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PubMed1991

Mercury in some commercial fish from Kuwait: a pilot study.

We investigated the total mercury content in the muscles, liver and gonads of eight commercial fish from Kuwait. Mercury concentrations in the muscle of all the fish were below the action level of 1 microgram g-1 (wet weight) set by the United States Food and Drug Administration. However, large specimens of Epinephelus tauvina (Hamoor) and Lutjanus Coccineus (Hamrah) showed concentrations which were close to the action level. The relationship between mercury concentration and fish age and length was in the form of an exponential correlation (Y = aXb), in which concentration increases with an increase in fish age or length. Correlation coefficients obtained ranged between 0.65 and 0.86.

Aging↗
PubMed1989

Brucellosis of camels in Kuwait.

This study investigated the presence of Brucella antibodies in serum and milk obtained from camels in Kuwait. Brucella strains were also isolated from the foetus using standard technique (Webridge Lab Techniques). Three serological tests for serum were adopted. These tests were Rose Bengal Plate Test (RBPT), the Serum Tube Agglutination Test (SAT) and the Complement Fixation Test (CFT). The RBPT was used for all sera samples, and both SAT and CET were used for the positive RBPT. Camels that showed a titer of 1:40 in SAT or 1:5 in CFT or greater were considered positive. Thirteen of the samples examined were found positive by CFT (at 1:5); by SAT, they showed a titer of 1:20. One serological test, the Milk Ring Test (MRT), was used for milk. Here 3 and 2 were considered positive reactors but 1+ was considered suspicious. We were unable to isolate the Brucella organism from Sedemine and Cream of milk, but we isolated them from Foetus Brucella abortus and it is confirmed by Webridge Laboratory, U.K. It is Brucella abortus (Biovar 1). The prevalence rate was 14.8% from serum by the CFT and RBPT methods and 10.8% by the SAT method. For milk, the prevalence rate was 8.0%. Two Brucella abortus were isolated from 5 foetuses.

Agglutination Tests↗
PubMed1990

Patterns of psychiatric consultations in Kuwait general hospitals.

Two hundred and nineteen consecutive referrals to psychiatric consultation services from all general hospitals in Kuwait over a 3-month period were studied and compared with a control group of 100 patients who were not referred for psychiatric consultation. The two groups differed significantly in age, sex, marital status, employment, and past psychiatric treatment. Inpatients were more often referred than outpatients with an overall low referral rate of 0.3%. The department of general medicine referred 74.4% of patients in contrast to 11.4% referred by the department of general surgery. The most common reason for referral was for assessment of a suicide attempt in the inpatient group, and the absence of organic cause for patients' physical symptoms in the outpatient group. Acute situational disturbance that resulted in a suicide attempt was the most common psychiatric diagnosis (26%), followed by depressive illness (19.5%) and organic psychotic disorders (8.2%). Our findings are similar to those reported in the literature, and the present study suggests a national underutilization of psychiatric consultation services in general hospitals.

Adult↗
PubMed1985

Primary gastrointestinal lymphoma in Kuwait. An 11-yr retrospective analysis of 108 cases.

One hundred and eight cases of primary gastrointestinal lymphoma from the files of Kuwait Cancer Control Center over a period of 11 yr were analysed retrospectively. The occurrence was 47 in the proximal small intestine, 38 in the stomach, 18 in the distal ileum and five in the colon and rectum. The majority of the patients were in stage III. Using a modified Rappaport's classification, lymphocytic lymphoma was the commonest histologic type (60%) as compared to histiocytic lymphoma (19%). Four patients had early IPSID (immunoproliferative small intestinal disease). The 'Western' type of lymphoma occurred in the fourth decade while the 'Mediterranean' type occurred in the third decade of life. The latter occurred more commonly among people of low socioeconomic background. Chemotherapy was the single most effective mode of treatment. Addition of surgery, radiotherapy or both did not improve the 2-yr survival but did improve the 5-yr survival.

Adolescent↗
PubMed1985

Handicapped individuals in Kuwait.

A large-scale community screening study is proposed for Kuwait, using a schedule based on the 1980 WHO Classification of Impairments, Disabilities and Handicaps. The needs for accurate prevalence data are reviewed from the standpoints of establishing aetiological patterns, pinpointing opportunities for prevention and furnishing a sound basis for planning in a country with a rapidly growing population and still-developing network of care services. A permanent mechanism for monitoring prevalence trends and service needs is proposed in the form of a Multidisciplinary Handicap Register. Details of these proposals and their feasibility are discussed in the light of previous work.

Activities of Daily Living↗
PubMed1996

Predictors of non-urgent utilization of hospital emergency services in Kuwait.

