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PubMed1999

Placenta accreta in Kuwait: does a discrepancy exist between fundal and praevia accreta?

OBJECTIVE: The purpose of this retrospective study was to compare maternal and neonatal outcome in relation to site of placenta accreta by stratifying the site of placenta accreta into upper and lower uterine segment implantation. SUBJECTS AND METHODS: Sixteen cases of placenta accreta which were reported in the Maternity Hospital of Kuwait over 11 years from January 1981 to July 1993 - (1990 and 1991 excluded) were retrospectively analyzed using the hospital medical records. RESULTS: The incidence of placenta accreta was 9.8 per 100,000 deliveries. The rate of accreta in patients with placenta praevia was 880 per 100,000 placenta praevia, compared to a rate of 5 accreta per 100,000 placenta implanting in the upper uterine segment. There were no differences between accreta found in the upper segment and lower segment for maternal and neonatal mortality, maternal complication, past obstetric history and possibility of conserving the uterus. Significant differences were found in the birth weight, gestational age at birth, antenatal symptoms, time of diagnosis and mode of delivery when accreta was stratified by site of implantation. CONCLUSION: Placenta praevia is a definite risk factor for placenta accreta. Combined abnormal penetration of placenta as in accreta and abnormality in site as in praevia does have a significant clinical implications.

Adult↗

PubMed1979

L-asparaginase-producing Streptomyces from the soil of Kuwait.

Five actinomycete isolates (all belonged to the genus Streptomyces), capable of producing detectable amounts of L-asparaginase, were isolated from the soil of Kuwait after enrichment. The three most potent enzyme producers were identified as different strains of Streptomyces collinus. Factors affecting enzyme production by the strongest strain were examined. Synthetic media with asparagine as a nitrogen source stimulated more enzyme production than natural media. Starch and asparagine at final concentrations of 1 and 0.8%, respectively, were optimum for enzyme production. An initial pH of 8.5 for the growth medium and an incubation temperature of 28-30 degrees C in a static culture for 6 days stimulated enzyme production by the examined strain of Streptomyces collinus.

Asparaginase↗

PubMed2002

An early onset form of methylenetetrahydrofolate reductase deficiency: a report of a family from Kuwait.

Methylenetetrahydrofolate reductase deficiency (MTHFR) is a rare autosomal recessive disorder. There have been 68 cases reported to date in the literature [Eur J Pediatr 1998;157 (Suppl 2):S77]. It affects intracellular folate metabolism and results in homocystinuria and hypomethionemia. We report a family in which three children (two boys and one girl) died before the age of 3 months with severe MTHFR deficiency. A fourth affected boy was treated with betaine and he improved clinically and biochemically. We demonstrate the unique dermatological and brain imaging features in a kindred from Kuwait.

Brain↗

PubMed2000

On substance abuse in Kuwait (1992-1997). Evidence from toxicological screening of patients.

PURPOSE: To assess preference for different psychoactive substances and time trends in Kuwait. METHODS: Analysis of urine and blood samples of specimens sent by attending physicians to the only public health reference laboratory for toxicological screening in the country. RESULTS: A total of 28,548 tests were performed on 3781 samples. Cannabinoids were positive in 40% of the tested samples, opiates in 24%, ethanol in 10%, and amphetamines in 5%. Elevated concentrations of methadone, cocaine, and phencyclidine did not exceed 0.1%. About 40% of samples was positive for benzodiazepines, but their therapeutic use obscures the informativeness of this finding. There was a significant increase in the proportion of positive results for ethanol, amphetamines, and benzodiazepines. IMPLICATIONS: It is high time to implement a modern and comprehensive preventive and control program. The tendency to blame the Iraqi invasion for drug addiction has hampered efforts to recognise and address the problem in its entirety.

Adolescent↗

PubMed2002

In vitro activity of 15 antimicrobial agents against clinical isolates of Clostridium difficile in Kuwait.

