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PubMed1997

Epidemiological profile, mineral metabolic pattern and crystallographic analysis of urolithiasis in Kuwait.

This study was conducted to determine the epidemiological profile of urolithiasis in Kuwaiti patients and the associated metabolic abnormalities favouring stone formation in this patient population. Between 1986 and 1994, a total of 421 Kuwaiti patients were studied in Al-Amiri renal stone laboratory. The mineral composition of stones was determined using a combination of stereoscopic microscopy and infrared spectrophotometry. Mineral metabolic screen (MMS) was available in 306 (72.7%) of those patients. The average annual incidence of new stone formation in Kuwaiti patients was 23.9 per 100,000 population. The incidence was only 6.9 per 100,000 population in those from pediatric age group, 33.4 in adults and 73.6 in the elderly. The frequency of new stone formation was higher among males as compared to females at different age groups. Calcium oxalate (CaO) constituted 72.1% of renal stones encountered in adults as compared to only 52.1% and 40.7% in elderly and pediatric age groups. Eighty four patients had recurrent and/or high stone load. Detailed family history was available in 57 of those 84 patients and was suggestive of strong family aggregation of stone disease in 30 (53%) patients. The proportion of urate stones was 15.4% of all stones formed and constituted a major cause of renal stones in children (24.1%), adults (14.4%) and elderly (12.5%). Cystine stones were found in 10 patients (2.4%). Hyperuricemia was detected in 1/3 of patients from pediatric age group. In adults, 89 (38.4%) of 232 patients had abnormal MMS, of which hyperuricosuria with or without hyperuricemia accounted for 79.8% of those abnormalities. In elderly patients, metabolic disorders were detected in 7 (17.5%) of the 40 patients. In the latter group, all except one, had hyperuricosuria with or without hyperuricemia. Cystinuria, distal renal tubular acidosis (d-RTA) and hyperparathyroidism constituted 6.6% of metabolic abnormalities in the patients studied. Primary abnormalities of upper and lower urinary tract was detected in 6% of adult patients as compared to 47% in children and 30% in the elderly. In conclusion; the incidence rate of new stone former in Kuwait is significantly lower from that reported in Europe and USA. This latter finding and the high familial aggregation of urolithiasis in our area constitute a cogent argument against the role of hot climate in the pathogensis of urolithiasis and are in favour of genetic predisposition. Isolated hyperuricosuria was detected in 17% of idiopathic CaO stone formers. The latter finding is of practical importance since red-meat is a common food item in our area and restriction of purine-intake may help to decrease the frequency of urate and CaO stone formation in predisposed patients.

Adolescent↗

PubMed1997

Scalds among children in Kuwait.

In a prospective study of 560 children treated for burns as in-patients over a period of four-and-a-half years in specialized hospitals responsible for the majority of burn cases in Kuwait, 388 patients (69%) had sustained scalds. The mean age of these 388 children, between 0 to 12 years, was 3.02 +/- 2.08, and male to female ratio 1.5 to 1. They were categorized into three age groups, first, up to 1 year comprised 17.5% cases, who were solely dependent on parents or childminder; second 2 to 5 years of age, who were inquisitive, independent, pre-school children, and constituted the majority of cases (73%), and third 6 to 12 years who were 9.5% school children. The pre-school children (2-5 years) thus formed a highly vulnerable group in the country. Accidents (99.4%) occurred at home and the kitchen being the commonest place. The hot water from pan and pots in the kitchen was the most common etiologic factor in 229 cases (59%), followed by tea/coffee 20.7%, soup 9.0%, hot oil 6.7%, and milk 4.6% patients. The most common circumstance was the child upsetting the pan of hot fluid in the kitchen. The mean total body surface areas of second and third degree burns were 14.21 +/- 9.66 (range 1 to 60%). The average length of stay in the hospital was 16.90 +/- 15.74 days, varying from one to 109 days. Thirty-nine children were ill prior to burn, and the commonest disease was respiratory tract infection. Three patients (0.8%) with 3rd degree burns were treated with primary excision and grafting, and 137 (35.3%) needed secondary skin grafting for residual burn wounds. Four patients (1%) died, one due to burn shock, two due to septicemia and one due to multiorgan failure. There is need for general awareness through public education, which may lead to the prevention of significant number of such accidents.

