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PubMed1998

Systemic lupus erythematosus in Kuwait--hospital based study.

The present study describes the clinical characteristics of patients with systemic lupus erythematosus (SLE), from the rheumatology service of the two main teaching hospitals in Kuwait. It was a retrospective-cum-prospective clinical study of 108 SLE patients. There were 98 females and 10 males, with a median age of 31.5y. Kuwaitis constituted 69%, while 31% were expatriates. The mean disease duration was 62 months. The main clinical features were: musculoskeletal involvement (87%), photosensitivity (48%), malar rash (43%), discoid lesions (10%), oral ulcers (33%), vasculitic skin lesions (10%), haematological features (53%), constitutional symptoms (51.4%), neuropsychiatric manifestations (23%), renal involvement (37%), serositis (29%), clinical manifestations of antiphospholipid syndrome (21%), cardiac involvement (10%) and pulmonary manifestations (19%). In conclusion, the clinical features of SLE in Kuwait were similar to most major studies from developed countries. Main differences included prominent haematological and mucocutaneous manifestations and possibly a low prevalence of anti-Sm antibodies. Whether these differences are due to the environment or genetic factors, remains to be studied.

Adult↗

PubMed2003

Morbidity associated with surgical treatment of ureteric calculi in a teaching hospital in Kuwait.

BACKGROUND: Ureteric lithiasis is a common urological problem in Kuwait. Because of the different interventional approaches, we carried out an audit on the morbidity associated with the surgical management of the disorder. PATIENTS AND METHODS: The surgical records were reviewed of all patients with the diagnosis of ureteric lithiasis that were managed surgically by ureteroscopy or ureterolithotomy in Mubarak Al-Kabeer Hospital in Kuwait between January 1996 and December 1999. Patients' bio-data, location of calculi, indications for surgical intervention, types of therapeutic interventions, operating surgeon and complications were analysed. Patients managed primarily and successfully by extracorporeal shockwave lithotripsy were excluded from this analysis. RESULTS: A total of 1383 patients with ureteric calculus were managed in the period under review--775 (56%), 567 (41%), and 41 (3%) patients were managed by extracorporeal shockwave lithotripsy, ureteroscopy and ureterolithotomy, respectively. The 608 patients managed by ureteroscopy or ureterolithotomy had a total of 710 operations. The commonest surgical procedure performed was ureteroscopy with Dormia basket with or without double 'J' stenting and this accounted for 418 (58.9%) operations. The least common procedure was ureteric meatotomy with Dormia basket and with or without double 'J' stenting in 9 (1.3%) patients. The overall complication rate was 110 out of 710 (15.5%) operations. Of the complications, 101 (92%) were minor (e.g. haematuria, fever, and mucosal injury). Nine (8%) complications were major complications (e.g. ureteric perforation and ureteric avulsions). Ureterolithotomy and ureteroscopy with intracorporeal lithotripsy were associated with the highest complication rates. CONCLUSIONS: This analysis has shown that with technological advances, the treatment of ureteric lithiasis has improved and major complications have decreased. However, with so many therapeutic options to choose from, there is a need to audit the various therapeutic options and select those associated with the least morbidity rates in each urology unit.

Adolescent↗

PubMed2000

The association of skin test reactivity, total serum IgE levels, and peripheral blood eosinophilia with asthma in Kuwait.

There is evidence that elevated serum immunoglobulin E (IgE) and eosinophilia correlate well with allergic skin test reactivity. These parameters have been used as alternative methods to characterize atopic subjects. Skin test reactivity is the only measure used routinely in clinical practice in Kuwait to reflect atopy in asthma patients. This study examines the usefulness of the two other parameters of atopy in patients with asthma, and to determine the most common allergens involved in Kuwait. Between 1998 and 1999, 101 asthma patients and 33 healthy controls were recruited for this study. Skin sensitivity test, serum total and specific IgE, total blood eosinophil count (B-EOS), and eosinophil cationic protein (ECP) tests were performed in patients and controls. Nine allergens known to be prevalent in this environment were selected for the skin test and specific IgE test. Spirometry was also measured. These parameters were repeated after 4 weeks of therapy in the patients only. Skin test reaction was positive in 81% of the patients, while total IgE above 200 kU/L was obtained in 63% of cases. B-EOS above 300 x 10(3)/L was found in 75% of cases. House dust mite reactivity (positivity) was the most frequently encountered skin allergy, occurring in 28% of the patients. IgE correlated positively with B-EOS and ECP. B-EOS similarly correlated positively with ECP. There was a negative correlation between ECP and forced expiratory volume in 1 sec (FEV1) (% predicted) as expected. At least one positive parameter of atopy was found in 95% of the patients. In 48% of the patients, all three parameters of atopy were found to be positive. Skin test reactivity and elevated IgE were found together in 62% of the cases. This study reveals a significant degree of allergy among patients with asthma in this environment. Skin testing was found to be the most effective measure of atopy in this environment, and correlates well with the other more sensitive newer tests.

