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PubMed2007

Serum prostate-specific antigen levels in Middle Eastern men with subclinical prostatitis.

OBJECTIVE: To investigate the influence of subclinical or histologically diagnosed prostatitis on serum prostate-specific antigen (PSA) in patients investigated for prostatic disease in Kuwait. MATERIALS AND METHODS: Serum PSA was assayed in patients investigated for prostatic disease in Mubarak Al-Kabeer Hospital, Kuwait, between December 2002 and December 2004. These included patients undergoing transrectal ultrasound with needle biopsy of the prostate gland and those who were treated with transurethral resection of the prostate or retropubic prostatectomy. The tissue was evaluated for prostatitis as well as the underlying disease, and the type and severity of prostatitis were compared with levels of serum PSA. RESULTS: Of the 331 tissue specimens, 18 (5.4%) did not show prostatitis, while 233 (70.4%) with benign prostate and 80 (24.2%) with malignant prostate disease showed prostatitis. Of 270 men with known serum PSA levels, 198 and 72 had benign and malignant prostate disease, respectively. Of the 198, 77 (41%) with benign prostate disease and prostatitis and of the 72, 52 (76%) with malignant prostate disease and prostatitis had serum PSA levels >10 ng/ml. CONCLUSION: The data showed that although raised serum PSA is more commonly associated with prostate cancer, subclinical prostatitis is a significant source of high serum PSA in over 40% of men in Kuwait. That local factors may obscure the usefulness of serum PSA as a screening tool suggests the need for a locally applicable paradigm to identify prostate cancer.

Adult↗

PubMed2006

Optimism and pessimism in Kuwaiti and American college students.

BACKGROUND: Cross-cultural comparisons in optimism (O) and pessimism (P) are few. Kuwait and the United States have different languages, situations, history and culture. On this basis, there is good reason to hypothesise that there are significant differences between the two countries in O and P. AIMS: To explore the differences in, and correlates of, O and P in Kuwaiti and American college students. METHOD: Two samples of male and female undergraduates were recruited from Kuwait (N = 460) and the United States (N = 273). Their mean ages were 21.9 +/- 3.0 and 23.2 +/- 6.5, respectively. All respondents completed the Arabic Scale of Optimism and Pessimism (ASOP), the Suicidal Ideation Questionnaire, the Ego-grasping Scale, the Death Obsession Scale, the Kuwait University Anxiety Scale and the Arabic Obsessive-Compulsive Scale. Kuwaitis responded to the scales in Arabic, and Americans responded in English. RESULTS: The ASOP displayed good internal consistency, a meaningful factorial structure and interpretable factors in both countries. It was found that O correlated negatively with the above scale scores, while the correlations of P were positive, indicating the convergent validity of the ASOP. The Kuwaiti mean score on O was significantly lower than the mean of their American counterparts, and vice versa for P. CONCLUSION: The findings are explained in the light of previous results on personality and psychopathology questionnaires in Kuwaiti and American societies. There is a need to investigate O and P in different cultures.

Adult↗

PubMed2006

Body mass index of Kuwaiti children aged 3-9 years: reference percentiles and curves.

AIM: The suitability of using the standards for body mass index (BMI), produced in the U.S. by the National Center for Health Statistics, for assessing overweight and obesity among children in Kuwait and other Arabian Gulf countries has not been examined. These standards were obtained from better-nourished and genetically different populations to those found in Kuwait and in other Gulf region countries. The purpose of this study was to develop BMI reference percentiles and curves appropriate for children aged 3-9 in these countries. METHOD: Attempts were made to include all healthy Kuwaiti kindergarten and elementary education children in this study The total sample was 113,013, comprising 55,053 males and 57,960 females. The children were measured for weight and height from which the BMI was calculated. Appropriate polynomial regression smoothing techniques were used to obtain the best-fitting percentile curves. RESULTS: At percentiles < or =25th, the BMI of boys exceeded that of girls. At the 50th percentile, boys' BMI was mostly higher than or equal to that of the girls except at age nine where it was lower At the 75th percentile, the BMI of both genders was similar, with exceptions at age six and nine years. At the 85th and 95th percentiles, girls' BMI was consistently higher than males. At the lowest percentile, the BMI of US children was higher than Kuwaiti, Saudi (starting at six) and Iranian children. The BMI of Kuwaiti children at higher percentiles was higher than that of Saudi, Iranian (except at age < four years) and US children. CONCLUSION: BMI curves for Kuwaiti children follow almost the same pattern as their US counterparts but with noticeable variations especially at the lower and higher percentiles. This study may reflect that western standards may not be directly applicable to assess the level of BMI in Kuwait and possibly in the neighbouring Gulf countries, since they may overestimate the levels of overweight, obesity and underweight.