Accidents, Home↗

PubMed2001

Heavy metal accumulation in the gastropod, Cerithium scabridum L., from the Kuwait Coast.

An in-depth study on various locations along the Kuwait Coast differentiated by the nature of coastal topography, human habitation and industrialization was made during the year 1995-1997 in relation to the gills of the gastropod, Cerithium scabridum, a bio-indicator of heavy metal pollution. The maximum concentration of heavy metals in the gills of C. scabridum, seawater and particulate matter was observed in Stations III when compared to the metal concentrations in the other seven stations. Co-efficient Variance (CV) revealed an increase in the accumulation of Cu and Pb in gills, seawater and particulate matter in winter than in summer. However, the CV was noted to be lower in winter than in summer in the case of Cr and V, in gills of C. scabridum and Ni in the case of seawater samples. Further, by ANOVA, except V, significant relationships were noted between the heavy metals (Cu, Cr, Pb and Ni) and various locations in the gills of C. scabridum.

Animals↗

PubMed2000

Burn mortality during 1982 to 1997 in Kuwait.

The study group is comprised of 234 patients (6.4%) who died out of 3680 patients treated for burn injuries during the period January 1982 to December 1997 in Kuwait. There were 112 (47.9%) males and 122 (52.1%) females and their mean age was 30 years (range 1-93) when compared with 24 years among survivors. The high mortality amongst two age groups 0-5 years (39 deaths, 16.7%) and 16-35 years (109 deaths, 46.6%) shows their vulnerability in the society. In 190 patients (81.2%) the burn injuries occurred at home. A total of 216 patients (92.3%) sustained flame burns mainly due to clothes on fire (40.6%) and cooking gas accidents (25.2%), and in 18 patients (7.7%) the burns were due to scalds. The suicidal burns occurred in 22 female and 5 male patients mainly of younger age groups. The mean percentage of burns was 71% (range 9-100%) as against 20% amongst survivors, and 195 patients (83.3%) had > or = 50% total body surface area (TBSA) burn. Four patients (1.7%) had superficial dermal burns, 94 (40.2%) had full thickness and 136 (58.1%) had mixed with full thickness burns predominance. The associated inhalation injury was diagnosed in 132 patients (56.4%). A total of 61 patients (26.1%) had either single or multiple pre-existing diseases and 51 of them sustained flame burns. The day of death varied from 1 to 103 days (mean 16 days) but 58 patients (24.8%) died within 48 hours of post burn. A total of 120 patients (51.3%) died due to septicaemia, 83 (35.5%) due to renal failure, 28 (10.2%) due to multi-organ failure, and 7 (3.0%) due to bronchopneumonia. The overall mortality rate was 6.4%, but this has significantly lowered to 4.4% (p = < 0.01) during last four years probably due to better burn care. The study thus shows that age group 0-5 and 16-35 years, domestic accidents, flame burn, inhalation injury, and pre-existing diseases are risk factors and septicaemia as the dominant cause of death in our patients.

Adolescent↗

PubMed2002

Benign thyroid disease and dietary factors in thyroid cancer: a case-control study in Kuwait.

We conducted a population-based study of 313 case-control pairs in Kuwait to examine the aetiology of thyroid cancer, the second most common neoplasm among women in this and several other countries in the Gulf region. Among the demographic variables, individuals with 12+ years of education had a significantly reduced risk of thyroid cancer (OR=0.6; 95% CI: 0.3-0.9). The average age at diagnosis (+/-s.d.) of thyroid cancer was 34.7+/-11 years in women and 39+/-13.4 years in men. History of thyroid nodule was reported only by cases (n=34; 10.9%; lower 95% CI: 12.0); and goitre by 21 cases and four controls (OR=5.3; 95% CI: 1.8-15.3). There was no significant increase in risk with history of hypothyroidism (OR=1.8) or hyperthyroidism (OR=1.7). For any benign thyroid disease, the OR was 6.4 (95% CI: 3.4-12.0); and the population attributable risk was about 26% (95% CI: 21.1-30.9). Stepwise regression analysis showed that high consumption of processed fish products (OR=2.2; 95% CI: 1.6-3.0) fresh fish (OR=0.5; 95% CI: 0.4-0.7) and chicken (OR=1.7; 95% CI: 1.2-2.3) were independently associated with thyroid cancer with significant dose-response relationships. Among the thyroid cancer patients who reported high consumption of fish products, a large majority also reported high consumption of fresh fish (98%) and shellfish (68%). No clear association emerged with consumption of cruciferous vegetables. These data support the hypothesis that hyperplastic thyroid disease is strongly related to thyroid cancer; and that habitual high consumption of various seafoods may be relevant to the aetiology of thyroid cancer. The association with chicken consumption requires further study.