Utilization of the emergency rooms (ERs) in Kuwait has increased considerably during the last decade. Such an increase is a concern for health planners because of the burden on ER services, lack of continuous service provided by the ER and the higher cost of such services. Based on a study of 2011 patients attending the medical ERs in the six government hospitals in early 1993, the predictors of non-urgent utilization were analyzed. Patients were asked about their reasons for visiting the ER rather than the primary health care (PHC) centre. Both patients and doctors were asked to rate the urgency of the visit. According to the doctors' judgement, 61% of the visits were for non-urgent problems that did not require emergency care, while 23% of the patients viewed their visits to be non-urgent. Multiple logistic regression analysis indicated that perceived urgency of the visit was the most important predictor of a non-urgent visit to the ER, after controlling for several predisposing and enabling factors. Patients who perceived their visit to the ER to be non-urgent were about four times more likely to visit the ER for a non-urgent condition as judged by the doctor. The level of education had a significant, positive effect on non-urgent utilization among both Kuwaiti nationals and expatriates. Several factors may explain the above finding. Employment of educated persons in the hospital was one route through which education facilitated ER use. It is also likely that educated persons had more influential contacts or wasta in the hospital. Also, the less educated might have delayed seeking care while the educated consulted for non-urgent reasons as soon as they noticed the symptoms. Like education, the level of non-urgent utilization was higher among Kuwaiti nationals with higher incomes. Thus, a higher social class seems to facilitate ER use for non-urgent reasons. Among the non-Kuwaitis, lack of registration at the PHC centre was a significant reason for non-urgent use of the ER. It is recommended that hurdles in the utilization of PHC facilities should be removed. Registration of non-Kuwaitis at the PHC must be improved, and referrals to the PHC back from the ER should be instituted to ensure the necessary follow-up care.

Adult↗
PubMed1988

Seasonal fluctuations of gastrointestinal helminths of camels in Kuwait.

Over a period of 1 year, from May 1982 to April 1983, the gastrointestinal tracts of 240 camels were examined for the presence of parasitic helminths. The study quantifies the prevalence of gastrointestinal helminths and the seasonal fluctuations in intestinal worm burdens and faecal worm egg counts. Among the three species of cestodes and eight species of nematodes which were recorded for the first time from Kuwait, Trichostrongylus probolurus (93.8%), T. colubriformis (34.2%) and Stilesia vittata (30.0%) were the most prevalent in the small intestine and Camelostrongylus mentulatus (59.6%) in the abomasum. Estimation of the intestinal worm burdens and faecal worm egg counts showed that Trichostrongylus infections were by far the most predominant. The highest worm and egg counts were recorded in June and August, during the hot dry season. This rise is attributed to infections acquired from February to April, during the cool wet season. Possibly the most effective control can be achieved by a critical treatment at the end of the wet season coinciding with the first rise in nematode population.

Abomasum↗
PubMed1988

Epidemiology of burns in Kuwait.

A prospective study of 765 burns cases treated as inpatients at the Burns Unit, IBN Sina Hospital and the Plastic Surgery Unit, Mubarak Al Kabeer Hospital from January 1984 to December 1986 is presented. Hot water scalds were the commonest type of injury. Most of the burns occurred at home but coinciding with standard working hours. Children up to 5 years old were commonly affected, but most of the fatal burns were among adults. The overall mortality rate was 7.2 per cent with a male to female ratio of 1.1:1. Our survival rate from burn injuries is improving due to advances in treatment, but prevention remains the best cure. We consider our epidemiological survey to be important as the basis for a preventive programme in Kuwait's extremely heterogeneous society.

Accidents, Home↗
PubMed1992

Electrical burns in Kuwait: a review and analysis of 64 cases.

Sixty-four patients with electrical burns were admitted to the Department of Plastic Surgery, Ibn Sina Hospital, Kuwait during the past 6 years. There were 1202 admissions during this period, the incidence of electrical burns being 5.3 per cent. Sixty-nine per cent of the patients sustained injury from direct contact with live electrical wire, the remaining 31 per cent sustained flash burns. The incidence of low voltage injury was much higher as compared to high voltage. Forty-four per cent of these injuries were not work related. Less than 10 per cent of the body surface area was involved in about 80 per cent of the patients. A total of 65 operations was carried out in 39 patients. Twenty of these patients had repeated debridements until the wound was ready for coverage. All 64 patients survived.

Adolescent↗
PubMed1996

Epidemiology and mortality of 162 major burns in Kuwait.

