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PubMed1998

The Gulf crisis experience of Kuwaiti children: psychological and cognitive factors.

This study examined a stratified random sample of 233 Kuwaiti 8- to 12-year-old boys and girls, in order to assess their level of exposure to violence during the Iraqi occupation of Kuwait and its relation to psychological and cognitive performance 1 year after the crisis. Children were assessed on intelligence, posttraumatic stress, and depression, and were interviewed about their crisis experience. No significant decline in intelligence scores was detected after the crisis. A difference in level of parental depression was found between those who stayed in Kuwait as compared to those who were out for all or part of the crisis. Depression in children was low but associated with the level of exposure to violence as reported in the interview, and greater levels of posttraumatic stress. The results support the hypothesis that acute trauma resulting from exposure to violence is related to posttraumatic stress in children.

Adult↗

PubMed1998

International collaboration in the development of postgraduate research training (692).

Research training leading to a higher degree can be difficult for those who live in countries where advanced educational facilities are not yet available, since it may involve translation of a whole family to a foreign country with resultant language, financial and cultural problems. There are special difficulties for females and those of the Moslem faith, who may have been married early and already have a family by the time of initial graduation. There may also be cultural difficulties preventing overseas study for the unmarried female. This paper describes a flexible approach developed by the University of Aberdeen in association with the Ministry of Health in Kuwait. This was an MSc course on the process of continuous quality assurance in medical practice which was based on the concept that research training was the best means of evaluating and measuring quality. The students were finally assessed on the quality of their research dissertation. The course, which was part-time, and thus lasted for 2 years, required them to spend 12 weeks in each of two successive summers in Aberdeen. The subject chosen for each dissertation was related to the work area of the candidate and was studied in the country of origin with the help of periodic visits by the supervisors. The results were surprisingly successful since the students became highly motivated by the problems of their own country and were encouraged by their colleagues at home. The process could have been even more successful if videoconferencing facilities had been available at both the Aberdeen and Kuwait centres. It is concluded that a more flexible approach by western universities would result in an increase in both the quantity and the quality of postgraduate study.

Education, Medical, Continuing↗

PubMed2002

The aetiology and pattern of recurrent pregnancy loss.

The aims of this study were to determine the aetiological factors and the pattern of recurrent pregnancy loss in Kuwait. Ninety consecutive patients attending the special recurrent miscarriage clinic were studied prospectively. A comprehensive history of all previous miscarriages and pregnancies, past medical and gynaecological events were established. A physical examination was performed. Extensive investigations were performed. Pregnancies which occurred during the study were monitored carefully. The mean age of the patients was 30.46+/-6.04 years. The patients were subdivided into the groups of secondary (57%) and primary (43%) recurrent miscarriages. Eighty-five per cent of all previous miscarriages occurred in the first trimester. The main aetiological factors were uterine anomaly 2.2%, chromosome anomaly (parental) 2.2%, PCOS, infections and other miscellaneous factors 21.1%, positive antiphospholipid antibodies 33.3% and unexplained in 35.6%. The overall live birth rate was 82% and maternal morbidity was low. Positive antiphospholipid antibodies are the most frequently associated cause of recurrent pregnancy loss in Kuwait.

Abortion, Habitual↗

PubMed1985

High incidence of lead poisoning revealed by erythrocyte protoporphyrin (EPP) screening in Arabian children.

The measurement of erythrocyte protoporphyrin (EPP) has been used in screening infants for undue exposure to lead. The infants were from a high risk area, Al Jahra in Kuwait, and were selected from those attending the emergency department of Al Jahra District Hospital. Dried spots of blood on Guthrie filter paper were mailed to the Central Laboratory of the Children's Hospital in Buffalo, New York. Elevated EPP values (greater than 50 micrograms/dl) were present in 63 (66%) out of 96 tests. Forty-four of the infants with elevated values were investigated further: 16 had blood lead levels above 30 micrograms/dl (1.45 mmol/l) and 12 had evidence of iron deficiency anaemia. Five infants with blood lead levels above 80 micrograms/dl (3.9 mmol/l) needed urgent chelation and in addition an 8-month-old infant with the highest EPP value (478 micrograms/dl) died of acute lead encephalopathy. We conclude that lead poisoning is a serious problem in Al Jahra, Kuwait, and that a comprehensive programme for screening and health education are urgently needed to avoid the irreversible effects of lead toxicity.

