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PubMed1985

Effective dose equivalent and associated risks from mass chest radiography in Kuwait.

The number of x-ray examinations performed on persons undergoing mass chest radiography in Kuwait reached a maximum of 1.858 X 10(5) in 1982 with miniature radiography (70 mm) claiming more than 90% of the total number and the rest done with the large film technique. The annual prevalence of asymptomatic tuberculosis patients diagnosed by x rays, as reported by the project statistics, does not, in our opinion, justify exposing such a large population. In this paper, the effective dose equivalent is calculated from both miniature and large film mass chest radiography as applied in Kuwait. The values obtained are 283 mu Sv and 35.5 mu Sv, respectively. These figures yield calculated risks of fatal malignancies per examination of 3.37 X 10(-6) and 0.422 X 10(-6), respectively. The annual collective effective dose equivalent to the population undergoing mass chest radiography in Kuwait during the 7 y 1977-1983 is found to vary between 38-48 man-Sv. These figures are used to calculate an average of 0.5 additional cases of fatal malignancies per year, or about 12 excess fatalities in the forthcoming 25-y period if the number of mass chest x-ray examinations stays at its existing level. A total of 98% of these calculated excess fatalities result from the predominant technique, miniature radiography.

Adolescent↗

PubMed2003

Prevalent PCR ribotypes of clinical and environmental strains of Clostridium difficile isolated from intensive-therapy unit patients in Kuwait.

Ninety-five isolates of Clostridium difficile from symptomatic and asymptomatic patients and 18 from their environment in the intensive-therapy units (ITUs) of four teaching hospitals in Kuwait were typed by PCR amplification of rRNA intergenic spacer regions (PCR ribotyping). A total of 32 different ribotypes was detected among the clinical isolates. The predominant ribotypes from the clinical isolates were types 097 and 078, which accounted for approximately 40 % of all isolates in the ITUs in Kuwait. Ribotypes 097 (toxigenic), 078 (toxigenic) and 039 (non-toxigenic) were three distinct clones that were circulating in all four hospitals. Ribotypes 097, 078 and 076 (i.e. 50 % of isolates from symptomatic patients) were the predominant isolates associated with C. difficile-associated disease (CDAD). The environmental isolates belonged to a diverse range of ribotypes, with no particular types common to all the hospitals. Ribotype 078 was found only in the patient environment in Mubarak hospital, while ribotype 097 was restricted to Amiri hospital. The hospital environment occupied by symptomatic as well as symptom-free patients was contaminated with C. difficile. Eight new strains that did not match any in the PCR ribotype library established at the PHLS Anaerobe Reference Unit, Cardiff, UK, were assigned ribotypes 105, 125, 128, 129, 131, 134, 140 and 141. These findings show that the isolates associated with CDAD in Kuwait are different from those found in the UK and some other European countries.

Clostridioides difficile↗

PubMed2006

Determination of the prevalence of lymphatic filariasis among migrant workers in Kuwait by detecting circulating filarial antigen.

The main objective of this study was to determine the prevalence of filarial infection among migrant workers in Kuwait. The study was conducted from April 2000 to November 2003. A total of 1050 migrant workers (>90 % from the Indian subcontinent) from filarial endemic countries and 260 individuals residing in Kuwait as controls (50 healthy Kuwaiti blood donors, 50 microfilaria-negative individuals from endemic areas and 160 patients with other parasitic infections) were screened for filarial infection. All specimens were tested for microfilaraemia by microscopy of nucleopore-filtered blood (NFB) and detection of circulating filarial antigen (CFA) by an immunochromatographic test (ICT) and the TropBio assay. The overall prevalence of filarial antigenaemia was 18.3 % (192 individuals) using the ICT and 20.3 % (213 individuals) using the TropBio assay. Thirty-two cases (3 %) of Wuchereria bancrofti were detected by microscopy and the mean microfilaria count in these cases was 816 microfilariae ml(-1). CFA was detected only in two of the 260 control subjects. Statistical analysis to calculate the sensitivity, specificity and prevalence of infection was carried out using maximum-likelihood statistical methods. The overall sensitivity and specificity of the ICT and TropBio assay to detect CFA were comparable. Compared with NFB microscopy, the sensitivity of the ICT was 93.8 % and specificity ranged from 84 to 100 %. The sensitivity and specificity of the TropBio assay were 90.1 and 100 %, respectively. However, the ICT failed to detect CFA in two cases with a microfilarial load of <20 microfilariae ml(-1). In conclusion, the prevalence of filarial infection among the migrant workers in Kuwait was 18.3 % as determined by the ICT.