Body Mass Index↗

PubMed1993

Smoking habits among physicians in two Gulf countries.

The smoking habit of physicians in United Arab Emirates (UAE) and Kuwait were studied as first step towards surveying the habit among medical professionals. A cross-sectional survey was conducted in Kuwait between January-June 1990. Out of the 300 physicians who were contacted 252 (84%) completed the questionnaires, 190 (75%) were males and 62 (25%) were females. Among male physicians, current smokers were 86 (45.3%), ex-smokers were 34 (17.9%) and non-smokers were 70 (36.8%), while among the female physicians 10 (16%) were smokers and 52 (84%) were non-smokers. Also, a cross-sectional study was conducted between December 1991-November 1992 to identify the extent of smoking among physicians in UAE. Of the 300 physicians, 275 (91.6%) responded, 214 (77.8%) were males and 61 (22.2%) were females. Among the males, current smokers were 94 (43.9%), ex-smokers were 32 (14.9%) and non-smokers were 88 (41.2%), while among the females 5 (8.2%) were smokers, 3 (4.9%) were ex-smokers and 53 (86.9%) were non-smokers. Most important factors responsible for non-smoking doctors for not taking up smoking were: 'Protection of health', 'Self-discipline' and 'To set a good example to others'. The majority of physicians in UAE (91.3%) and Kuwait (75.6%) strongly agreed that smoking is hazardous to health. The results revealed that less than 50% of physicians provide information to over 70% of smoking patients. The majority of physicians and health professionals were aware of association between smoking and various diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2005

Kuwaiti high school students' perceptions of nursing as a profession: implications for nursing education and practice.

The shortage of nurses in Kuwait is attributed to low production of indigenous nurses, resignation and emigration of foreign nurses, and expansion of health care facilities. This study explored Kuwaiti high school students' perceptions of nursing as a profession, their sources of information about nursing, and factors that affected their choice of nursing as a future career. Questionnaires from 289 students attending seven all-female high schools in Kuwait were analyzed. The results revealed that all of the participants were knowledgeable about the functional aspects of the nursing profession, and 35% of them received this information through contact with nurses during hospital visits. However, only 19% indicated they might consider nursing as a future career. The implications of the study for nursing education and practice, and strategies to attract and retain indigenous high school graduates into nursing programs in Kuwait are discussed.

Adolescent↗

PubMed2004

Contribution of AGC to ACC and other mutations at codon 315 of the katG gene in isoniazid-resistant Mycobacterium tuberculosis isolates from the Middle East.

The presence of ACC and other mutations at codon 315 in the katG gene was detected by PCR amplification followed by restriction fragment length polymorphism (PCR-RFLP) generated with restriction enzymes Msp I and MspA1 I in 37 isoniazid-resistant and 22-susceptible Mycobacterium tuberculosis isolates from Kuwait obtained in 2001. The mutation AGC to ACC was detected in 22 (60%) isolates while any mutation at codon 315 of the katG gene was present in 24 (65%) of 37 isoniazid-resistant isolates. The typing studies showed that majority of the isolates carrying mutations at codon 315 exhibited unique DNA banding patterns. The results were extended by additional analysis of 67, 28 and 17 isoniazid-resistant and 18, seven and six-susceptible M. tuberculosis isolates from Kuwait, Dubai and Beirut, respectively, that were analyzed previously for ACC mutation alone. These studies showed that one of 21, one of 10 and two of 11 isolates (all recovered from patients of Middle Eastern origin) with no AGC to ACC mutation from Kuwait, Dubai and Beirut, respectively, contained other mutations at codon 315 of the katG gene. None of the susceptible strains contained any mutation at codon 315. The PCR-RFLP with MspA1 I that detects all mutations at codon 315, compared with Msp I that detects only ACC mutation, identified more isoniazid-resistant strains with mutations at codon 315 in the katG gene. The data also showed that mutations other than AGC to ACC at codon 315 in the katG gene occur frequently in M. tuberculosis isolates recovered from Middle Eastern patients and should be incorporated in a rapid screen for the detection of mutations for isoniazid-resistance in the katG gene from this ethnic group.