Adolescent↗

PubMed2000

Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyperlipidaemic subjects after Ramadan fasting in Kuwait.

BACKGROUND: In patients with metabolic and nutritional disorders such as diabetes and hyperlipidaemia, where strict compliance to advice on timing and composition of food intake is important, the prolonged daylight fasting during the month of Ramadan could produce undesirable biochemical consequences. AIM: The study aimed to compare pre- and post-Ramadan lipid and lipoprotein profiles in stable Kuwaiti hyperlipidaemic subjects attending a Lipid Clinic. SUBJECTS AND METHODS: The study population comprised 64 adult Kuwaitis (33 M, 31 F) who had been attending a Lipid Clinic for at least 12 months and were considered stable, without any acute systemic illness. At each clinic visit, the following parameters were measured: weight, total cholesterol (TC), triglycerides (TG), HDL, LDL, apo A-1, apo B, glucose and uric acid. These biochemical parameters were measured by routine automated analyzer techniques. The pre-Ramadan values comprised the means of two measurements taken at about 3 month and 1 month before commencement of Ramadan. Post-Ramadan values were obtained within 1 month of the end of the Ramadan fast. The parameters so obtained were compared in the whole group, and then according to gender, glycaemic status and modality of treatment (diet alone or with a fibrate or statin). RESULTS AND DISCUSSION: In the nondiabetic subjects, apo A-1 and apo A-1/apo B and apo A-1/HDL ratios were increased post-Ramadan (P<0.001). Weight did not change and the other lipid parameters-TC, TG, LDL, apo B-did not worsen. These observations, more consistent in the men than in the women, and in subjects treated with a fibrate or a statin rather than on diet alone, indicate a favorable coronary heart disease (CHD) risk profile. In the diabetic patients, these changes in the apo A-1 level and its ratio to HDL and apo B were also present, but TC and apo B levels increased, the latter significantly (P<0.05). These divergent effects in diabetic patients could variably influence CHD risk liability. Serum uric acid levels were also simultaneously reduced post-Ramadan in the non-diabetic subjects and those on statin treatment. CONCLUSION: When pre- and post-Ramadan lipid and lipoprotein profiles were compared in stable hyperlipidaemic subjects attending a Lipid Clinic in Kuwait, the most consistent changes post-Ramadan were increased levels of apo A-1 and apo A-1/apo B and apo A-1/HDL ratios and reduced uric acid levels. Body weight remained essentially unchanged and the other lipoprotein and lipid parameters were not worsened. These results suggest that Ramadan fasting in hyperlipidaemic subjects might favorably influence CHD risk.

Adult↗

PubMed2003

Clinicopathological features and HLA tissue typing in pemphigoid gestationis patients in Kuwait.

Pemphigoid gestationis (PG) is a rare autoimmune disease of pregnancy. We report a series of 22 cases of PG in Kuwait. They constituted 18% of all the autoimmune bullous diseases registered in our centre over a span of 11 years. PG was observed to be the third most common bullous disease in our region. Ninety-five per cent of the patients were of Arab ethnicity. The clinical features observed in our patients were comparable to those reported elsewhere. Systemic steroids (prednisolone 20-60 mg daily) remained the mainstay of treatment to control the active disease and an optimal dose of 20 mg of prednisolone was maintained throughout the pregnancy and immediate postpartum period. We observed a favourable outcome of pregnancies complicated by PG without any associated maternal or foetal morbidity. Kuwaiti patients with PG were observed to have a predominance of HLA-DR3 and DQ2 antigens. No predominance of HLA-DR4 antigen was observed.