Adolescent↗

PubMed1999

Knowledge, attitudes, beliefs, and practices about HIV/AIDS in Kuwait.

This survey is aimed at assessing knowledge, attitudes, beliefs and practices in Kuwait regarding AIDS/HIV. Structured face-to-face interviews were conducted during the year 1995 on a sample of 2,219 subjects, aged 18 to 60, health professionals were excluded. The survey instrument included 26 questions on AIDS/HIV knowledge, 6 about attitudes and beliefs, and 6 about behavior and practice. The remaining 22 items dealt with sociodemographic characteristics, role of religion, source of information, and satisfaction about AIDS control programs. Two thirds of subjects had good knowledge about the main modes of HIV/AIDS transmission. Using a multiple regression model, the knowledge score was positively associated with level of education, age, years of hearing about AIDS, and socioeconomic status. The multiple logistic regression showed that subjects tend not to change their behavior related to AIDS if they were less than 40 years old, had low education, were females, single, had a lower socioeconomic status, had heard about AIDS for less than 3 years, and had a low level of knowledge about AIDS. More than half of the participants were satisfied with the government's action for AIDS prevention. The majority of subjects thought that religion was important in dealing with daily life problems. In conclusion, while most of the people in Kuwait were aware of the main modes of AIDS transmission, a gap existed about modes that did not transmit the disease. This was reflected in their attitudes and practice toward AIDS patients. The study calls for a greater role for medical professionals, mass media, and religion in AIDS prevention and control.

Adult↗

PubMed2001

Reflections on the reconstruction of a nation: rebuilding the national identity of Kuwait.

The 10th anniversary of the liberation of Kuwait offers a time for reflection upon the reconstruction of a nation, not just physical reconstruction, but psychological reconstruction, as well. This paper briefly describes the efforts of the Social Development Office, Amiri Diwan, as an essential element in the preservation and reconstruction of the national identity of Kuwait in the wake of the Iraqi invasion and occupation. SDO may serve as a useful model for other war-torn countries on how to rehabilitate a national identity in the wake of a national disaster.

Crisis Intervention↗

PubMed2001

Dental caries experience of disabled children and young adults in Kuwait.

OBJECTIVE: The aim of the study was to assess the caries experience of disabled children and young adults in Kuwait, to set baseline data, and to determine their treatment need. METHOD: Dental caries was scored by surface in accordance with WHO criteria. The study population comprised 832 disabled children and young adults (3-29 years; mean age 12.1 years) who were visually impaired, hearing impaired, had physical handicaps or developmental disorders, attending special needs schools. RESULTS: The proportion of caries free subjects in the primary dentition (3-12-year-old children) was 11.2%. The mean dmft was 5.4, and dmfs 15.2, being highest in the Down's syndrome and lowest in the blind. The proportion of caries-free subjects in permanent dentition, over 5 years of age was 24.2%. The smallest percentage of caries-free subjects was found in the hearing impaired (16.4%) and highest percentage in the blind (35.5%). The mean DMFT was 4.5 and the DMFS 8.7, being highest in the Down's syndrome and lowest in the blind. Prevalence of untreated decay was highest in hearing impaired (86%). The caries experience of first permanent molars represented the largest proportion of the DMFT score (53.6%). In the permanent dentition increasing age, impaired hearing, and poor oral hygiene were significantly associated with caries risk. CONCLUSIONS: Caries experience among this disabled population was clearly higher than among the respective age groups in a previous national population survey. The study confirmed the need for strengthening organised preventive and restorative care for this population in Kuwait.

Adolescent↗

PubMed1975

The demography of the Kuwaiti population of Kuwait.