A total of 73 clinical isolates of Clostridium difficile isolated from stool/rectal swabs of patients admitted to the intensive care units at Mubarak Hospital, Ibn Sina Hospital Burn unit and Haematology wards at the Kuwait Cancer Control Centre, were investigated for their susceptibility to 15 antibiotics using the Etest. Amoxycillin-clavulanic acid, ampicillin, meropenem, metronidazole, penicillin, piperacillin, piperacillin/tazobactam, teicoplanin and vancomycin had excellent activities with MIC(90)s of 0.38, 0.5, 1, 0.19, 1.5, 2, 3, 0.25 and 0.75 mg/l, respectively. Of the 73 C. difficile isolates, 86% were resistant to imipenem (MIC(90) >32 mg/l) and almost 97% were resistant to trovafloxacin (MIC(90)>256 mg/l). Forty eight percent of the isolates were resistant to clindamycin. A total of 18 isolates were highly clindamycin-resistant with an MIC of >256 mg/l; 10 of these were toxin producers. Multiple antibiotic resistance (two or more antibiotics) was noted in 63 isolates. These were more common among the toxigenic strains than the non-toxigenic strains by a ratio of 2.5:1.

Anti-Bacterial Agents↗

PubMed2000

Isolation and characterization of two hydrocarbon-degrading Bacillus subtilis strains from oil contaminated soil of Kuwait.

Two strains of hydrocarbon-utilizing bacteria were isolated from soil samples of the Kuwait Burqan oil field at a temperature of 37 degrees C. The bacteria were motile endospore-forming rods with slight differences in their metabolic patterns and 16S rRNA sequence. Vegetative cells of the strains designated as AHI and AHII had an ultrastructure typical of gram-positive bacteria and showed gram-positive staining. The bacteria did not show pigmentation. Best growth was observed at 37 degrees C at neutral pH and NaCl concentrations in the range of 5-10 g per l. Both strains were obligatory aerobic and developed on synthetic media with either Diesel fuel, n-decan or naphthalene as the sole carbon and energy source. No specific growth factors were required. On the basis of their morphological, physiological and biochemical features, as well as their 16S rRNA analysis and electron microscope study, both strains were assigned to the species of Bacillus subtilis.

Alkanes↗

PubMed2001

Variations in 7Be concentrations in the atmosphere of Kuwait during the period 1994 to 1998.

The Beryllium-7 (7Be) concentrations in the atmosphere of Kuwait, as found by gamma-ray measurements for 243 air filters collected over a five-year period, produced variable values ranging from 0.2 to 14.9 mBq/m3 with a behavior pattern which has oscillatory characteristics, with increased activities occurring in the summer months of each year. The annual levels of occurrence of 7Be were found to be correlate with the cyclic pattern resulting from the eleven-year temporal variations associated with the solar activity.

Air Pollutants, Radioactive↗

PubMedDate not supplied

Efficacy and reliability of fundus digital camera as a screening tool for diabetic retinopathy in Kuwait.

OBJECTIVE: Many screening and follow-up methods are available for detecting diabetic retinopathy (DR). However, once patients develop retinopathy, it is unclear as to what method should be used for their review. This study is designed to assess the correlation between fundus digital image and clinical examination and to develop a screening program for the early detection of sight-threatening DR using a Canon CF 60 UV fundus camera. METHODS: Patients who were not treated for DR earlier were enrolled in the study. All patients underwent digital fundus photography. The photographs were evaluated and compared with the clinical findings as recorded by retinal specialists. DR and macular edema were analyzed separately, and the correlation was statistically measured. The kappa statistic was used to estimate the extent of the agreement between the two procedures. RESULTS: A total of 92 eyes of 51 patients were eligible to be entered in the study. Comparison of the digital image of the fundus and the examination by an ophthalmologist showed a good correlation. The kappa score for retinopathy was estimated to be 93% with 95.6% concordance. The kappa score for diabetic maculopathy was 88% with concordance of 92.2%. CONCLUSION: We conclude that digital images provide an efficient method for diagnosing and classifying sight-threatening DR, particularly proliferative diabetic retinopathy (PDR). However, agreement between the digital fundus camera and clinical examination by an ophthalmologist for diabetic maculopathy detection, though substantial statistically, was not very satisfactory. It was also felt that the digital photographs can be used as a tool for teleophthalmology and can be integrated as a screening system in Kuwait.

Adult↗

PubMed1990

Socioeconomic and health care determinants of child survival in Kuwait.

