Trace metals in marine sediments of Kuwait.
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A semiconductor surface barrier detector with an active area of 450 mm2 and depletion layer thickness of 300 microns has been used to measure the alpha activity of cigarette tobacco. The performance parameters of the counting system, the calibration and the results of alpha-activity in some cigarettes are presented.
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Twenty patients aged between one and eighteen months (mean six months) were found to have lead encephalopathy. They were seen in one 30-bed ward during a four year period from 1977 to 1980. Blood lead was determined in 19 children and ranged between 2.9 and 12.4 mumol/l (60 and 257 micrograms/dl) mean 5.42 mumol/l (113 micrograms/dl). Two patients died before starting treatment. Of the 18 patients treated with B.A.L. (2.3 dimercaptopropanol) and EDTA (ethylenediaminetetra-acetic acid), three died. Eleven patients made an apparently complete recovery and four had neurological sequelae. The source of lead was traced in 18 patients: in 11 it was due to the liberal use of Kohl (also known as surma) commonly used as an eye cosmetic in the Arabian peninsula. Other local sources of lead poisoning are discussed.
Over a 12-month period 1045 children were hospitalized because of acute gastroenteritis. The disease accounted for 26% of admissions and for 20% of the total bed utilization. Prevalence peaked twice (autumn and spring), was low during summer and lowest in winter. Only 20% of children were breastfed on admission and in the great majority of those who were not, breast feeding was stopped under the age of two months. Early cessation of breast feeding may be responsible for the increased frequency of gastroenteritis in very young infants, and should be a cause for major concern in developing countries.
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OBJECTIVE: To illustrate the clinical features, laboratory findings, and management of anticonvulsant hypersensitivity syndrome (AHS), emphasizing the importance of recognizing its multiple clinical components and raising awareness of the cross-sensitivity among different anticonvulsants. CLINICAL PRESENTATION AND INTERVENTION: Two cases of AHS due to carbamazepine and a combination of sodium valproate and lamotrigene are reported. Both patients presented within the first month of starting the new antiepileptic medication with fever, skin rashes, hematological abnormalities, and hepatitis. The offending antiepileptic drugs were immediately stopped in both cases. Skin rashes responded to intravenous immunoglobulin in case 1 and to intravenous hydrocortisone in case 2. CONCLUSION: AHS is a serious, life-threatening condition. This report demonstrates that the most important steps in the management of AHS are to recognize the disorder, discontinue the offending antiepileptic drug, and provide supportive care in an inpatient setting and treat with benzodiazepines if seizures occur.
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Thirty-one consecutive patients with SLE were screened for antinuclear antibody (ANA), anti-DNA antibodies, extractable nuclear antigen antibodies (anti-ENAs) including anti-Sm, anti-RNP, anti-SSA (anti-Ro), anti-SSB; (anti-La), anti-Scl-70, rheumatoid factor (RF), C-reactive protein (CRP), C3 and C4 levels, anti-cardiolipin antibodies (aCL), biologically false positive serological test for syphilis (BF-STS) using VDRL test and Coombs' test. The age of the patients ranged from 11 to 52 year with a median of 29 year; female to male ratio of 5:1. There were 21 Kuwaitis, four Egyptians, three from the Indian subcontinent, two Filipinos and one Syrian. Main clinical categories of SLE were: mild cutaneous SLE in 12 (38.7%), clinical antiphospholipid syndrome (APS) secondary to SLE in 8 (25.8%), haematological manifestations of SLE in 5 (16.1%), renal lupus in four (12.9%), neuropsychiatric in three (9.7%), others (6.4%). Clinical features overlapped in several patients. ANA was positive in 96.8% (mean value 891.61 units/ml), anti-DNA in 35.5% (mean value 56.4 units) that was lower than expected and could be due to selection bias as the patients were from a rheumatology clinic, anti-ENA in 42%, anti-Sm 13% that was lower than other non-Caucasian populations, anti-RNP 13%, anti-SS-A in 35.5%, anti-SS-B in 19.4%, Scl-70 in 13%, CRP in 71% (moderate 58%, very high 13%); C3 mean 1.52 mg/ml (3.2% low levels), C4 mean 0.35 mg/ml (32% low levels), anticardiolipin mean GPL 35.35 units (high 58%), mean MPL 10.61 units (high 26%), BF-STS in 6%, Coombs' test in 6%, RF positive in 36%. The only significant positive clinical associations observed were those of renal involvement with anti-DNA antibodies (P = 0.042), and clinical antiphospholipid antibody syndrome with aCL antibodies (P = < 0.05).
Ninety-six patients, fifty-eight healthy patients and thirty-eight special needs patients, ranging in age from 3 to 31 yr (average age 6.9 yr) had received dental treatments under general anesthesia (GA) at Amiri Hospital. The mean number of dental procedures per child was 13.6 (SD+/-5.4) with a mean number of 15.6 procedures for healthy patients and 10.5 special needs patients. There was a statistically significantly higher number of dental procedures for healthy patients than for special needs patients (p<0.001). The number of pulpotomies and stainless steel crowns placed for healthy patients was significantly higher (3.5) than for special needs patients (1.3) with (p<0.001) The average number of extractions was similar for the two groups of patients, 2.8 for normal and 2.2 for handicapped. On the basis of these results, it was concluded that dental treatment under GA in hospital environment is beneficial for certain group of patients, such as very young children and those with special needs. Underlying medical conditions influenced the treatment provided.
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