Child, Preschool↗

PubMed2001

Prevalence of coronary risk factors in healthy adult Kuwaitis.

Obesity has been shown to be a serious health risk and is associated with a wide range of comorbid conditions, including diabetes mellitus, coronary heart disease (CHD), gall bladder disease, hypertension, osteoarthritis, and certain cancers. Studies in Kuwait and other Gulf States indicate that obesity is prevalent and may be increasing. Previous studies in Kuwait have mostly focused on the epidemiology of overweight and obesity in children, adolescents, and young adults. Relatively less is known about the prevalence of overweight and obesity and its correlates in older adults for whom obesity may be more closely related to CHD risk. The purpose of this study was to examine the prevalence of overweight and obesity in 9755 adult men and women and to determine the relationship of weight to other risk factors for chronic disease. For the first time we examine a sample of older Kuwaitis to explore the relationship between high BMI, hypercholesterolemia and hyperglycemia. One-third of adult Kuwaitis are obese (BMI > 30 kg/m2), 4.7% of Kuwaiti females have severe obesity (BMI > 40 kg/m2). BMI, cholesterol, and glucose values increase with age across the life span. Older Kuwaitis have a greater constellation of risk factors for chronic diseases. The results of a multiple linear regression model in which cholesterol values were studied, controlling for age, BMI, blood glucose, and sex revealed that age, BMI and sex were significant predictors of cholesterol values. These results indicate that actions to reduce obesity, hypercholesterolemia, and hyperglycemia are needed.

Adult↗

PubMed2004

Changes in the environmental parameters of treated wastewater in soils.

Available data about treated sanitary and industrial wastewater in Kuwait were collected and reviewed. Potential changes in the environmental parameters of these waters when permeated through predominantly loamy sand soil samples collected from three agricultural sites in Kuwait, an arid land desert area. The environmental parameters investigated included pH, dissolved oxygen (DO), total Kjeldahl nitrogen (TKN), total organic content (TOC), and total hydrocarbon content (THC). The results indicated these parameters have generally reflected marked variations. These variations were attributed to the interactions between soil, soil pore water, and influent wastewaters used in this study. The results also indicated that the above-investigated environmental parameters stayed well within the allowable limits set for the reuse of tertiary treated sanitary and industrial wastewaters in agricultural irrigation applications.

Data Collection↗

PubMed2006

Implant recommendation as a replacement option after tooth loss for periodontal reasons.

PURPOSE: The aim of this study was to examine the frequency of implant recommendation by general dental practitioners to patients who had extractions as a result of periodontal disease and factors that influenced their decisions. MATERIALS AND METHODS: Dentists in each of 20 general dental practice centers in Kuwait were asked to document replacement options given to patients after all tooth extractions performed for periodontal reasons within a 30-day period. The association of demographic and medical/dental history variables with the decision to recommend an implant was statistically tested. RESULTS: A total of 711 patients with a mean age +/- of 47.34 +/- 0.45 years (range 18-96) had 2202 teeth extracted for periodontal reasons during the study period. Only 21 implants for 12 patients were offered as a replacement option (1.7%). Factors significantly associated with a less likelihood of implant recommendation included older age, male gender, diabetes mellitus, inadequate compliance with regular periodontal maintenance visits, inadequate oral hygiene practices, and anterior tooth types (P < 0.05; chi test). CONCLUSION: Dental implants were rarely recommended to patients losing their teeth for periodontal reasons by general dentists in Kuwait.

Adolescent↗

PubMed1990

Childhood bronchial asthma in a desert country.