This paper analyses the socioeconomic and health care determinants responsible for the decline over the last two decades in infant mortality in Kuwait. Published data and the results of a national health survey conducted in 1984-85 show the following. With the overall affluence of the society, health care in terms of immunization has improved dramatically and more than 90% of all children are covered. Of all births, 99% now occur in a hospital or clinic. About half of the mothers continue to breast-feed their babies for about 16 months. Despite these favourable conditions, differences still exist between social classes. The risk of stillbirth remains much higher among the poorer women, those without any education and those who gave birth at home. These findings are consistent with developed countries like the USA and Japan, where the social class differences in mortality still persist.

Cross-Sectional Studies↗

PubMed2004

Parental perceptions of costs and benefits of children as correlates of fertility in Kuwait.

Kuwait is a high fertility country where the average number of desired children still exceeds 5. However, fertility behaviour is beginning to show a noticeable change and the current TFR is about 4.2 children. In order to understand the decline in fertility, the impact of perceived benefits and costs of children on Kuwaiti women's desired and achieved fertility is analysed. Data from a nationally representative survey of Kuwaiti households held in 1999 are used. Bivariate analyses show that the mean desired number of children is significantly higher among those who rank higher on the perceived value of children, and lower among those who are concerned about the cost of raising children. Achieved fertility (children ever born) shows a similar pattern. In the multivariate analysis, however, large family values emerge as the only significant predictor of (higher) desired as well as achieved fertility, net of the respondent's demographic and socioeconomic characteristics. The sociocultural, economic and political contexts that shape the mother's perceptions of the benefits and costs of children are analysed and it is concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behaviour.

Adult↗

PubMed1997

Temporal variations in the infection of a population of Clypeomorus bifasciata (Gastropoda: Prosobranchia) by a digenean microphallid larva in Kuwait Bay.

The prosobranch snail Clypeomorus bifasciata in Kuwait Bay was examined for digenean infections over a one year period during 1994/1995. A total of 1500 snails was examined and 567 (37.8%) were found to harbour nine digenean species. The prevalence of a microphallid species was 33.9% while each of the others occurred in less than 1.2% of the snails. The prevalence of infection increased with shell size. Multiple infections were observed in only five of the infected snails and the microphallid was involved in all of them. Snails were infected with the microphallid throughout the year and there appeared to be two peaks in the proportion of infected snails shedding cercariae, a winter peak from November to January and a summer peak from June to August. The crab Xantho exaratus collected from snail sampling sites was heavily parasitized by microphallid metacercariae of the genera Longiductotrema and Microphallus. This is the first report on microphallid metacercariae in crabs in the Arabian Gulf region.

Animals↗

PubMed1976

The role of native domestic animals in the dissemination of Echinococcus infection among dogs in the state of Kuwait.

Infection with hydatid cysts of domestic animals slaughtered by private individuals and at the Government Central Slaughterhouse is recorded. Both fertile and non-fertile cysts were seen in the infected animals. The home slaughtered sheep seems to play an important role in the dissemination of the parasite and the life cycle of Echinococcus granulosus in the State of Kuwait is assumed to be sheep--dog--sheep.

Animals↗

PubMed1976

The epidemiology of Echinococcus infection in Kuwait.

Infection of dogs with E. granulosus is recorded for the first time in the State of Kuwait and observations on 204 dogs from different suburbs showed an infection rate of 23.039%. Cattle, sheep, goats and camels killed for public consumption in the period 6th April to 6th May, 1975, in a slaughter house were inspected and the rate of infection with E. granulosus cysts was recorded. The possible methods of transmission from animals and dogs to man is discussed.

Animals↗

PubMed1987

Prevalence of secretory otitis media among school children in Kuwait.

Tympanometry and otoscopy were performed by the authors on 893 school-children in Kuwait during early 1983. Based on tympanometry 31.3 per cent were found to have tympanograms indicating secretory otitis media. The otoscopic findings confirmed this high prevalence (30.0 per cent). At re-examination three months later, the point prevalence had decreased by almost 5 per cent which is well in accordance with the seasonal variation of this disease.

Acoustic Impedance Tests↗

PubMed1996

Nasal carriage of enterotoxin-producing Staphylococcus aureus among restaurant workers in Kuwait City.