Antitubercular Agents↗

PubMed1999

DNA damage in humans exposed to environmental and dietary polycyclic aromatic hydrocarbons.

The paper describes recent research on human DNA damage related to environmental and dietary polycyclic aromatic hydrocarbon (PAH) exposures. The study populations either represent general populations of large geographical regions, or their exposure situation may have relevance to the general population. In Silesia, Poland, and Northern Bohemia, Czech Republic, where coal-based industry and domestic heating are the major sources of PAHs, significant differences have been observed in white blood cell DNA adducts and cytogenetic biomarkers between environmentally exposed and rural control populations, and significant seasonal variations of DNA damage have been detected. Bus drivers, traffic policemen and local residents have been involved in biomarker studies in Copenhagen, Athens, Genoa and Cairo, and differences have been measured in the level of DNA damage of urban and rural populations. Burning of smoky coal in unvented homes in Xuan Wei region, China, causes high PAH exposure of residents, which has been reflected in DNA adduct levels in different tissues. Indoor wood burning in open fireplaces did not increase human DNA adduct levels. Oil-well fires left burning in Kuwait after the Persian Gulf war created an unprecedented environmental pollution. However, insignificant environmental PAH levels were measured several miles from these fires. Aromatic and PAH-DNA adduct levels in white blood cells of US Army soldiers were lower during their deployment in Kuwait, than in Fulda, Germany, where they were stationed before and after serving in Kuwait. The contribution of dietary PAH exposure to blood cell DNA adduct levels had been demonstrated in studies in which volunteers consumed heavily charbroiled beef. Environmental tobacco smoke did not cause detectable changes, as measured by 32P-postlabelling, in DNA adduct levels in non-smokers. In the reviewed studies, observed DNA adduct levels were generally in the range of 1 to 10 adducts, and not higher than 40 adducts in 108 nucleotides. Typically, 1.5 to 3-fold differences have been detected in DNA adduct levels between the exposed and control groups.

Air Pollution↗

PubMed1996

Seroprevalence of human parvovirus B19 in children of a desert region.

A seroepidemiological study was conducted in Kuwait to evaluate the pattern of acquisition of human parvovirus B19 by children in Kuwait and to compare it with patterns described in other regions in different climatic zones. A total of 218 serum samples from children less than 16 years of age were tested for the presence of anti-B19 IgG by enzyme immunoassay. The overall seroprevalence was 17.4%. Infants in Kuwait had low levels of maternally-acquired anti-B19 IgG (8.6%). The age of peak exposure to parvovirus B19 was 10-15 years compared with less than 10 years in England and Wales and more than 20 years in Singapore. The results of this study indicate an influence of geographic differences on transmission of parvovirus B19.

Antibodies, Viral↗

PubMed1976

An antigenically atypical strain of variola virus.

The Kuwait-5-67 strain of variola virus, although indistinguishable from variola virus in its other properties, behaved atypically in immuno-diffusion tests with antivaccinia serum. The precipitation line pattern produced was similar to that of cowpox virus but lacked one of the main precipitation bands given by all other strains of variola, alastrim and vaccinia viruses tested. Trypsin treatment of cowpox virus preparations revealed the missing precipitation line but did not do so with the Kuwait-5-67 strain. The antivaccinia serum absorbed by Kuwait-5-67 strain lost its ability to interact with this strain, but still gave precipitation lines with variola, vaccinia and cowpox viruses.

Antigens, Viral↗

PubMed2004

Changes in blood levels of eosinophil cationic protein and tryptase after exercise challenge in adolescents with exercise-induced asthma.