A 3 year-study of emergency room visits (total 50,300) to the paediatric clinic of the main teaching hospital in Kuwait revealed that the rates of bronchial asthmatic attacks increased significantly from 8.8% of all visits during the 1st year to 14.9% during the 3rd year. The seasonal distribution of asthmatic attacks showed maximum rates during the winter and minimum values in the summer, giving a very close inverse correlation to temperature and direct correlation to relative humidity. A similar, excellent correlation was seen between asthmatic attacks and upper respiratory infections. Occurrence of atmospheric pollen, which characteristically shows a bi-annual pattern i Kuwait, was not found to correlate with asthma attack rates. Neither was there any demonstrable effect of dust storms on the frequency of asthmatic attacks in the children. Independent of season, the boy to girl ratio among the asthma cases was remarkably constant, around 2:1.

Asthma↗

PubMed1996

An optimized model for substitution of expatriate workforce in a Gulf-Council country: the Kuwaiti case.

"This article is based on data from a research project carried out during 1992-1994 to achieve a replacement mechanism and a model for the substitution of expatriate labour by Kuwaiti nationals. Since Kuwait can readily enforce its Kuwaitization policy in the public sector, the presented model aims at reducing the share of non-Kuwaitis in that sector over five years. Published data on distribution of the workforce in the public sector by nationality indicate that the non-Kuwaiti share of the total workforce is 38 per cent. The majority of [migrant] workers are unskilled or semi-skilled and engaged in production, commerce and services. Sex ratios are unbalanced and workers exhibit a high rate of literacy...." (SUMMARY IN FRE AND SPA)

Asia↗

PubMed1990

The effect of established and gestational diabetes on pregnancy outcome.

OBJECTIVE: To study the prevalence and type of glucose intolerance in pregnancy and the effect of different types on perinatal mortality and fetal size. DESIGN: A prospective case-control study with data collected by patient interview and examination of all available records during a 16-months period between 1984 and 1986. SETTING: A large maternity hospital in Kuwait where diabetes in pregnancy is common. SUBJECTS: The cases were a consecutive sample of 731 women, delivered during the study period, recorded in the labour ward register as being diabetic or having abnormal glucose tolerance, the control group was formed from the next woman in the register (provided she was not known to be diabetic). MAIN OUTCOME MEASURES: Type of diabetes followed the WHO classification, with subdivision depending on level of fasting plasma glucose. Type of perinatal death was examined in detail and birthweight centile calculated. RESULTS: Of the 731 cases, 22% were established diabetics, most were treated with oral hypoglycaemic drugs before pregnancy and insulin during pregnancy. Of those discovered during pregnancy, 43% were classified as gestational diabetes and the remainder as impaired glucose tolerance. Overall, 50% of cases were treated with insulin. Established diabetics had a perinatal mortality rate nearly four times greater than non diabetics (RR, 3.7, 95% CI 2.6 to 6.4) and for gestational diabetics RR was 2.0 95% CI 1.2 to 3.7). Unexplained deaths were particularly common, both in established diabetics (RR, 18.4, 95% CI 3.9 to 85.7) and in gestational diabetics (RR, 13.4, 95% (CI 2.9 to 61.6). Cases with impaired glucose tolerance had no stillbirths and had a lower perinatal loss than the controls, though this was not statistically significant. Heavier babies were seen in all case groups compared with controls, though the impaired glucose tolerance group had lower birthweights than the other two case groups. CONCLUSIONS: Type 2 diabetes was found to be common, most cases being diagnosed in pregnancy. Under the conditions found in Kuwait, diabetes, in the sense of a raised fasting glucose, is accompanied by a high rate of perinatal loss from unexplained stillbirth. This applies whether the condition was present before pregnancy or was discovered during pregnancy. Fetal macrosomia was also common in both situations. Impaired glucose tolerance, where fasting levels remain normal, does not appear to increase fetal loss, but may be associated with fetal macrosomia. As these women age they are likely to develop overt diabetes in the non-pregnant state, and subsequently to develop serious complications of this disease. Improving glycaemic control, both during preg

Adult↗

PubMed1999

Influence of seasonal variation on pregnancy-induced hypertension and/or preeclampsia.