Kuwait has experienced a dramatic rise in national income since 1945, and its material standard of living is as high as that of any country in the world. The national population (Kuwaitis) is a stable and almost closed population comprising 45 percent of the total population of the state. The Kuwaitis, readily separable from the immigrant population, both de facto and de jure, have a very low level of mortality but retain their traditionally high level of fertility. It is suggested that this largely unaltered pattern of fertility is a function of the peculiar form of economic development to which Kuwait has been subjected and of the strongly pro-natalist pressures associated with Arabic Islam.

Adolescent↗

PubMed2002

Disclosure of cancer diagnosis and prognosis by physicians in Kuwait.

To analyse preferences for disclosure of cancer diagnosis and prognosis among physicians practising in Kuwait, a cross-sectional survey was conducted in public hospitals in both urban and suburban parts of the country, which included physicians likely to encounter adult cancer patients in their practice. A total of 217 physicians participated, 67% indicating they preferred full and complete disclosure of cancer diagnosis to patients. However, 79% of those would withhold the truth if the patient s family requested them to do so. Preference for concealment was more common among physicians who had experienced cancer directly with a friend or a family member, or who were in medical as opposed to surgical specialties. The belief that patients in Kuwait did not want to hear the truth about cancer diagnosis or prognosis was also significantly associated with concealment preference. Changes in public norms and expectations should be monitored, because they seem to play a major role in physicians preference for disclosure of cancer diagnosis and prognosis.

Adult↗

PubMedDate not supplied

Racial variation in risk factors and occurrence of acute myocardial infarction: comparison between Arab and South Asian men in Kuwait.

BACKGROUND: There are little data available on the rates of occurrence, risk factors and mortality due to acute myocardial infarction among the various ethnic groups living in Middle-East countries. Therefore, we did a study to compare Arabs and South Asians living in Kuwait. METHODS AND RESULTS: The data for this retrospective study were collected from the computerized database of the Coronary Care Unit at the Mubarak Al-Kabeer Hospital (a 476-bed teaching hospital) and the 1997-2000 Census data for the State of Kuwait. Arab and South Asian men above 25 years admitted between September 1997 and August 2000 with a diagnosis of acute myocardial infarction were included in the study A total of 866 Arabs and 277 South Asian men were admitted. The rate of admission for the entire patient population was two-fold higher among Arabs as compared with South Asians (6.7/1000 population and 3.3/1,000, respectively). Diabetes mellitus was present in 453 Arabs (52.3%) and 109 South Asians (39.4%) (p< or = 0.001) of those >25 years of age. Hypertension was recorded in 247 Arabs (28.5%) and 57 South Asians (20.6%) (p < or = 0.01). Among patients <55 years of age (454 Arabs and 226 South Asians); the rate of admission was 4.0/1,000 in Arabs and 3.5/1,000 in South Asians (not significant). Hypertension was present in 97 Arabs (21.3%) and 43 South Asians (19%) (not significant). Diabetes mellitus was present in 202 Arabs (44.5%) and 80 South Asians (35.4%) (p < or = 0.05). Smoking was recorded in 353 Arabs (77.8%) and 160 South Asians (70.8%) (notsignificant). Hypercholesterolemia was presentin 182 (40.1%) and 88 (39%), respectively (not significant). While in hospital, 11 Arabs and 9 South Asians died (not significant). CONCLUSIONS: Among men >55 and <75 years of age, Arabs had a higher rate of admission with acute myocardial infarction compared with men of South Asian origin. The incidence of diabetes and hypertension was significantly higher among Arabs in this age group. In younger patients (<55 years), the rate of acute myocardial infarction was not different between the two groups; however, diabetes was present more often among Arabs. The smoking rate is very high in both groups and is an important risk factor for both Arab and South Asian men living in the Middle East.

Adult↗

PubMed1995

New population policy in Kuwait: the quest for a balance in the population composition.

"This study investigates the development of population policy in Kuwait following the Gulf crisis, reveals the changes induced by the post-Gulf-war population policy, and provides an attempt to assess the policy's success. The study concludes that despite the new population policy, expatriates continue to make up the majority of the population. The problem continues to be a challenge for policy makers. There appear to be new levels of sincerity, explicitness and seriousness of purpose in Kuwait's new population policy, but there have not been many real changes in direction from earlier policies. Short of closing the door to expatriates, effective policy options for increasing the Kuwaiti share in the country's total population are limited."