Adolescent↗

PubMed1980

A model for establishment of educational programmes in developing countries: the nursing paradoxes in Kuwait.

While American nursing attempts to deal with the multitude of dilemmas that have been plaguing it for decades, many developing countries look to the USA for a nursing model to emulate, and then become lost in this confusion of its nursing profession. However, these countries continue to reach out and seek consultants with educational and practical experience in nursing in the USA, as well as in other developed countries. A paradigm is proposed for use by educators and consultants to help delineate the major issues a developing country has to confront in establishing a stable nursing service. This paradigm is explicated by applying it to the situation in Kuwait, a Fourth World country with many social paradoxes (e.g., rich in economic resources but poor in human resources). Four major paradoxes in nursing are identified by using the proposed paradigm. They are: 1 educational needs vs. educational reality; 2 locals vs. cosmopolitans; 3 role congruency vs. role incongruency; and finally 4 medical vs. nursing conceptual models. Although these paradoxes became manifest through work done by the author in Kuwait, any international health care professional will quickly realize that the prardoxes are not unique to Kuwait but have parallels in many other countries which are at different stages of development.

Developing Countries↗

PubMedDate not supplied

Child abuse in Kuwait: problems in management.

OBJECTIVES: To explore the extent of child abuse in Kuwait and examine the difficulties associated with its management. SUBJECTS AND METHODS: A retrospective analysis of the 60,640 medical records of children admitted to Al-Amiri and Mubarak Al-Kabeer Hospitals, Kuwait, between 1991 and 1998 was done. RESULTS: Of the 60,640 records, 16 children showed evidence of abuse. Of these, the perpetrator was a parent in 75% of the cases, which involved the following abuses: physical, 13; sexual, 2; and Munchausen syndrome by proxy in 1. Children with physical abuse had more than one type that included bruises (77%), burns (38%), intracranial haemorrhage (38%), fractures (23%) and cut wounds (15%). Seven of the children were returned to their biological parents, 7 were lost to follow-up and 2 died. CONCLUSION: Child abuse exists in Kuwait and is probably underreported. Management proceedings are not ideal and guidelines as well as legislation are needed.

Child↗

PubMedDate not supplied

Prevalence of low back pain among physical therapists in Kuwait.

OBJECTIVE: To determine the life and point prevalence rates and study the characteristics of work-related and non-work-related low back pain (LBP) among physical therapists in Kuwait and its effect on their regular activities. SUBJECTS AND METHODS: A specially designed self-administered questionnaire was distributed to 143 physical therapists in Kuwait. The questionnaire included demographic data, history and characteristics of LBP before and after working as a physical therapist, the effect of LBP on regular activities and current LBP. A visual analogue scale was used to score the intensity of the pain. RESULTS: One hundred (70%) of the 143 physical therapists completed the questionnaire; mean age and standard deviation of the respondents were 35.9 +/- 8.45 years. The lifetime prevalence of work-related LBP was 70% (61.8% in males and 74.2% in females) and the point (current) prevalence rate was 57% (31.6% in males and 68.4% in females). All the 100 therapists were college graduates who worked full-time and 82% were employed in general hospitals and rehabilitation centers. The most common areas of specialty were orthopedics (32%) and neurology (23%). Fifty percent reported that LBP affected their regular activities, 28.6% reported limitation due to pain and 11.4% changed their work settings because of LBP. The main site of pain was at low back and buttocks. Pain intensity was scored similarly among male and female physical therapists. CONCLUSION: Work-related and point prevalence rates of LBP among physical therapists in Kuwait are high and affect their daily activities, necessitating changes in work settings.

Adult↗

PubMedDate not supplied

Prevalence of metabolic syndrome among hypertensive patients attending a primary care clinic in Kuwait.