BACKGROUND: Exercise-induced asthma (EIA) is increasingly encountered among school children in Kuwait. Available evidence has shown that inflammatory mediators may be involved in the pathogenesis of EIA. Studies on release of inflammatory mediators have been carried out in adult patients with asthma in Kuwait, but no study on EIA involving children has taken place in this region. OBJECTIVE: To investigate changes in the concentration of some of the mediators involved in EIA in adolescent school children, using exercise challenge. DESIGN: Prospective, case control study. SETTING: Respiratory and Cardiology units Mubarak Hospital, Kuwait, between January and June 2001. SUBJECTS: Nine EIA and 14 non-EIA and 10 normal control subjects, designated as groups one, two and three aged between 13 and 17 years, who were non-smokers, were enrolled for the study. MAIN OUTCOME MEASURES: Blood eosinophils (EOS), eosinophil cationic protein (ECP) and tryptase were estimated pre-exercise, 5 and 30 minutes after exercise. Spirometry was measured at the same period. RESULTS: In group one, ECP and tryptase levels fell after exercise, but significant difference in the levels were obtained only in tryptase between pre-exercise and 30 minutes after exercise (4.1 microg/L Vs 3.8 microg/L) P <0.05, while the difference for ECP was not significant (P=0.09). In group two, both tryptase (6.0 microg/L Vs 5.7 microg/L) P < 0.05, and ECP (21.8 microg/L Vs 12.1 microg/L) P<0.01, fell after exercise. However, in group three, no appreciable difference was observed between pre and post exercise. Correlation between tryptase and EOS (r=0.770; P<0.05) and between tryptase and ECP (r=0.850; p<0.05) was observed pre-exercise and after exercise in groups one and two. CONCLUSION: A fall in the level of the mediators was observed after exercise challenge, but the relevance of this finding in the pathogenesis of EIA remains unclear. Further studies are required to verify this finding.

Adolescent↗

PubMed2002

Silent brain infarcts are rare in Kuwaiti children with sickle cell disease and high Hb F.

Overt stroke is rare among sickle cell disease (SCD) patients in Kuwait. However, there are no previous studies of silent cerebral infarcts, which have been described in up to 20% of American children with Hb SS. We have carried out a prospective brain MRI study among otherwise normal SCD patients, who were consecutive patients seen in a 1-year period to document the prevalence of silent cerebral infarcts in children with sickle cell disease in Kuwait. Any patient with a previous seizure or other neurological abnormality was excluded. MRI was done with a 1.5 Tesla unit with super-conducting magnet. T1- and T2-weighted sagittal and axial sections and proton density axial images were obtained in 5-mm thick sections. The study group consisted of 30 (23 SS and 7 Sbeta(0)Thal) patients-19 males and 11 females-whose ages ranged from 6 to 17 (mean of 9.8 +/- 3.5) years. Hb F ranged from 11% to 35% with a mean of 22.8% +/- 5.7%. Only one patient, a 10-and-a-half-year-old boy with Hb SS, showed hyperintense signals in the parietal white matter, consistent with small infarcts, thus giving a prevalence of 3.3%. Silent brain infarcts are uncommon in our patients, and the protective factors remain to be fully elucidated.

Adolescent↗

PubMed2002

Epidemiology of reproductive and hormonal factors in thyroid cancer: evidence from a case-control study in the Middle East.