Enterotoxin-producing Staphylococcus aureus is a common cause of staphylococcal food poisoning. To determine the incidence of carriage of enterotoxin-producing S. aureus in a sample of the healthy population in Kuwait city, restaurant workers in the city were screened for nasal carriage of S. aureus. 26.6% of 500 workers studied carried S. aureus and 86.6% of the S. aureus produced staphylococcal enterotoxins. 28% produced enterotoxin A, 28.5% produced enterotoxin B, 16.4% produced enterotoxin C and 3.5% produced enterotoxin D. Ten isolates produced both enterotoxins A and B or A and C. 73% of the isolates were untypeable with standard phages. However, 17.1%, 3% and 6% belonged to phage groups I, II and III respectively. The results demonstrated a high level of enterotoxigenic S. aureus carriage among restaurant workers which although lower than that reported for the general population and hospital workers may be important in the restaurant industry.

Bacteriophage Typing↗

PubMedDate not supplied

Ocular sarcoidosis in Kuwait with a review of literature.

OBJECTIVE: To study 18 cases of sarcoidosis, the hall mark of which was uveitis. SETTING: Referrals from peripheral eye clinics. PATIENTS: 18 patients with bilateral almost symmetric uveitis, negative Mantoux test and positive gallium scan were enrolled in the study. Preliminary bronchoscopy and bronchial lavage were not done due to social habits. RESULTS: Age ranged between 7-48 years with median 15 and mean 19 years. Although the patients were multinational, yet all of them were residents of Kuwait. A father and son were affected within 8 months period. 78% were strictly ocular, associated pulmonary and salivary gland affection 11% each. Sole anterior uveitis was found in 28%, associated with intermediate uveitis in 55% and with posterior in 16.6% of cases. Clinically detectable dry eyes associated 33% of cases. All our patients developed glaucoma which resolved with treatment of uveitis in 88% of them. Gallium uptake of the eye balls was found in 22%, of the lacrimal glands (panda sign) in 67%, and of the salivary glands or chest 11% each. Positive biopsy was found in 72%, 22% of which was conjunctival. Chest X-ray and SACE were positive in 11%. 61% had hypergammaglobulinaemia and all had negative ANA and RF. CONCLUSIONS: (1) 61% of ocular sarcoidosis presented below sarcoid age. (2) Multinationality together with father's and son's affection indicate a climatic or environmental insult in an already predisposed person. (3) Routine chest X-ray and SACE may not be adequate for diagnosis of ocular sarcoidosis. Gallium should be done in suspected cases. (4) Follow-up for prospects is emphasized.

Adolescent↗

PubMed1999

Studies on normal haematological and serum biochemical values of the 'Hijin' racing camels (Camelus dromedarius) in Kuwait.

Haematological estimations and serum biochemical analyses were made on 100 samples collected from clinically healthy 'Hijin' racing camels (Camelus dromedarius) in Kuwait. The red blood cell counts, packed cell volume, haemoglobin concentration, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and total white blood cell counts were estimated. In the serum biochemical analyses, sodium, potassium, iron, calcium, phosphorus, magnesium, total bilirubin, blood urea nitrogen, creatinine, glucose, total protein and cholesterol concentrations were measured, as were the alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, creatine kinase and alkaline phosphatase activities. The results are discussed in relation to other findings reported in camels.

Animals↗

PubMed2000

Surface morphology of Probolocoryphe uca (Sarkisian, 1957) (Digenea: Microphallidae) from Kuwait bay.

The surface ultrastructure of Probolocoryphe uca (Digenea: Microphallidae), recovered from a rat experimentally fed on crabs, Nanosesarma minutum (Brachyura: Grapsidae), naturally infected with the metacercariae, was studied by scanning electron microscopy. The flukes were leaf-like, ventrally concave and pyriform or ovoid in outline. The anterior end was modified into a sucker-like organ, comprising a protrusible disc-shaped structure surrounded by single-pointed spines. This organ is probably involved in the attachment and feeding process in a manner similar to the action of the oral suckers. Apart from the sucker-like organ, the entire tegumental surface was covered with triangular spines with multi-pointed tips. Ciliated, dome-shaped papillae were observed, singly or in groups, arranged symmetrically on the sucker-like organ and around the oral and ventral suckers. Kuwait Bay constitutes a new geographical record and the crab N. minutum is a new second intermediate host record for P. uca.

Animals↗