OBJECTIVE: To determine the prevalence of metabolic syndrome among hypertensive patients using the criteria of the National Cholesterol Education Program's Adult Treatment Panel III in a primary care health center in Kuwait. SUBJECTS AND METHODS: A population of 250 Kuwaiti hypertensive patients (129 males and 121 females) over the age of 40 were screened for metabolic syndrome by determining body mass index (BMI), waist circumference, levels of fasting plasma glucose and fasting plasma lipids (serum triglycerides, total cholesterol and high-density lipoprotein cholesterol). The study was carried out in the Mishref Family Practice Health Center, Kuwait, from January to July 2001. RESULTS: The total number of patients who met the criteria for metabolic syndrome was 85 (34%), 55% of them were males and 45% females. Prevalence of the syndrome was 28.2% among 40- to 55-year-olds and 41.9% in those above the age of 55 years. Among the 250 hypertensive patients, type II diabetes mellitus was found in 52.8% (54% males and 46% females), impaired fasting glucose in 8% (70% males and 30% females), high plasma triglycerides in 44.8% (53% males and 47% females) and low high-density lipoprotein cholesterol in 63.2% (54% males and 46% females). Obesity measured as BMI = 30 kg/m(2) was noted in 46% (43% males and 57% females) and increased waist circumference in 58% (44% males and 56% females). CONCLUSION: The prevalence of metabolic syndrome is high among hypertensives attending primary health care centers in Kuwait.

Adult↗

PubMedDate not supplied

Differential distribution of risk factors and outcome of acute coronary syndrome in Kuwait: three years' experience.

OBJECTIVE: To compare the distribution of risk factors and clinical outcome of acute coronary syndrome (ACS) between Kuwaiti and other Arab men living in Kuwait. SUBJECTS AND METHODS: The data for this study was collected from the computerized database at the Mubarak Al-Kabeer Hospital, Kuwait and the 1997-2000 census data for the State of Kuwait. 1,329 Arab men (666 Kuwaitis and 663 other Arabs) older than 25 years who were admitted between September 1997 and August 2000 with a diagnosis of ACS were included in the study. RESULTS: The rate of admission for the entire patient population was twofold higher for Kuwaiti (1.68/1,000) than other Arab men (0.72/1,000), (p < 0.001); the mean age of the Kuwaiti men was 56.7 +/- 11.9 years and other Arab men 53.0 +/- 10.5 years (p < 0.001). The prevalence of hypertension, diabetes, smoking and hypercholesterolemia for Kuwaiti men was 35.9, 56.9, 51.7 and 36.2%, respectively; the corresponding prevalence for other Arab men was 28.8, 42.7, 68.2 and 32.0%, the difference in the prevalence except for hypercholesterolemia was significant (p < 0.001). In Kuwaiti men younger than 55 years of age, the prevalence of hypertension, diabetes mellitus, smoking and hypercholesterolemia was 26.6, 49.5, 68.6 and 43.3%, respectively; the corresponding values for other Arab men was 22.3, 36.2, 77.7 and 43.3%; the difference in prevalence except for hypertension was significant (p < 0.001). The in-hospital mortality for the whole study was 6.2% (Kuwaiti) and 2.3% (other Arab men; p < 0.001); while that for men younger than 55 years was 2.7% (Kuwaiti) and 0.8% (other Arab men; p < 0.05). CONCLUSION: The rate of admission for the entire patient population with a diagnosis of ACS was twofold higher for Kuwaiti than other Arab men. Among all patients and also those less than 55 years, the prevalence of diabetes mellitus was consistently higher among Kuwaiti than other Arab men thereby probably leading to the higher admission rate and in-hospital mortality.

Adult↗

PubMedDate not supplied

Differences in the location and multiplicity of mandibular fractures in Kuwait, Canada and Finland during the 1990s.

