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PubMed1988

A six year experience with recurrent infection and immunodeficiency in children in Kuwait.

Sixty-five Arab children in Kuwait with recurrent infections were subjected to laboratory investigations to determine their immune function. Twenty (31%) of these children were found to have a primary immunodeficiency syndrome, 36 patients (55%) had laboratory abnormalities but could not be classified, three patients (5%) had other well defined diseases responsible for their laboratory defect, and six patients (9%) had normal laboratory values. The most common infection site was the upper respiratory tract or chest, and the most frequent organisms isolated were Candida albicans, Staphylococcus aureus and Salmonella sp. in patients in whom detailed information was available, 70% had a family history of similar disease and 68% had consanguinous parents. These children represent only a fraction of those that should be investigated and it is recommended that a referral center for the investigation of children with recurrent infection be established.

Bacterial Infections↗

PubMed1986

Nitrate-reducing bacteria in Kuwait domestic sewage.

Domestic sewage in Kuwait is mainly treated by an activated-sludge process, where different effluents and sludges are separated. Nitrate reduction in the raw sewage, effluent-1 and effluent-2 were studied. Various enrichments of these sewage samples were effected using 0.2 mg/ml of nitrogen as potassium nitrate and/or 0.5% carbon as glucose. Addition of 0.2 mg/ml nitrate-nitrogen enhanced more ammonia production (117.6 micrograms/ml) in comparison with other enrichments to sewage samples. Nitrate-reducing bacteria were also at a maximum with nitrate enriched sewage samples, especially with effluent-1 (109 X 10(6)/ml). Escherichia coli and Klebsiella pneumoniae were the only two nitrate-reducing bacteria found in all sewage samples tested. Nitrite was unstable during the 7 days incubation period under anaerobic conditions which suggests that nitrates are reduced to ammonia.

Anaerobiosis↗

PubMed1987

Some demographic and therapeutic features of diabetes mellitus in Kuwait.

A survey of all consecutive visits to all diabetic clinics in Kuwait over a period of 4 months yielded 1,266 male and 1,838 female Kuwaiti patients. Their age structure analysis revealed percent frequencies of 1.25, 15.5, 57.8 and 25.3 for the age groups under 19, 20-39, 40-59 and over 60 years respectively. The overall female:male ratio was 1.42. The body mass index peaked in the age groups 30-39 (mean +/- SD = 31.3 +/- 7.1 for women and 29.4 +/- 6.4 for men) and was consistently higher in women than in men for all age groups. Diabetic women over 30 years of age received insulin therapy more often than men. Home urine testing was practised by only 25% of those under 30 years of age and 12% of those 30 years and over. The study showed that the majority of Kuwaiti patients were relatively young and that the women were affected more often and probably more severely than men as suggested by the higher frequencies of insulin administration.

Adolescent↗

PubMed1986

Rhinosporidiosis in Kuwait.

Three cases of rhinosporidiosis are reported for the first time from Kuwait, a state in the Arabian Gulf. All patients were male expatriate workers from the Indian subcontinent. Relevant epidemiological, clinical and pathological aspects of the disease are discussed.

Adult↗

PubMed1985

Malaria in non-endemic Kuwait: resident status of patients with imported infections and the need for prophylaxis.

Kuwait is non-endemic for malaria but, with a large expatriate population, the number of imported infections has escalated from 87 in 1980 to 534 in 1984, an increase of over 613%. During a period of 1 year at the Infectious Diseases Hospital, where most of the cases were diagnosed each year, 16.7% of blood samples sent for microscopy were positive for malaria; 95.47% of these patients were hospitalized for an average of 4 days. In a 2-year period, only three (0.52%) Kuwaiti nationals imported the infection out of a total of 577 patients with malaria. About equal numbers of expatriate 'residents' and 'new arrivals' were responsible for the remainder, but over 80% of patients with Plasmodium falciparum were 'residents'. The proportion of residents among the patients is increasing and will be more pronounced with the downturn in the economy. To curtail the tide of imported malaria, the current data suggests the viability of an active campaign to offer chemoprophylaxis to travellers at risk who are essentially 'semi-immune visitors of a non-malarious area visiting a malarious area'. The benefits of simple prophylactic measures need to be emphasized. The disinfection of aircraft arriving from endemic zones should be mandatory.

Antimalarials↗

PubMed1985

Maternal plasma proteins, magnesium, zinc and copper concentration at term associated with birth size in Kuwait.