The burns intensive care unit at IBN Sina Hospital reopened in July 1991, following the Iraqi occupation of Kuwait and the Gulf War. Epidemiology and mortality of 162 burn patients with 30 per cent and over total body surface area (TBSA) burns, treated from July 1991 to December 1994, is presented. There were 91 males and 71 females with a ratio of 1.3 to 1. The median age was 30 years (range 4 months to 93 years) and 44 per cent of the patients were 15-40 years of age. 124 (76.5 per cent) accidents occurred at home and the flame burn was the commonest involving 131 (80.9 per cent) patients. The median burn surface area was 45.5 per cent and the majority of them sustained deep burns. The hospital stay of the surviving patients ranged from 11 to 174 days (median 38 days), while the day of the death was from 1 to 134 days. Forty-six deaths represent an overall mortality rate of 28.4 per cent amongst our patients. All the patients whose Baux score was 130 and above died. Burn shock was responsible for 10 deaths, and out of them eight were not actively resuscitated due to high Baux score. Sixteen deaths occurred within 48 h postburn. Septicaemia and its related effects were responsible for the majority of the deaths.

Adolescent↗
PubMed1990

Attitudes of a sector of the Arab-Muslim population in Kuwait towards alcohol and drug misuse: an objective appraisal.

The attitude of a sample of 1001 Arab Muslims living in Kuwait towards alcohol and drug misuse was examined by using a 30-item questionnaire. Eighty percent condemned drug misuse, 93.6% thought it was a contravention of Muslim religious teachings, yet 90% held an enlightened attitude compared to only 26% that chose the punitive attitude. The older generation, the less educated, females and Non-Kuwaiti Arabs were less likely to be sympathetic towards substance misusers. These findings while indicating the sample's strong religious condemnation of substance misuse demonstrated the adoption of Western concepts of care especially by the younger educated Kuwaiti males. Indirect evidence of drug misuse and smoking in the sample may be inferred from the low rates of denunciation of such behaviours.

Alcohol Drinking↗
PubMed1992

Evaluation of outpatient prescribing for substance misusers in Kuwait: the need for a rational approach.

The outpatient follow-up care of 140 substance misusers in Kuwait was evaluated. Treatment has been traditionally based on substitution pharmacotherapy with no set objectives or criteria for outcome evaluation. Patients' structural characteristics, mode of referral, clinical diagnoses, medication prescribed and screening urine samples for drugs were examined for meaningful associations between these variables. Benzodiazepines were by far the most prescribed (94%) medication. Only 40% of the urine test results were positive for drugs containing different combinations of medications and street drugs. Unlike patients who received benzodiazepine, those who received tricyclic antidepressant medication were significantly more likely to associate with predictors of improvement. There is a need for better training of doctors and careful selection of patients in order to implement treatment strategies based on good doctor-patient relationships and well defined objectives for treatment and clear criteria of outcome.

Adolescent↗
PubMed1991

Childbirth in Kuwait: the experiences of three groups of Arab mothers.

The aims of the present study were to characterize the childbirth experiences of three groups of Arab mothers delivering in Kuwait and to evaluate the use of visual analog scales (VAS) for assessing their pain (N = 301). Kuwaiti, Palestinian, and Bedouin women who were expected to have an uncomplicated vaginal delivery were studied. 73% of the women described their maximum labor pain as "unbearably painful," and more than one-half reported that they were "very frightened" or "terrified." The deliveries of Bedouin mothers were remarkable for the absence of pain behaviors; yet their VAS reports indicated that they experienced no less pain. Painful menstruation and fear of childbirth emerged as risk factors for a painful labor. Among the issues discussed are the validity of the VAS data, the difficulties of managing Bedouin mothers' pain, and the importance of excluding physical factors before cultural differences in pain perception are assumed.

Delivery, Obstetric↗
PubMed2005

Distribution of vacA and cagA genotypes of Helicobacter pylori in Kuwait.

There is considerable geographical variation in the distribution of allelic types of Helicobacter pylori. This first study from Kuwait determined the prevalence of cagA and vacA genotypes among 117 unselected patients attending a gastroenterology center. We found that whereas vacA s1 and s2 types were equally likely to be present in biopsies obtained from patients of Middle-Eastern origin, African Arabs were predominantly infected with s2 type and South-Asians the s1 type. South Asians most frequently carried the cagA positive genotype with Bangladeshis showing the highest prevalence rate of 87%.

Adult↗
PubMed2005

Predicting factors influencing the fatal outcome of burns in Kuwait.

