASO titres was significantly higher in children with carditis than in those without carditis (P less than 0.01); there was no significant difference in AH titres between the two groups. Analysis of the Geometric Mean Titres (GMT) of both antibodies in relation to other variables is also presented.
A total of 1041 asymptomatic "normal" schoolchildren in Kuwait, aged 6-16 years, were investigated over six months from November 1978 through April 1979 for hemolytic streptococcal throat carriage and for streptococcal immune response. A high carrier rate of beta-hemolytic streptococci (47%) with an unusually high prevalence of group C (32%) was found. Group A was isolated in 10%, group B in 2%, and group G in 3% of the children. Comparison of the prevalence of the different serogroups of beta-hemolytic streptococci in our study with that of similar studies reported from temperate, subtropical, and tropical zones showed a high prevalence of groups C and G and a lower prevalence of group A in subtropical and tropical countries in contrast to a high prevalence of group A and lower prevalence of groups C and G in countries with temperate climate. The geometric mean titer of antistreptolysin O in group A carriers in our study was 270 Todd units and significantly higher than that in group C carriers (p less than 0.001), while the geometric mean titer of antihyaluronidase in group A carriers was 240 units and significantly higher than that in groups B, C, and G carriers (p less than 0.0005). The high magnitude of the streptococcal immune response probably reflects a high frequency of streptococcal infections in schoolchildren in Kuwait and possibly indicates a high attack rate of rheumatic fever in the country.
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The relation between collagen content and bursting pressure of human fetal membranes is reported. There is a highly significant association between the two variables. No significant relationship was found between parity, maternal age, sex and body weight on the one hand and the collagen content per unit surface area of fetal membranes on the other . However, the bursting pressure of fetal membranes seems to be lower among the age group of less than 25 yr compared to 25-29-yr-old mothers. Neither parity nor sex of the newborn seem to affect the bursting pressure of fetal membranes.