The study was carried out on Arab women who were admitted for delivery to Al-Sabah Hospital in Kuwait. The concentration of maternal serum proteins and magnesium was not correlated to infant birth size. The zinc and copper concentration in maternal serum at term was positively correlated to infant birthweight, length and head circumference. The results suggested the possibility that the mothers in the present study had a marginal zinc and copper nutriture, which when combined the hemodilution due to pregnancy led to serum levels inadequate to supply the requirement of the fast growing fetus.

Adolescent↗

PubMed1983

Poxvirus infection in a rat (Rattus norvegicus) in Kuwait.

A poxvirus was isolated from skin lesions on the tail of a rat (Rattus norvegicus) in Kuwait in February, 1982. The virus grew on the chorioallantoic membrane (CAM) developing chicken embryos and induced small generalized haemorrhagic pock lesions, 72 hours post-inoculation. It grew also with cytopathic effect (CPE) in CER and Vero cell lines. In cultured cells it produced cell rounding and syncytia 48-72 hours post-infection. The virus was resistant to the effect of ether as well as to chloroform, and showed haemagglutinating activity against chicken red blood cells in a low titer (1:16). It induced in the rabbit skin nodular lesions 4-5 days post-infection. Electron microscopy of the negatively stained preparations revealed brick-shaped typical poxvirus virions measuring 220-250 millmicron in diameter. By using vaccinia antiserum the virus antigen was precipitated in the agargel immunodiffusion test and this indicates its relation to the genus Orthopoxvirus.

Animals↗

PubMed1983

Descriptive epidemiology of acute myocardial infarction in Kuwait, 1978.

In 1978 there were 428 cases of acute myocardial infarction (AMI) among the 18 000 patients admitted to the medical wards of the two main general hospitals in Kuwait; of these, 360 (84%) were males and 171 (40%) were Kuwaitis. The male crude incidence rate (13.1 per 10 000 population per year) was 3.7 times the female rate; male age-group specific rates were greater than corresponding female rates for all age groups, although the ratio of male to female rates decreased with increasing age. AMI incidence rates increased with increasing age in both sexes for Kuwaitis and non-Kuwaitis.Kuwaitis living in high or medium socioeconomic status areas had significantly higher AMI incidence rates (6.6 and 4.5 per 10 000 population per year, respectively) than Kuwaitis in low status areas (2.5 per 10 000 population per year). Managers, administrators, professionals, and technical workers had the highest AMI rates, though the mean age and socioeconomic status did not differ among those affected in these occupational groups. Twenty per cent of the patients had been admitted previously for AMI, 22% had a hypertension history, 30% a diabetes mellitus history, and 71% a smoking history. Female patients were more often hypertensive and diabetic, but less often smokers, than males. Kuwaitis, diabetics, and those with a previous admission for acute myocardial infarction had increased mean serum cholesterol levels. Of the 16% of patients who had died in the hospital, half died within 48 hours of admission. Those who died were older and had lower systolic and diastolic blood pressures and lower serum cholesterol levels than the survivors. Twenty-seven per cent of those with extensive anterior myocardial infarcts died compared with 12% of those with acute infarcts in other locations. Those who died within 48 hours of admission had lower systolic and diastolic blood pressures than those who died later.

Adult↗

PubMed1983

Drug resistance among Salmonellae in Kuwait.

The status of drug resistance among Salmonella spp. prevalent in Kuwait during 1979-1980 has been assessed. Antibiotic sensitivity of 345 clinical isolates against 14 antimicrobial agents was done by disc-diffusion technique and their MIC was determined by plate dilution. Only 9.6% of these isolates were sensitive to all the 14 drugs. There was resistance to sulfisoxazole (78%), tetracycline (69%), kanamycin (61%), ampicillin (56%), streptomycin (53%), chloramphenicol (38%) and mezlocillin (38%). Multiple drug resistance (three or more drugs) was seen in 71% of isolates and many of them were resistant to five or more drugs. The common resistance patterns observed were ACGKSSuT, ACKSSuT, ACSSuT, and ASSuT. Co-trimoxazole was the drug of choice as only 15 strains (4%) were resistant to it. The minimum inhibitory concentration (MIC) of the resistant strains was invariably high. Salmonella typhimurium was the commonest (41%) single species and the frequency and level of resistance was higher in this serotype than in others.

