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PubMed1984

Popliteal artery injury in Kuwait.

While there is an abundant literature on popliteal artery injury secondary to penetrating trauma, few reports deal with popliteal artery injury caused by severe blunt trauma with or without fracture. Eight cases of popliteal artery injury are described. Seven of the patients had sustained blunt trauma, usually resulting also in damage to bone and soft tissues. The popliteal vein was involved in five of the injuries. The time lag between causal trauma and vascular repair averaged 25 hours. Delay was due mainly to failure to consult the vascular surgeon at an early stage. Leg amputation was necessary in two cases. Two patients died. The importance of early recognition of the vascular injury and appropriate surgical measures was illustrated in this small series of patients from a developing Middle Eastern country. Adequate fasciotomy, venous repair, use of intraoperative Doppler and repeated postoperative débridement are discussed in connection with management.

Adult↗
PubMed1984

Mantoux and Tine tuberculin tests compared in Kuwait.

Mantoux and Tine tests were performed on 260 patients with an overall agreement between the 2 tests of 96%. On clinical evaluation, 17% of those expected to be positive reactors were found to be negative to both tests, and 8% were positive in those expected to be negative. The Tine test produced comparable results with the Mantoux test, and is suitable for clinical tuberculin testing purposes. Although both tests were sensitive but not highly specific, tuberculin testing is still wanted in our area, perhaps not in diagnosing pulmonary tuberculosis, but in the investigation of lymphadenopathy where positive reactions make non-tuberculous origin unlikely.

Adult↗
PubMed1982

Enumeration and identification of pathogenic bacteria from sewage in Kuwait.

Mycobacterium spp. was isolated and enumerated in all sewage samples at different stages of the sewage treatment. Aeromonas hydrophila, Salmonella spp., Shigella dysenteriae and others were isolated from both treated and untreated sewage. Moreover, the serological identification of Salmonella spp. was also done, using antisera specific to their antigenic structures. Counts of bacteria in various sewage sludges and effluents tested showed the efficiency of the activated sludge process in reducing the bacterial number. Seasonal variation in either the number or kind of pathogenic bacteria revealed inconsiderable changes. Almost all species of bacteria tested were found to be resistant to ampicillin.

Aeromonas↗
PubMed1994

War injuries during the Gulf War: experience of a teaching hospital in Kuwait.

The war injuries of 361 patients admitted to Mubarak Al-Kabeer Teaching Hospital, during the Gulf War are reported. More abdominal and chest injuries were seen in this series in comparison with other conflicts owing to the short evacuation time. Of the injuries, 54% were caused by gunshots, 34% were fragment injuries and 5.5% were glass and stab injuries. Civilians accounted for 50% of the injured. Wound infection rate was 7%, average hospital stay was 8.8 days and hospital mortality was 5.5%. We advocate radical wound excision, exploration of penetrating wounds of neck and abdomen, and mainly conservative management of chest injuries that do not involve the mediastinum.

Abdominal Injuries↗
PubMed1994

Dirofilariasis in Kuwait: first report of human infection due to Dirofilaria repens in the Arabian Gulf.

Zoonotic dirofilariasis has been reported sporadically from many areas of the world but thus far, there are no such reports from the Arabian Peninsula. We present the first report of human dirofilariasis from this region in the Middle East and discuss the significance of the finding. A fixed, elongated mass in the abdominal wall of a 50-year-old Kuwaiti man was excised and a worm was identified in an abscess in tissue sections. The location of the nodule in subcutaneous tissue, the diameter of the worm in section, the multilayered cuticle with fine longitudinal ridges on the external layer, prominent internal cuticular ridges, and abundant somatic muscles suggested the diagnosis of the worm as Dirofilaria (Nochetiella) repens, a natural parasite of dogs and cats in Asia, Africa, and Europe.

Abdominal Muscles↗
PubMed1996

Nocardiosis in renal transplant recipients in Kuwait.

BACKGROUND: Nocardiosis has emerged as an important bacterial disease among renal transplant recipients, leading to considerable morbidity and mortality. Apart from the increasing problem of resistance in pathogenic nocardiae, the spectrum of species causing disease has enlarged in recent years. There are no published reports on nocardiosis from Middle-East countries. METHODS: A retrospective review of case records of 513 renal transplant recipients between January 1989 and January 1995 was done in the transplant unit of our hospital. Information was collected on clinical details, type of donor, immunosuppressive therapy, prophylaxis, and outcome. Isolation of Nocardia species from appropriate clinical specimens was the sole criterion for diagnosis. RESULTS: Nocardiosis was diagnosed in six recipients with a disease incidence of 1.2%. Four patients had received unrelated kidneys. Co-morbid conditions were diabetes mellitus (3), viral hepatitis (2) and neutropenia (1). Clinical manifestations included deep-seated skin abscesses and pulmonary disease in three each. Cerebral abscess and meningitis were found in two patients with pulmonary disease. Pathogens were Nocardia asteroides in four and N. otiti discaviarum and N. farcinica in one each. In contrast to in vitro susceptibility results, clinical response was different in that five patients who received trimethoprim-sulphamethoxazole (TMP-SMX) alone (2) or in combination with cefuroxime (3) responded well. CONCLUSIONS: The study stresses a high index of suspicion for nocardiosis in susceptible hosts who present with cutaneous abscess, pulmonary infiltrative lesions, and cerebral manifestations. TMP-SMX in combination with cefuroxime seems to be a highly effective therapy. It does not appear mandatory to reduce or discontinue immunosuppressive therapy during treatment of nocardiosis.

Adult↗
PubMedDate not supplied

Obstetric and gynecologic implication of brucellosis in Kuwait.

OBJECTIVE: To study the possible correlation between maternal Brucella infection and reproductive failure as expressed by abortion, intrauterine fetal death, and preterm delivery. STUDY DESIGN: Maternal enzyme-linked immunosorbent assay serologic and microagglutination testing and conception product culture for Brucella were done in 227 women with preterm delivery, 51 with intrauterine fetal death, 29 with spontaneous abortion, and 39 with term delivery of a normal baby. RESULTS: Ingestion of raw milk was positive in 18% of the control cases, 28% of preterm delivery cases, 30% of intrauterine fetal death cases, and 21% of spontaneous abortion cases. Acute or chronic Brucella infection was found in 8% of preterm, 10% of intrauterine fetal death, and 7% of abortion cases. None of the control cases had evidence of Brucella infection. None of the four groups showed positive culture of the placenta for Brucella. The titres of Brucella-specific immunoglobulin G and M were significantly higher in the preterm, abortion, and intrauterine fetal death groups than in the control group. CONCLUSION: A possible correlation may exist between Brucella infection and preterm and intrauterine fetal death, which does not seem to be related to transplacental infection but possibly may relate to the acute illness.

Abortion, Spontaneous↗