Asia↗

PubMed1991

The relative economic progress of male foreign workers in Kuwait.

"A human capital framework is utilized to examine the economic progress of nine nationality groups of foreign workers [in Kuwait] using data from the 1983 national Labor Survey. The sources of earnings' variations of particular interest to us included different degrees of education and experience transferability, occupational affiliation and ethnic background. In general, the results derived from the analysis suggest that 1) foreign workers achieve a discernible economic progress as their residence lengthens; 2) the rate of economic progress varies depending on worker's education, home and Kuwait-specific experience, occupational status and ethnic background; and 3) about one third of the earnings inequality is due to unexplained factors including discrimination."

Asia↗

PubMed2002

Consanguinity and spousal concordance in Kuwait.

Consanguineous marriage is favored in Kuwait. This research focuses on the relationship of physical and cultural traits to marriage types in Kuwait and examines concordance as a function of consanguinity and marriage duration. In a nonrandom opportunistic sample of 242 couples anthropometric and blood pressure data have been collected as well as data on acculturation, religiosity, Farsi proficiency, level of education, occupation, and attitudes regarding fertility. Significant concordances occur in cultural characteristics among couples in all three types of marriages with respect to the degree of religiosity, acculturation, language similarity, education, and occupation. Non-consanguineous spouses have the highest concordance in educational level, occupation, and degree of acculturation, but the lowest for religiosity and Farsi proficiency. Nonkin marriages seem to be based on personal preferences. In the wider potential nonkin marriage pool spouses show more concordance in stature and education indicating the positive assortative mating for those traits. Non-consanguineous spouses show a significant association for triceps and subscapular skinfold thicknesses hip and waist circumferences, and body fat distribution. Unrelated spouses exhibit more concordance for physical traits than do related spouses. There is a significant correlation between spouses in first and double cousin marriages as well as in spouses in second and less than second cousin unions for systolic and diastolic blood pressure, while non-consanguineous spouses show a significant association in diastolic blood pressure only.

Adult↗

PubMed2003

Pollution potential of oil-contaminated soil on groundwater resources in Kuwait.

The only natural freshwater resource of Kuwait occurs as lenses floating on the saline groundwater in the northern part of the country, near to the oil fields. Rainwater is the only means of recharge of this limited groundwater resource. This groundwater is used as bottled drinking water and the fresh groundwater aquifer is considered as a strategic drinking water reserve for Kuwait. As a result of the 1991 Gulf War, the upper soil layer has been widely contaminated with crude oil and crude oil combustion products, which are potential pollutants likely affecting the groundwater resources. Significant efforts have been made to assess this pollution. These included: (a) a soil survey for assessing the soil contamination, and (b) leaching experiments to characterise the mobilization of the soil-associated pollutants. Fluorescence measurement techniques were used during field surveys as well as for laboratory testing. In addition, determination of the total extractable matter (TEM), total petroleum hydrocarbons (TPH), and GC/MS measurement of polyaromatic hydrocarbons (PAHs) were performed for the assessments. The laser induced fluorescence (LIF) measurement, having good correlation with the other laboratory measurements, was proved to provide necessary information for the assessment of the oil-contamination level in the desert soil. The subsequent leaching test with water demonstrated the mobilization of the fluorescing compounds (e.g. PAHs), and the alteration in the leaching characteristics of the contamination during the long-term environmental weathering of the oil.

Data Collection↗

PubMed2003

Incidence and risk factors associated with the patency of ductus arteriosus in preterm infants with respiratory distress syndrome in Kuwait.

OBJECTIVE: Patent ductus arteriosus (PDA) is considered to be an important cause of morbidity and mortality among preterm infants. The aim of this study is to determine the incidence of PDA in ventilated preterm infants with respiratory distress syndrome (RDS) and to evaluate the role of some antenatal risk factors on its occurrence in our population. METHODS: The case records of the preterm infants of <34 weeks gestational age, who were ventilated for RDS at the neonatal intensive care unit of Maternity Hospital, Safat, Kuwait, between March 1998 and February 1999, were reviewed. Diagnosis of PDA was based on echocardiographic findings. The association between the risk factors chosen and the PDA was also evaluated. RESULTS: A total of 101 infants whose gestational ages ranged between 25-33 weeks, and birth weights between 685-1580 grams were included. Fifty-four had a significant PDA (53.4%). Maternal diabetes and antepartum hemorrhage (APH), birth weights, gestational ages, multiplicity and gender of the infants were found to be related to the incidence of PDA. CONCLUSION: The incidence of PDA in our ventilated preterm infants with RDS is similar to those reported from other neonatal units outside Kuwait. There are some factors that may identify babies, who are prone to develop PDA, which need to be confirmed by further prospective studies using a larger population.