Adolescent↗

PubMed1997

Lipoprotein(a), tissue plasminogen activator and plasminogen activator inhibitor 1 levels in hyperlipidaemic patients in Kuwait.

Plasma levels of lipoprotein(a) [Lp(a)], tissue plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI-1) were assessed in addition to anthropometry and levels of glucose, total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and apo A1 and B in 73 patients (36 men and 37 women) with primary hyperlipidaemia (group NDHL) in Kuwait. Lp(a) levels (212 mg L-1, 8-600 mg L-1, median and range) were similar to those obtained in a matched group of 32 non-insulin-dependent diabetes mellitus (NIDDM) patients with hyperlipidaemia (218 mg L-1, 50-610 mg L-1) and slightly higher, although not significantly so (P = 0.06), than levels seen in 68 healthy normolipidaemic control subjects (182 mg L-1, 70-488 mg L-1). tPA levels (8.4 ng mL-1, 3.8-18.4 ng mL-1, median and range) in group NDHL were lower than in the diabetic group (11.4 ng mL-1, 5.2-14.2 ng mL-1) but higher than in the healthy control subjects (7.4 ng mL-1, 2.8-12.6 ng mL-1). PAI-1 levels in group NDHL (40.4 ng mL-1, 8.6-55 ng mL-1, median and range) were higher than in the control subjects (32.5 ng mL-1, 14.6-46.4 ng mL-1) but lower than in diabetic patients (43.8 ng mL-1, 15.6-55 ng mL-1). Hyperlipidaemia phenotype (hypercholesterolaemia or hypertriglyceridaemia) did not influence tPA and PAI-1 levels, but Lp(a) levels were significantly lower with hypertriglyceridaemia. Gender, cigarette smoking and racial origin (Kuwaitis, other Arabs or South Asians) did not affect Lp(a), tPA and PAI-1 levels, but tPA levels were higher in postmenopausal subjects. Low-density lipoprotein (LDL) levels (whether in total cholesterol or as apo B) correlated significantly (P < 0.05) with Lp(a) levels. tPA levels were correlated with age and the plasma levels of glucose and uric acid (P < 0.05); this correlation with glucose may explain the high levels associated with diabetes, whereas the age association might account not only for the differences observed between group NDHL and the younger control group but also for the higher levels in the postmenopausal women. PAI-1 levels correlated with tPA and triglyceride (TG) levels in the groups of subjects (normo- and hyperlipidaemic). In the normolipidaemic control group, the significant associations of tPA and PAI-1 were with body mass, expressed as the body mass index or the waist-hip ratio. These results suggest that different factors influence the plasma levels of the prothrombotic factors Lp(a), tPA and PAI-1 in healthy control subjects and in patients with hyperlipidaemia. In the latter, hyperlipidaemia phenotype, age, glycaemic status and uric acid levels are important determinants of the levels of these prothrombotic variables, whereas in the healthy, young control population, body mass was the single important association with tPA and PAI-1.

Adolescent↗

PubMed2003

Ethnic variations in birthweight percentiles in Kuwait.

The objectives of this retrospective study were to assess the effect of ethnicity on birthweight percentiles and to compare ethnic-specific percentiles with other references. Analysis was made of 35 768 singleton live births from 22 to 44 completed weeks of gestation at two major obstetric hospitals in Kuwait, after exclusion of data with inaccurate gestational age, major congenital abnormalities, stillbirths, and outlying birthweights. The population included four major ethnic groups: Gulf Arabs, Mediterranean Arabs, Egyptians, and a group combining Indians and Southeast Asians. Total population and ethnic-specific smoothed birthweight percentiles according to gestational age were developed. Indians-Asians had the smallest birthweights, the highest prevalence of small-for-gestational-age (SGA) birthweights and the lowest prevalence of large-for-gestational-age (LGA) birthweights. On the contrary, Egyptians had the largest birthweights, the lowest prevalence of SGA birthweights and the highest prevalence of LGA birthweights. Plotting our birthweights on a reference from Canada resulted in a low prediction rate for SGA and a low sensitivity in identifying LGA of all ethnic groups. We conclude that interpretation of fetal growth and birthweight should involve locally derived and ethnically specific percentiles based on accurately calculated gestational age.

Arabs↗

PubMed1999

Pemphigus in Kuwait.