Seasonal variation of temperature and humidity are said to influence the incidence of hypertensive disorders of pregnancy. The aim of this study was to determine if temperature and humidity exert any influence on the incidence of pregnancy-induced hypertension and preeclampsia in Kuwait. This is a retrospective study performed in the Maternity Hospital, Kuwait (MHK) in the years 1992-1994. Monthly distribution of all deliveries and those in which the patients had pregnancy-induced hypertension and preeclampsia were recorded. There are some studies including ours which do not show any significant correlation between meteorological factors and hypertensive disorders of pregnancy. We found that the incidence of pregnancy-induced hypertension per 1,000 deliveries was high in June when the temperature was very high and the humidity at its lowest. The reverse was true for the incidence of preeclampsia per 1,000 deliveries, which was high in November when the temperature was low and the humidity high.

Female↗

PubMed2002

Performance of students in the final examination in paediatrics: importance of the "short cases".

AIMS: To determine which component of the final examination in paediatrics at Kuwait University best predicted the final outcome. METHODS: The performance of 356 medical students in the short cases, the long case, multiple choice questions (MCQs), and the essay components of the final examination in paediatrics at Kuwait University was correlated with the final grade, and the mean difference between each component and the final score calculated. RESULTS: The correlation was highest for the short cases, followed by MCQs, the long case, and essays. The mean difference between the final score and that of short cases was not significant, but was highly significant for the other components. CONCLUSION: Results show that performance in the short cases component of the final examination in paediatrics is a better discriminator of competence than that in the long case.

Achievement↗

PubMed1991

Detention of British citizens as hostages in the Gulf--health, psychological, and family consequences.

OBJECTIVE: To describe the physical, psychological, and family consequences of the detention of British subjects as hostages in Kuwait or Iraq, or both, after the invasion of Kuwait on 2 August 1990 and to investigate the relation between types of trauma experienced and these reactions. DESIGN: Postal questionnaire. SUBJECTS: 381 respondents. RESULTS: Many health, social, and psychological sequelae were identified. Problems with present finance, accommodation, and work are important causes of distress. Many hostages coped well and gained self esteem. CONCLUSIONS: A minority of respondents require further support and treatment. Expatriates in risk areas should retain assets in their home country.

Adult↗

PubMedDate not supplied

Monoclonal gammopathy among patients with chronic hepatitis C infection.

OBJECTIVE: To determine the prevalence of monoclonal gammopathies in Kuwait and its association with chronic hepatitis C virus (HCV) infection. METHODOLOGY: Serum protein electrophoresis and measurement of immunoglobulin levels were carried out prospectively in 100 consecutive patients with chronic HCV infection. RESULTS: Among the 100 patients tested (82 males, 18 females; median age 45 years), 59 had polyclonal band in serum protein electrophoresis while the other 41 had a normal pattern. None of the patients had monoclonal gammopathy. The mean serum immunoglobulin levels were: IgG 18.4 g/l (range 4-39), IgA 2.9 g/l (range 0.09-8) and IgM 1.6 g/l (range 0.14-6.08). CONCLUSION: There was no evidence of monoclonal gammopathies in patients with chronic HCV infection in Kuwait.

Electrophoresis↗

PubMedDate not supplied

Differences in physician compliance with guideline on lipid profile determination within 24 h after acute myocardial infarction.

OBJECTIVE: To evaluate the American College of Cardiology/American Heart Association guidelines on blood lipid testing within 24 h of the onset of chest pain in patients with myocardial infarction. SUBJECTS AND METHODS: This is a cross-sectional observational study on 83 patients (77 male, 6 female) admitted into the Coronary Care Units of the Al-Amiri and Mubarak Al-Kabeer Hospitals, Kuwait with myocardial infarction. The lipid profiles were obtained within 24 h of the onset of chest pain. Twenty patients were on treatment with statins prior to admission. Diagnosis of myocardial infarction in all patients was based on standard criteria. Total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and triglycerides (Tg) were measured and low-density lipoprotein (LDL) cholesterol was calculated. RESULTS: Twenty-three patients had normal cardiac markers on admission but later developed increased serum markers and ECG changes of acute myocardial infarction. Mean (95% confidence interval) TC, HDL, Tg and LDL were 5.1 (4.8-5.4); 0.93 (0.88-0.98); 1.85 (1.56-2.14), and 3.39 (3.13-3.65) mmol/l, respectively. 70% of the patients had normal or only mild elevations of LDL with low HDL and poor HDL:TC ratio (<20%). Thirty-eight patients had low HDL (<0.9 mmol/l) and only 22 (27%) patients met the National Cholesterol Education Program guideline of target LDL <2.6 mmol/l. Fifty-six patients were classified as having the metabolic syndrome according to the criteria of the WHO. CONCLUSION: The findings indicate that HDL appears to be the main lipid risk factor in patients presenting with AMI in Kuwait, therefore primary prevention strategies should focus on treatment modalities that increase HDL. We recommend that the lipid profile should be done within 24 h of admission and lipid-lowering therapy initiated as part of secondary prevention strategy.