Thyroid cancer is the second most common neoplasm among women in Kuwait and several other countries in the Middle East. Most of these countries also have relatively high birth and total fertility rates. To examine potential relationships between reproductive and hormonal factors and thyroid cancer, we conducted a population-based case-control interview study among 238 women diagnosed with thyroid cancer and a similar number of individually matched controls in Kuwait. Among the demographic variables, women with 12+ years of education had a significantly reduced risk of thyroid cancer (OR = 0.4; 95% CI: 0.2-0.8; p-trend <0.05). The average age at diagnosis (+/-SD) of thyroid cancer was 34.7 +/- 11 years. Events such as age at menarche, pregnancy, menopausal status and age at menopause were not associated with thyroid cancer. There was an association with age at last pregnancy and parity. Women who had their last pregnancy at ages > or = 30 years were at a significantly increased risk (OR = 2.1; 95% CI: 1.2-3.8); there was also a significant trend in risk with increasing age at last pregnancy. There was a modest increase in risk among women who had borne > or = 5 children (OR = 1.5; 95% CI: 0.9-2.5). A joint analysis of these factors showed that childbearing during the latter half of reproductive life had a substantial effect on the incidence of thyroid cancer; for any given level of parity, there was about a 2-fold increased risk if the age at last pregnancy was > or = 30 years. A substantial recent-birth effect, in relation to subsequent diagnosis of thyroid cancer, was observed during the second and third year after a birth (OR = 2.0; 95% CI: 1.0-4.1). In contrast, spontaneous abortion seemed to have a protective effect. There was a significant decrease in risk among women who had a miscarriage as outcome of first pregnancy (OR = 0.1; 95% CI: 0.03-0.4) and those who had experienced > or = 3 miscarriages (OR = 0.3; 95% CI: 0.1-0.8; p-trend <0.05). Overall, any female hormone use was not associated with thyroid cancer risk. New association is suggested for a history of post-partum thyroiditis (OR = 10.2; 95% CI: 2.3-44.8). These data support the hypothesis that reproductive factors and patterns may influence, or contribute to, the risk of thyroid cancer among women.

Adenocarcinoma, Follicular↗

PubMed1982

Effect of modernization on Kuwaiti women.

This research explores the effects of rapid modernization on women who, on one hand, have new educational and occupational opportunities and, on the other hand, still confront conservative societal restrictions based on Middle Eastern norms and values. The setting is the Sheikdom of Kuwait, symbolizing a traditional society that has been recently catapulted into the 20th century through its rapid increase in wealth. Such sudden wealth, with ensuing modernization, is expected to have more profound effects on women because of their paradoxical world with its conflicting norms and values. This study explores the relationship between a number of modernization variables--levels of education and occupation--on potential stress. Indicators for stress used are based on Inkeles' cross-cultural studies and psychosomatic complaints. In addition, the study considered levels of powerlessness, happiness and decision making in the family. Spearman correlations and Kendall's Tau were used to determine relationships. Results indicate that women who have obtained more education tend to participate significantly more in decision making in the family (P less than 0.0001), be happier (P less than 0.000), manifest fewer psychosomatic complaints (P less than 0.05), and be older in age. The younger generation, with less education, appears to manifest more somatic complaints. The manuscript discusses results in relation to Inkeles' previous cross-cultural research on men and implication of findings on changing roles of women in Kuwait.

Cultural Characteristics↗

PubMed1990

Reliability of death certificate diagnoses.

Consistency between death certificates and clinical records from 5 general hospitals in Kuwait was studied for 470 deaths with the following underlying or associated causes: hypertensive (HYP), ischaemic heart diseases (IHD), cerebrovascular diseases (CVD) and diabetes mellitus (DM). Direct causes were not considered since they are of little interest analytically. Only deaths with definite or most probable ascertainment were included. One cardiologist, who was provided with the WHO criteria and relevant documents on death certification, independently reviewed the records. To test the reviewer's bias and the reliability of his judgement, an adjudication process was effected by having one senior cardiologist re-review a random subsample of 140 records. The two reviewers showed good agreement. Specific diagnoses criteria for deciding the underlying cause of death in multiple morbid conditions by the reviewer were followed. Due to possible reviewer bias, we aimed at measuring the difference between initial certifiers and the reviewer rather than measuring the diagnostic accuracy of initial certifiers in reference to the reviewer. The agreement index kappa showed poor agreement between original and revised certificates. The original certificates under-estimated CVD as an underlying cause of death by 69.2%, DM by 60%, IHD by 33.5% and HYP by 31.8% in our sample. Associated causes were also consistently under-estimated by initial certifiers as compared with the reviewer. This bias calls for basing mortality statistics in Kuwait on hospital death committees' reports rather than on initial certifier death certificates, use of multiple-causes of death instead of one underlying cause and adequate training of the medical profession on the value and process of death certification.