BACKGROUND: Although pemphigus is a well-characterized entity, detailed epidemiologic studies from the Arabian Peninsula are not available. The purpose of this study was to elucidate the clinical features, course, and prognosis of pemphigus patients followed at a national dermatology center in Kuwait. METHODS: Fifty-four patients with pemphigus in this report were treated between 1981 and 1996, and were studied for several clinical features, treatment, course and prognosis. RESULTS: Around 80% of pemphigus patients were Arabs, and Kuwaitis constituted the largest number (46.3%) with a female predominance (F: M = 2:1). Pemphigus vulgaris (PV) was the commonest clinical type. The mean age of onset was 36 years. The follow-up period ranged from 2 months to 12 years (mean, 4.5 years). The majority of the patients could be managed with low-dose steroids (30-60 mg/day). Twenty per cent of the patients were in complete clinical remission and were off systemic therapy for an average of 3 years. No death secondary to the disease or its treatment was observed. CONCLUSIONS: Kuwaiti patients with pemphigus were observed to have a relatively young age of onset and a female predominance. Low doses of steroids were enough to control the disease in the majority, and at least 20% of patients were off therapy and in complete remission on follow-up.

Age of Onset↗

PubMedDate not supplied

A prospective survey of pediatric dermatology clinic patients in Kuwait: an analysis of 10,000 cases.

Skin diseases are common in children. However, only a very few prospective epidemiologic surveys are available in the literature. The present survey was directed at determining the spectrum and pattern of skin diseases of children in Kuwait. A total of 10,000 consecutive new patients were studied; 96% were children of Arab descent. A female preponderance (52%) was observed, and infants constituted the largest group within the patient population (28.7%). A total of 162 dermatoses were recorded. Atopic dermatitis was the most prevalent dermatosis (31.3%), followed by viral warts (13.1%), alopecia areata (6.7%), pityriasis alba (5.25%), psoriasis (4%), and diaper dermatitis (4%). Atopic dermatitis was the most frequently seen dermatosis in children of all age groups, whereas, viral warts were more prevalent in school-age children. The prevalence of alopecia areata and psoriasis was higher than reported earlier in other ethnic groups. A female preponderance was seen in children with alopecia areata, psoriasis, vitiligo, acne vulgaris, contact dermatitis, and pityriasis rosea. Dermatitis, superficial cutaneous infections, and nevi/nevoid disorders were the important groups studied.

Age Distribution↗

PubMed2005

Trypanosoma avium incidence, pathogenicity and response to melarsomine in falcons from Kuwait.

Epidemiological and clinical studies on Trypanosoma avium are lacking in the Middle East. The aims of this study were to determine the T. avium incidence in falcons from Kuwait, report clinical signs and find an effective therapy. Blood smears from 921 diseased and 56 healthy falcons were examined between May 2003 and April 2004. 12 birds 11.3%) were found infected by T. avium and ten of these were treated with melarsomine (Cymelarsan) at a dosage of 0.25 mg/kg intramuscularly for four days. All affected birds presented clinical signs, including incapacity of flying high, poor appetite, lethargy, loosing weight, weakness, dyspnoea and death. Signs disappeared within 1-7 days after administration of melarsomine. Trypomastigotes were not detected in blood smears made 1-7 days after the end of therapy. This study suggests that T. avium induces disease in falcons and that melarsomine can be an effective therapy eliminating both clinical signs and circulating trypomastigotes.

Animals↗

PubMed2006

Serratospiculosis in falcons from Kuwait: incidence, pathogenicity and treatment with melarsomine and ivermectin.

The aims of this study were to determine the incidence of the filarial avian nematode Serratospiculum seurati in falcons from Kuwait, report clinical signs and find an effective therapy. Naturally occurring S. seurati infestation was diagnosed in 149 (8.7%) out of 1,706 captive falcons examined between May 2003 and April 2005, and 140 of these were treated with melarsomine at dosage of 0.25 mg/kg injected intramuscularly for two days, and ivermectin, injected once at the dose of 1 mg/kg, 10 days later. Infestation was reportedly symptomatic in 107 (71.8%) and non-symptomatic in 42 (28.2%) falcons. Signs reported more often were dyspnoea (58.8%), reduced speed and strength in flight (56%), weight loss (38.3%), anorexia/poor appetite (22.4%) and lethargy (16.8%). After administration of melarsomine, signs disappeared within 1-10 days in symptomatic birds and improvement of flight performances was noted in non-symptomatic birds. Dead adult parasites were ejected in 22 cases. Embryonated eggs were not detected in coproscopic checks made 10 and 40 days after the end of therapy, in association with lasting clinical remission. The main conclusion is that Serratospiculum seurati is overall pathogenic for birds of prey in the Middle East and that melarsomine + ivermectin can be an effective protocol of therapy eliminating both clinical signs and parasites.