OBJECTIVE: To compare the location and multiplicity of mandibular fractures in Kuwait, Canada and Finland during the 1990s. SUBJECTS AND METHODS: Data were collected from several hospitals in Kuwait (1991-2000), Toronto General Hospital in Canada (1995-2000) and Oulu University Hospital in Finland (1990-1999). The data were analyzed statistically using chi-square test, ANOVA, t test and logistic regression. RESULTS: Condylar fractures were more common in Finnish patients (41%) than Canadian (35%) or Kuwaiti patients (21%). Condylar fractures caused by falls were about 3.4 times more common in Kuwait and Finland compared to Canada. In Finland the risk of road traffic accidents caused by condylar fracture was about 4 times higher than those caused by other etiologies. In Canada male gender was about 2 times higher for the condylar fracture than female gender. Female patients often had more multiple injuries than men in all three countries and multiple fractures were observed especially in traumas caused by falling. CONCLUSION: Differences in location and multiplicity of mandibular fractures are due to differences in etiologies and demographic patterns.

Accidental Falls↗

PubMed2005

DNA diagnosis of single gene disorders in patients of non-European origin: experience from Kuwait.

OBJECTIVE: The aim of this study was to establish genetic DNA-diagnostic service in Kuwait. METHODS: Polymerase chain reaction, restriction fragment length polymorphisms, heteroduplex analysis and DNA sequencing were applied. RESULTS: Direct testing for common mutations had variable success in Kuwaiti patients with different genetic disorders, and additional mutation analysis was required in many cases. Genetic heterogeneity, mutations of Mediterranean, African and Arabic/Middle Eastern origin, and homozygosity by descent are characteristic of patients from Kuwait. CONCLUSIONS: More efforts aimed at the identification of mutations underlying genetic disorders in Kuwait as well as in other Gulf countries are warranted. This can be achieved by focusing genetic research in the academic institutions of Gulf countries towards this goal.

Arabs↗

PubMed2006

Changing spectrum of squamous cell abnormalities observed on papanicolaou smears in Mubarak Al-Kabeer Hospital, Kuwait, over a 13-year period.

OBJECTIVE: The aim of this study was to determine the incidence of squamous cell abnormalities in cervical cytology in Mubarak Al-Kabeer Hospital, Kuwait, and to document any change in the pattern of these lesions. MATERIALS AND METHODS: Over a 13-year period (1992-2004), 86,434 cervical smears were studied in Mubarak Al-Kabeer Hospital, Kuwait. Conventional Pap smears were first examined by cytotechnicians and finally reported by cytopathologists. The smears were classified according to the modified Bethesda system. The age of presentation of squamous cell abnormalities in Kuwaiti women was analyzed. RESULTS: Smears from 83,052 (96.09%) patients were found satisfactory for reporting while the remaining 3.9% was unsatisfactory. Atypical squamous cells of undetermined significance (ASCUS) were seen in 1,790 (2.2%) cases, atypical glandular cells of undetermined significance (AGUS) in 630 (0.8%) cases, low grade squamous intraepithelial lesion including human papillomavirus changes (LSIL) in 824 (1.0%) cases, high grade squamous intraepithelial lesion (HSIL) in 189 (0.2%) cases, and carcinoma in 79 (0.1%) cases of which 44 (0.05%) were squamous cell carcinoma. A comparison of average cases/annum during the study period revealed a significant increase in ASCUS from 1.13 to 2.83% (p < 0.001) and AGUS from 0.33 to 1.08% (p < 0.001). However, the percentage of LSIL, HSIL and carcinoma detected in Pap smears remained the same. CONCLUSION: A significant linear trend (p < 0.001) was observed in satisfactory smears, ASCUS and AGUS over the years. However, no significant change was found in the detection of LSIL, HSIL and carcinoma. A reduction in the age of LSIL/HSIL and an increasing trend in the number of Kuwaiti women over the years was also observed which makes screening of young women essential in Kuwait.

Adolescent↗

PubMed2006

Risk factors of spontaneous pneumothorax in Kuwait.

OBJECTIVES: To determine the risk factors of spontaneous pneumothorax (SP) in Kuwait. SUBJECTS AND METHODS: From January 2002 through December 2003, 254 consecutive cases with a diagnosis of SP were reviewed. Analyses of pneumothorax rates by age, sex, smoking, body mass index (BMI) and climatic conditions were evaluated. RESULTS: Of the 254 patients, 242 (95%) were male and 12 (5%) were female; a larger proportion of 180 (88%) were Kuwaitis and 74 (12%) were expatriates. Two hundred and eight (82%) episodes were regarded as primary SP and 46 (18%) as secondary SP. The mean age was 24.5 +/- 5.8 years for primary SP and 45.7 +/- 14.5 years for secondary SP. One hundred and ninety-six (77%) individuals were current smokers. BMI in primary and secondary SP was 19.3 and 22.4, respectively (p < 0.001). There was no relationship between SP and climatic conditions (a rise or fall in temperature, humidity or atmospheric pressure). However, a slight increase in SP occurred in July, probably the hottest month in Kuwait. CONCLUSIONS: The data indicate that the most important risk factors of SP in Kuwait are smoking, low BMI and the male gender.