Anti-Bacterial Agents↗

PubMed1984

Inflammatory bowel disease in Kuwait.

Inflammatory bowel disease is considered to be rare or nonexistent in some Arab countries. During a period of 6 years, 91 patients with ulcerative colitis and 17 with Crohn's disease were seen for initial diagnosis in the Gastroenterology Department of Amiri Hospital, which serves 55% of the population of Kuwait. From this group, 43 patients with ulcerative colitis and 14 patients with Crohn's disease were followed up for an average of 30.9 months. In the remaining 51 patients, the diagnosis was established in the same manner as in this series, but these patients were sent back to the referring physicians and therefore were not available for follow-up. The severity of the disease in the majority of patients with ulcerative colitis was mild to moderate. Nine of 14 patients with Crohn's disease underwent surgery as a diagnostic procedure in an acute abdominal emergency or for treatment of complications. The duodenum was involved in two patients with Crohn's disease and the endoscopic picture and histology of these were initially interpreted as immunoproliferative small intestinal disease which is highly prevalent in this area. We suggest that the assumption that inflammatory bowel disease is uncommon in our population is wrong.

Adolescent↗

PubMed1995

Takayasu's arteritis in Kuwait.

The present study describes the epidemiological profile and clinical features of Takayasu's arteritis (TA) in Kuwait, as well as its association with other autoimmune diseases and primary hypercoagulable states. Thirteen patients were included from its start on 1 January 1989 till 30 June 1994. Diagnosis of TA was established by angiographic studies. Twelve patients were Arabs and 7 were Kuwaiti nationals. Five patients were males and renal disease secondary to isolated involvement of the abdominal aorta (TA, type II) was the main presentation in 4 patients. Coagulation tests were performed in 7 patients and included antiphospholipid antibody (aPL) assay as well as protein S, protein C and antithrombin III activity. Only one manifested recurrent thrombosis and laboratory tests confirmed the presence of a hypercoagulable state secondary to aPL and protein S deficiency. Serological tests of systemic lupus erythematosis (SLE) were positive in this patient. These data indicate that TA is not a rare disease in the Arabic population. In our study, female predominance was not a common feature of TA and renal disease secondary to TA type II disease was commonly encountered. The association of TA with SLE and primary hypercoagulable states was not a consistent finding in our patients with TA, and hence, the proposed role for thrombotic vasculopathy in the pathogenesis and progression of this disease was unfounded.

Adolescent↗

PubMed1995

Descriptions of two new didymozoids from the barracuda Sphyraena obtusata in Kuwait Bay.

Two new species of didymozoid trematodes, belonging to the subfamily Didymozoinae (Ishii, 1935), genus Allodidymozoon Yamaguti, 1959, are described from the barracuda Sphyraena obtusata caught in Kuwait Bay. Allodidymozoon pharyngi n. sp. from cysts in the pharyngeal muscles is distinguished from its congeners by the posteriorly extended testes, glandular cells surrounding the esophagus, and the distribution of the ovarian and vitelline branches in the dorsal side of the hindbody. Allodidymozoon trilobata n. sp. from cysts in the muscles on the inner surface of the operculum is distinguished by the trilobed hindbody and distally curved testes.

Animals↗

PubMed1993

Ophthalmomyiasis in Kuwait: first report of infections due to the larvae of Oestrus ovis before and after the Gulf conflict.

We report for the first time four cases of ophthalmomyiasis due to the larvae of Oestrus ovis in Kuwait, before and after Operations Desert Shield and Desert Storm. The larvae were easily removed under local anaesthetic. The symptom complex of acute foreign body sensation, irritation, redness, lacrimation and photophobia resolved rapidly. Ophthalmic antibiotic and corticosteroid drops were also instilled and recovery was uneventful. The ophthalmomyiasis may not always be associated with contact with sheep-rearing per se. Medical personnel should therefore be aware that in cases of what might appear initially as acute, non-specific catarrhal conjunctivitis, patients with the persistent symptom complex should be re-examined to exclude ophthalmomyiasis due to the larvae of O. ovis in endemic areas.

Adult↗

PubMed1993

Acute renal failure in Kuwait--a prospective study.