Animals↗

PubMed2000

The epidemiology of lip, oral cavity and pharyngeal cancers in Kuwait 1979-1988.

Of the 10 539 cases of cancer recorded in the Kuwait Cancer Registry in the 10 years 1979-1988, 784 (7.4%) involved the lip, oral cavity or pharynx. Nearly half of these were of the nasopharynx or salivary glands, and the incidence of salivary gland cancer appears to be increasing. The aetiology may be related to poor oral hygiene and tobacco-smoking.

Adolescent↗

PubMed1981

Obstructed umbilical hernias in childhood in Kuwait - Richter - and other types.

Obstruction of umbilical hernia in children is uncommon, but seven out of 51 operations for umbilical hernia were done as emergencies for obstruction, in 38 months, in Kuwait. Unusual conditions like Richter type obstruction and gangrenous omentum were noted in two children. Solid faeces is considered to be the precipitating factor for obstruction.

Child↗

PubMed1979

Incidence of dermatophytosis in Kuwait.

Dermatophytosis in Kuwait was found to be associated with poor, over-crowded socioeconomic localities. This infection occurred in all age groups, but patients below 10 years of age were most susceptible. Tinea capitis was observed in 71.1% of 135 patients with dermatophytosis, with a higher incidence (48.2%) in males than in females. Microsporum canis caused 60.7% of all cases of dermatophytosis and 76% of tinea capitis. A high rate of failure to culture from microscopically positive specimens was observed in tinea cruris and onychomycosis.

Adolescent↗

PubMedDate not supplied

Application of an enzyme-linked immunosorbent assay for screening of sheep urine and animal tissue for the androgenic steroid trenbolone acetate in the State of Kuwait.

This study was undertaken to determine the presence of any residue-positive meat and urine samples from live sheep in the State of Kuwait market by using an enzyme-linked immunosorbent assay (ELISA) method and to examine the accuracy and precision of the method. A total of 350 samples, including 230 sheep urine, 30 beef meat and 90 chicken, were subjected, after extraction, to an ELISA for the determination of their contents of the androgenic hormone, trenbolone acetate. The results obtained showed that the trenbolone acetate levels in the urine ranged from 0.1 to 0.9 ng/ml and in the muscle tissue from 0.02 to 0.05 ng/g all of which are below the maximum residue levels accepted (2.0 ng/g) by FAO/WHO. The mean recovery and CV, respectively, ranged from 36.7% and 5.8 (spiking level to 0.2 ng/g) to 49.6% and 10.4 (spiking level 1.5 ng/g). These results were confirmed by gas chromatography-mass spectrometry analysis (GC-MS). Based on the data obtained, it was concluded that ELISA can be used safely for screening purposes, however, any suspect sample must also be analysed by GC-MS to exclude any false positive identifications.

Anabolic Agents↗

PubMed1999

Dietary intake of pesticides: State of Kuwait total diet study.

The State of Kuwait conducted a total diet study (TDS) to determine the dietary intakes of selected pesticides. This paper reports the results of this study. A national food consumption survey was performed and core food lists for different population groups were established representing the total diet of the Kuwaiti population. Food items (table-ready) were purchased/prepared and analysed for their contents of organophosphate/organochlorine carbamate, benzimidazole and phenylurea pesticides according to the US FDA Pesticide Analytical Manual (PAM I). Dietary intakes of these pesticides are presented for 19 population groups, which range from infants to elderly adults. The intakes of selected population groups are compared with representative findings from the US FDA/TDS and data published from other countries. In general, the average daily intakes were well below acceptable limits, but higher than those reported from developed countries.

Adolescent↗