Adolescent↗

PubMed2006

Practice and opinion towards disposal of unused medication in Kuwait.

OBJECTIVES: The aim of this study was to measure the attitude and practice of Kuwaiti patients in Kuwait with regard to safe disposal of unwanted medicines. SUBJECTS AND METHODS: Three-hundred patients or their family members waiting for prescriptions at public general hospitals in Kuwait completed a questionnaire soliciting their practice with regard to medication use and disposal, and their opinion of the best way to dispose of unwanted medicines. RESULTS: Almost half of the respondents (45.4%) obtained medicines on prescription more than 3 times a year and almost all had unwanted medicines in the home. Reasons for possessing unused medication were mostly due to a change of medication by the doctor (48.9%), or self-discontinuation (25.8%). Their most common method of disposal was to throw unwanted medicines in the trash (76.5%) or flush them down the drain (11.2%). Half (54.0%) thought that a system of taking medicines to pharmacies for safe disposal would be favorable. CONCLUSION: The study indicates that the need for an appropriate method for disposal of unwanted medication exists in Kuwait. Hence, guidelines on safe disposal of unwanted medicines are required and an organized method of collecting unused medication needs to be introduced.

Adult↗

PubMed1988

Some psycho-social aspects of old people living outside their families in Kuwait.

One hundred and ninety four elderly subjects were studied, 133 of whom were living away from their families, in the only old people's home and in the only psychiatric hospital in Kuwait. They were compared to 61 consecutive elderly subjects attending a psychiatric out-patient clinic. Psychiatric, social and clinical characteristics of subjects admitted and those living with their families were analysed and related to recent socioeconomic changes and conditions prevailing in Kuwait. Higher admission rates were significantly related to female sex, the widowed and single status and Kuwaiti and Bedouin nationalities. Low income or housing problems, poor relationships to their families and/or relatives, absence of an interested family member, a small number of own children, referral by family members on account of disabilities, organic brain syndromes or chronic psychiatric disorder was also associated with higher admission rates. Sixty four percent of the residents of the old people's home had psychiatric illnesses in spite of the official policy of excluding the mentally ill from admission. Some of the above mentioned characteristics were similar to findings in other countries, but others e.g. the role of nationality and location of residence in admission to institutions were different. Planning social and medical services in Kuwait should take these findings into account.

Aged↗

PubMedDate not supplied

Drug information centers as bases for continuing education programs in Kuwait.

Over the past few years, there has been a modernization of pharmaceutical services in Kuwait. In 1983 a drug information center was opened. A one-year postgraduate, long-distance program leading to a diploma in clinical pharmacy was started in October 1987 in cooperation with Queen's University of Belfast, Ireland. Pharmacist and physician tutors were assigned to supervise students in the major hospitals in Kuwait. A questionnaire was developed and distributed to 50 practicing pharmacists to assess the feasibility of using the Drug Information Center at Adan Hospital (DICAH) as a base for continuing education programs. Although certain difficulties were identified, it was concluded that the DICAH has the potential to be used as a base for future continuing education for pharmacists in Kuwait, especially as there is no school of pharmacy in the country.

Attitude of Health Personnel↗

PubMed1990

Expatriate maids and food patterns in Kuwait.