Adult↗

PubMed1987

Asthma and serum IgE levels in children in a desert country.

The frequency of asthma admissions to the paediatric outpatient clinic in a teaching hospital in Kuwait was found to increase from 8.8 to 14.9% of all admissions during a 3-year period. Seasonal variation of admissions was consistent, with peak incidences during the cold and humid months. The incidence of asthma was remarkably well correlated to low temperature and high frequency of upper respiratory infections but not to pollen seasons or occurrence of dust storms. In agreement with the clinical impression that atopic allergy is frequent in Kuwait, high levels of IgE were found in different groups of individuals. In umbilical cord serum, elevated IgE levels in blood donors and in children with asthma or other diseases were clearly higher than those found in corresponding groups in Western countries. Possible factors contributing to the generally increased IgE levels may be endemic diseases, like viral hepatitis and brucellosis.

Asthma↗

PubMed1995

The growth pattern of Kuwaiti pre-school children. Compared to NCHS/CDC reference population.

The aim of this study was to present growth charts of pre-school children based on cross-sectional data of the population in Kuwait to determine their health status. This survey was carried out during September 1989 to June 1990. The growth patterns of weight and heights per age were designed separately for boys and girls. The growth pattern of height for age, and weight by age were constructed and smoothed by the spline regression polynomial technique. The girls were taller than the boys after the age of one year. The growth deficit in children from Kuwait compared with internationally recommended reference populations may be attributed to genetic and environmental factors. The growth pattern presented here will suffice as a standard in monitoring the growth of Kuwaiti children in particular and those in the Gulf region in general.

Age Factors↗

PubMed1998

Pulmonary toxicity in hamsters of smoke particles from Kuwaiti oil fires.

The Kuwaiti oil wells set on fire by retreating Iraqi troops at the end of the Persian Gulf War released complex particles, inorganic and organic gases, and hydrocarbons into the atmosphere, damaging the environment where many people live and work. In this study, we assessed the health effects of particles from the Kuwaiti oil fires by instilling hamsters intratracheally with particles (<3.5 microM in size) collected in Ahmadi, a residential area in Kuwait located downwind of hundreds of oil fires. Twenty-four hours after instillation, we performed bronchoalveolar lavage (BAL) to assess various indicators of pulmonary inflammation, including neutrophil and macrophage numbers; albumin, an index of air-blood barrier permeability; and activities of three enzymes: lactate dehydrogenase (LDH; an indicator of cell injury), myeloperoxidase (MPO; which indicates activation of neutrophils), and ss-N-acetylglucosaminidase (GLN; which is indicative of damage to macrophages or neutrophils). We compared the response of hamsters instilled with particles from Ahmadi to animals instilled with urban particles collected in St. Louis, Missouri. We also compared the Ahmadi particles against a highly fibrogenic positive control ([alpha]-quartz) and a relatively nontoxic negative control (iron oxide). When compared to hamsters instilled with particles from St. Louis, the animals treated with the Ahmadi particles had between 1.4- and 2.2-fold more neutrophils in their BAL fluids. The Ahmadi hamsters had more macrophages and lower MPO and LDH activities, but comparable albumin levels and GLN activities. Thus, the acute toxicity of the Ahmadi particles was roughly similar to that of urban particles collected in the United States, when identical masses were compared. However, the relatively higher concentrations of particles measured in Kuwait and Saudi Arabia during the oil fires (at times more than 16 times higher than the EPA standard) is of particular concern. In addition, since the long-term effects of exposure to these particles remains unknown, further studies are needed to fully assess the health effects of the Kuwaiti oil fires.

Animals↗