Birth Weight↗

PubMedDate not supplied

Liver schistosomiasis in Kuwait. Clinical presentations and pathological findings.

This is a study on hepatic schistosomiasis including twenty eight cases, diagnosed over nine years period in a district general hospital in Kuwait. The clinical and histological picture in relation to the type of parasite is reviewed and the role played by S. haematobium species in the pathogenesis of liver disease affecting the immigrants in Kuwait is pointed out. The significance of the incidental finding of the schistosomal eggs in the liver and of the associated HBV infection is discussed. The topographic relation of schistosomal eggs and the surrounding granuloma to the fibrosis is described and these findings are related to the morphogenesis of this lesion.

Adult↗

PubMed2003

Clinicopathological and therapeutic patterns of idiopathic pulmonary fibrosis in Kuwait: a prospective study.

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.

Adult↗

PubMed2004

Myiasis in Kuwait: nosocomial infections caused by lucilia sericata and Megaselia scalaris.

Myiasis, the invasion of live human tissue by larvae of Diptera, is reported in the nasopharynx and a leg wound in two patients who were hospitalized for more than 72 hours in Mubarak Al-Kabeer Teaching Hospital in Kuwait City, Kuwait. On the fourth and fifth days after a 10-year-old Kuwaiti boy was admitted to the hospital intensive care unit in a bloodied and comatose state following a traffic accident, 'worms' that came out of his nostrils were fixed, cleared, and identified as second and third instar of Lucilia sericata (Diptera: Calliphoridae). After 14 days, 'worms' were seen in the original dressing of a 35-year-old Iranian man admitted to the Orthopedic Unit of the hospital with multiple lacerations and fractures. The larvae, in various stages of development, were identified as those of Megaselia scalaris (Diptera: Phoridae). Since the presence of larvae in both patients was recorded after a stay of at least 3-4 days in the hospital, by definition, these infestations are considered nosocomial.

Adult↗

PubMed2004

A registry of acute myocardial infarction in Kuwait: Patient characteristics and practice patterns.

BACKGROUND: Coronary artery disease is the leading cause of death in Kuwait, yet data about patient characteristics and practice patterns are lacking. OBJECTIVES: To establish a registry of all acute myocardial infarction (AMI) cases admitted to the general hospitals in Kuwait, so that the characteristics and management patterns of patients with AMI could be accurately determined. METHODS: For six consecutive months, all patients with AMI admitted to the coronary care units of the five participating hospitals were prospectively included in the registry. RESULTS: Of the 662 patients, 87% were men. The mean age was 55 years. A history of diabetes, hypertension and current smoking was found in 41%, 35% and 49% of patients, respectively. A history of hypercholesterolemia or a fasting cholesterol of 5.2 mmol/L or greater was found in 56% of patients. Eighty per cent suffered ST-segment elevation AMI. Four hundred seventy-six patients who were eligible for thrombolytic therapy were identified, 12 (3%) of whom did not receive it. The median time from diagnostic electrocardiogram to thrombolytic therapy was 45 min. The rate of prescribing acetylsalicylic acid, beta-blockers, angiotensin-converting enzyme inhibitors and statins at discharge among survivors was 98%, 86%, 51% and 50%, respectively. The in-hospital mortality rate was 6.2%. CONCLUSIONS: The Kuwaiti AMI population is young, with high rates of diabetes, smoking and hypercholesterolemia. The majority of patients have ST-segment elevation AMI. Thrombolytic therapy is appropriately used, but measures need to be introduced to decrease the time to treatment. The rate of use of acetylsalicylic acid and beta-blockers was appropriate, while that of angiotensin-converting enzyme inhibitors and statins needs to be improved.

Cardiovascular Agents↗