A prospective study was carried out on a total of 2111 burn patients admitted at the Burn Center in Kuwait, during 1993 to 2001, with the purpose of predicting the risk factors influencing the fatal outcome. A total of 111 (5.3%) patients died, giving an annual average of 12 deaths, and a mortality rate of 0.64/100,000 population. The data, from the in-patient records, included the most commonly available demographic features viz. age, gender and nationality, as well as best recorded clinical factors, such as cause of burn, total body surface area (TBSA), duration of hospital stay and outcome, for analysis. Kolmogorov-Smirnov z test showed the median age (30 years) and TBSA (80%) significantly higher (p < 0.001) among those died as compared to 24 years and 10%, respectively in patients survived. The Chi-square test revealed a fatal outcome associated with gender and cause of burn. The multiple logistic regression model predicted patients, aged 60 years and above (OR: 9.9, p < 0.001), female gender (OR: 2.2, p < 0.016), Flame burns (OR: 3.5, p < 0.035), and TBSA > 90% (OR: 23.5, p < 0.001), as the most influencing risk factors for a fatal outcome at this burn center. Patients with these characteristics need to be given special attention during in-patient care.

Adolescent↗
PubMed2006

Paediatric burns in Kuwait: incidence, causes and mortality.

From a prospective study on burn patients admitted at the Burn Center in Kuwait during 1993-2001, 826 paediatric burn cases, in 0-14 years age group, were retrieved to study incidence, causes, and mortality among children. The demographic characteristics, clinical features, and outcome constituted our data file in Statistical Software, SPSS. Overall incidence rate was 17.5/100,000 children aged 0-14 years, being almost twice (34/100,000) among those between 0 and 4 years, constituting 70.8% of all paediatric burns. Scald was the main cause of burn (67%), followed by flame (23%). Mean age (6.4 years) of children with flame burns, was significantly higher (p < 0.001) than those with scalds, or other causes. A positive significant correlation existed between duration of hospital stay and TBSA% (r = 0.56, p < 0.001). Overall mortality rate was 0.23/100,000 children, maximum (0.52/100,000) being in children below 5 years. Among 11 (1.3%) non-survivors, flame burns caused nine fatalities. Multiple logistic regression mooring predicted children aged < 5 years, flame burns and TBSA >or= 70%, (OR = 29.2, p < 0.001), as main contributing factors to fatal outcome among children. Gender and nationality had no influence on incidence or mortality. These findings will hopefully stimulate development of targeted and sustainable interventions for reducing burns occurrence among identified paediatric high-risk groups.

Adolescent↗
PubMed2004

Post-dialysis retention of blood lipoproteins and apolipoproteins in patients with end-stage renal disease on maintenance haemodialysis in Kuwait.

BACKGROUND: The commonest cause of death in patients with end-stage renal disease (ESRD) on maintenance haemodialysis (MHD) is coronary heart disease (CHD). It has been suggested that dyslipidaemia, an important CHD risk factor, may be worsened by dialysis. This study evaluated changes in blood lipoproteins and apolipoproteins after dialysis in ESRD patients on MHD. METHODS: The subjects were 57 (20 M, 37 F; 24 diabetic, 33 nondiabetic) patients with ESRD, aged 21-73 years, undergoing MHD at a major Dialysis Unit in Kuwait. Pre- and post-dialysis non-fasting blood samples were collected from each subject on the same day, and analyzed for plasma glucose, urate, triglycerides (TG), total cholesterol (TC), HDL, LDL and apolipoprotein (apo) A1 and B. Pre- and post-dialysis levels for each of the analytes were compared for the diabetic and non-diabetic subgroups of patients and linear correlations sought between Delta values (corresponding to differences between pre- and post-dialysis levels) of the lipoproteins and apolipoproteins. RESULTS: There was a general trend towards significant increases in post-dialysis TC, HDL, LDL, and non-HDL levels in both sub-groups, and additionally for the non-diabetic, TG, apo A1 and apo B. The pre- to post-dialysis increases were essentially similar for the diabetic and non-diabetic groups-Diabetic: TC 14%, HDL 25%, LDL 19%, non-HDL 16%, apo A1 14%, apo B 10%; Non-diabetic: TC 20%, TG 29%, HDL 25%, LDL 26%, non-HDL 21%, apo A1 14%, apo B 14%. Generally, there were significant correlations between Delta values for the lipoproteins and apolipoproteins (r, 0.50-0.92) in both groups. CONCLUSION: Levels of atherogenic lipoproteins increase post-dialysis in diabetic and non-diabetic patients with ESRD and the changing levels of these lipoproteins correlate significantly with corresponding changes in levels of apolipoproteins. The increase in lipid levels is therefore related to retention of apo A1 and B with each dialysis. We speculate that, with repeated dialysis, dyslipidaemia may get progressively worse and further accentuate CHD risk.

Adult↗