This prospective study was conducted over a period of 18 months (February 1989 to July 1990) in the State of Kuwait. It covered a population of 1,024,211 and eight multidisciplinary hospitals with an in-patient admission of 118,079 per year. Two hundred and twenty-six adult patients with acute renal failure (ARF) were seen and followed up by nephrologists. This made the calculated annual incidence of ARF 14.7 per 100,000 population, nearly five times that reported by the EDTA registry (Biesenbach et al. 1991). Drugs, sepsis and volume depletion were the most frequent causes, with sepsis resulting in 36% cause specific mortality compared to zero mortality with the other two. The overall mortality rate was only 14% which clearly indicated a markedly improved prognosis in cases of ARF. The prognosis in ARF depended on two major factors, viz. the type of aetiological insult and the presence of predisposing associated medical illnesses. Multiple insults, though common, do not affect the mortality rate. Secondary sepsis or gastrointestinal bleeding as a cause of death in ARF was rarely seen in our study. Those who required dialytic support for renal failure had a 45% patient mortality rate in general. Over 40% of our patients were 60 years or older compared with only 3.5% in the local population. This indicated old age as a major risk factor in the development of ARF. The overall mortality in the elderly did not differ from that in the young, but sepsis in the elderly carried a mortality rate of 60% compared to only 14.8% in the younger age group.

Acute Kidney Injury↗

PubMed1996

Pattern of acute head injuries in Kuwait.

Of two hundred and six consecutive head injuries, 28% had fallen from heights, and 58% had been involved in road traffic accidents, mainly pedestrians (50%). Head injury preventive measures in Kuwait should be directed to road traffic accidents and falls from heights.

Accidental Falls↗

PubMed1998

Serogroups and antimicrobial susceptibility of clinical isolates of Salmonella species from a teaching hospital in Kuwait.

Salmonella strains isolated in a teaching-cum-general hospital in Kuwait during 1990-1993 and 1996 were analysed to determine the trend in the prevalence of the serogroups and their changing pattern of susceptibility. The records were reviewed for all the 661 isolates encountered during these periods. The most prevalent serogroup in both children and adults was serogroup B, followed by serogroup C and D. A sizeable proportion of the strains were resistant to first-line drugs. About 39% of the isolates were resistant to ampicillin, 17% to co-trimoxazole, 13% to chloramphenicol, and 15% to cephalothin. The majority were, however, susceptible to the other drugs with low to very low resistance rates: 7% to amoxicillin/clavulanic acid, and 0.3% to cefotaxime. All the strains were susceptible to ciprofloxacin. In all, resistant strains were more prevalent among children than adults.

Adult↗

PubMed1999

Eolian dust affects phytoplankton in the waters off kuwait, the arabian gulf

Summer phytoplankton assemblages from surface waters off Kuwait were enriched with levels of eolian dust (10(5), 10(6), and 10(7) mg/m(3)), similar to seasonal dust fallout for this region. Algal growth was positive and dose dependent. Highest biomass was up to 527 &mgr;g chlorophyll a/l on day 5. The maximum doublings of biomass per day were 0.64, 0.77, and 1.42, corresponding to 10(5), 10(6), and 10(7) mg/m(3) enrichment and were significantly higher than the 0.56 for control. Changes in the phytoplankton species composition occurred with changes in biomass, with small algae dominating peak populations. It is suggested that through enrichment of trace elements via eolian dust, a high level of phytoplankton biomass and growth can be sustained in this arid environment.

Journal Article↗

PubMed1990

Crude oil and hydrocarbon-degrading strains of Rhodococcus rhodochrous isolated from soil and marine environments in Kuwait.

Soil and marine samples collected from different localities in Kuwait were screened for microorganisms capable of oil degradation. Both fungi and bacteria were isolated. The fungal flora consisted of Aspergillus terreus, A. sulphureus, Mucor globosus, Fusarium sp. and Penicillum citrinum. Mucor globosus was the most active oil degrading fungus isolated. Bacterial isolates included Bacillus spp. Enterobacteriaceae, Pseudomonas spp., Nocardia spp., Streptomyces spp.,and Rhodococcus spp. Among these Rhodococcus strains were the most efficient in oil degradation and, relatively speaking, the most abundant. Bacterial and fungal isolates differed in their ability to degrade crude oil, with Rhodococcus isolates being more active that fungin in n-alkane biodegradation, particularly in the case of R. rhodochrous. In addition to medium chain n-alkanes, fungi utilized one or more of the aromatic hydrocarbons studied, while bacteria failed to do so. R. rhodochorous KUCC 8801 was shown by GLC and post-growth studies to be more efficient in oil degradation than isolates known to be active oil degraders.

Journal Article↗