The aim of this study was to investigate the role of the maid and her nationality on infant feeding patterns, nutritional status of mothers and food pattern in Kuwait. A multistage stratified sample of 2004 Kuwaiti families was taken to represent all districts in Kuwait. Mothers were interviewed to collect data on infant feeding patterns, types of foods presented daily and the nutritional status of the mother was assessed. When there was no maid, 65.3% of the infants were breast fed, such rate declined to 55.1% when a maid was employed. The duration of breast feeding was prolonged from 5.43 months in the presence of a maid to 7.29 months in her absence. Obesity was more prevalent among mothers (44.7%) when a maid was employed and decreased when they received no help (35.4%). The results show that traditional dishes are presented for lunch which is the major meal of the day. Food items presented for breakfast or dinner are more diversified. Hamburger, fried potato, macaroni and fried chicken have become popular dishes in Kuwait. The types of food presented were significantly associated with the nationality of the maid.

Breast Feeding↗

PubMed1999

Obesity among Kuwait University students: an explorative study.

University students' dietary habits have been criticised for their nutritional inadequacy and faddism. Kuwait University students may face the risk of obesity because of affluence and modernization and the dynamic changes in their level of physical activity and caloric intake. This promoted a study of a random sample of 842 Kuwait University students for dietary and socioeconomic factors associated with obesity. Weight and height were measured to calculate the body mass index (BMI), which is the weight in kilograms divided by the height in meters squared (kg/m2). Obesity was classified into grade 1 and 2 (BMI > 25 and > 30 kg/m2). The associated factors studied and obtained through questionnaires included gender, age, marital status, parental obesity, education and occupation, dieting, last dental and health check-up, year of study, number of siblings (total, brothers and sisters), eating in between meals, high school and college GPA and major, exercising, number of regular meals eaten, obese relatives, those living at home, and servants, highest desired degree, birth order, having a chronic disease, countries prefer visiting, family income, governorate, and socioeconomic status (SES). Grade 1 and 2 obesity were found to be 32.0 and 8.9%, respectively. Factors that were found to be significantly associated with obesity included gender, age, marital status, obesity among parents, dieting, last physical check-up, year of study, number of brothers, sisters and regular meals eaten and high school GPA. Logistic regression analysis revealed that the same factors significantly contributed to the development of obesity except the last four. The level of obesity among Kuwait University students is high. Obesity is a risk factor for a variety of chronic diseases. There is a need to address the challenge of instituting measures that would reduce the future ill-effects of obesity on young adults. It is widely believed that during the young adult years many important health habits are formed and set. It is at this stage (or earlier) that wellness and self-care programming for college students is essential and worthy of being explored and its efficacy assessed.

Adolescent↗

PubMed2001

Prevalence of penicillin-resistant Streptococcus pneumoniae in Kuwait.

The worldwide incidence of penicillin-resistant Streptococcus pneumoniae has increased at an alarming rate during the past decade. However, there has been little published data about the extent of this problem in Kuwait. The present study was undertaken to ascertain the preponderance of S. pneumoniae, either resistant or intermediate-resistant to penicillin, other beta-lactams and non-beta-lactam antimicrobials in Kuwait. Two hundred and fifty fresh isolates from as many patients suffering from different clinical conditions were collected from all clinics and hospitals in Kuwait. Optochin sensitivity and bile solubility tests reconfirmed these. Susceptibility testing to penicillin, ampicillin, cefuroxime, ceftriaxone, cefotaxime, imipenem, erythromycin, chloramphenicol, ciprofloxacin and vancomycin was done using E-test strips and to oxacillin, tetracycline, trimethoprim and amoxicillin-clavulanate by disc diffusion technique. Full and intermediate resistance to penicillin was observed in 1.6% and 52.8% of the isolates respectively. Full resistance to third-generation cephalosporins ranged from 0.4% to 3.2%, however, intermediate resistance to these antibiotics varied between 18.8% and 21.2%. Ampicillin resistance was noted in 0.8%, but 40.4% of isolates were intermediately resistant. However, only 0.4% of the isolates showed either intermediate or full resistance to amoxicillin-clavulanate. Resistance to imipenem was observed in 0.4% and intermediate to 13.6% of the organisms. The rates of S. pneumoniae resistant to chloramphenicol, erythromycin, tetracycline and trimethoprim were between 8.4% and 37.6% and intermediate resistance between 1.2% and 17.6% while only 0.4% showed resistance to ciprofloxacin and none to vancomycin. Multiresistance to both beta-lactam and non-beta-lactam antibiotics was observed in 52% of the penicillin-resistant isolates.

Drug Resistance, Multiple↗