Adolescent↗

PubMed2006

Polymorphism of p53 gene codon 72 in Kuwaiti with coronary artery disease and diabetes.

BACKGROUND AND AIM: Polymorphism in the p53 gene at codon 72 has been linked to the development of certain diseases including cancer. A possible association between such polymorphism and the development of coronary artery disease (CAD) and diabetes is being investigated, but no conclusive evidence has been reached yet. Our study is the first pilot study to be conducted on Kuwaitis suffering from CAD and diabetes, aiming at investigating the possible existence of the above association. MATERIALS AND METHODS: We analyzed the genotype distribution and allele frequency of p53 gene at codon 72 in 158 CAD samples and 110 controls, and in 142 diabetic and 130 controls. RESULTS: Analysis of CAD patients revealed an alarming significant association between the disease and the existence of diabetes (P=0.0007). Also, the CAD patients had significantly higher level of triglyceride (P<0.0001) and cholesterol (P<0.0001) as compared to control. As for the polymorphism in p53 gene codon 72, we could not detect any association with the genotype Pro/Pro, Pro/Arg or Arg/Arg distribution (P=0.28) or allele (Pro or Arg) frequency (P=0.25) in the CAD patients. Similarly, no association was found with the genotype Pro/Pro, Pro/Arg or Arg/Arg distribution (P=0.44) or allele (Pro or Arg) frequency (P=0.26) in the diabetic patients. CONCLUSION: CAD seems to be strongly linked to diabetes in Kuwait. Polymorphism in the p53 gene at codon 72 revealed no significant association with the development of CAD or diabetes in Kuwait, which confirms other similar results obtained in the US and Asia.

Adult↗

PubMedDate not supplied

A cytogenetic study of Kuwaiti couples with infertility and reproductive disorders: short arm deletion of chromosome 21 is associated with male infertility.

Chromosomal anomalies may be a reason for both male and female infertility. The aim of this study was to investigate the contribution of chromosomal abnormalities in sterile couples from Kuwait. A total of 118 patients with clinical diagnosis of infertility was analyzed using cytogenetic banding techniques. Common chromosomal abnormalities were detected in 12 patients. We describe here one new case of an infertile male with the karyotype 46,XY, del(21)(pter;q11.2). The overall incidence of 11% abnormality indicates that routine chromosome analysis of infertile couples in Kuwait should be considered before the planning of intracytoplasmic sperm injection.

Adult↗

PubMed1998

Lead, nickel and vanadium in seafood: an exposure assessment for Kuwaiti consumers.

Human exposure to lead (Pb), nickel (Ni) and vanadium (V) through the ingestion of six species of fish and two species of shrimp in Kuwait are determined. The study on seafood consumed by the Kuwaiti residents was analyzed by conducting a survey in five districts of the country, namely, Kuwait city (Capital), Farwaniya, Jahra, Hawaly and Ahmedi. Samples consisting of fish and shrimp were purchased from the local fish market during November 1995 and June 1996. Based on the survey, three major factors were investigated: (i) Pb, Ni and V concentration in the fish of locally consumed fish and shrimp; (ii) daily dietary intake of these elements in humans through consumption of seafood; and (iii) characterizing potential health risks associated with the estimated daily intakes. The risk associated with Pb, Ni and V in seafood was estimated based on a Hazard Index (HI). Although the highest HI (using the 95th percentiles of the daily intake of the element as the dose of concern) was observed for zobaidy, hamoor and shrimp, it is always < 1. This indicated that no serious health threats are associated with oil-related elements in fish and shrimp.

Animals↗

PubMed1989

Estimation of fertility and mortality of the Kuwaiti population.

Indirect techniques are applied to estimate the current level of fertility and mortality among Kuwaiti nationals in Kuwait during 1980-85. The various methods discussed provide estimates in the vicinity of 45 per thousand for birth rate and 8 per thousand for death rate. While child spacing by birth order in Kuwait is about 2 years, the proportion of childlessness is very low (1%). As a consequence of lower mortality and stable high fertility, the Kuwaiti population remains young.

Adolescent↗