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PubMed2000

Retinopathy of prematurity in infants with birth weight above 1500 grams.

OBJECTIVE: To identify the rate and prognosis of retinopathy of prematurity (ROP) among newborn infants of birthweight of above 1500 grams, and the possible risk factors associated with the disease. DESIGN: A prospective cohort study. SETTING: Neonatal unit at Maternity Hospital, Kuwait city, Kuwait. METHODS: All low birth weight infants were examined for the presence of ROP in the period between January 1996 to December 1997. Prospective collection of data on babies who were above 1500 grams was done to find an association between the disease in these babies and some of the maternal and neonatal risk factors. RESULTS: A total of 68 babies of birth weight above 1500 grams were screened for ROP out of which 13 (19.1%) had different stages of the disease. None of the patients had threshold disease requiring surgery. Among the risk factors chosen, oxygen therapy, presence of hypotension at birth and the non-use of surfactant were the only risk factors to be associated with disease. However, with logistic regression analysis, none of these were independently associated with ROP. CONCLUSION: ROP may occur in newborn infants of larger birthweight but with good prognosis, and oxygen therapy seems to predispose to the disease.

Cohort Studies↗

PubMedDate not supplied

Clinicopathological features in 102 cases of Hirschsprung disease.

BACKGROUND: Hirschsprung disease [HD] is a predominantly childhood disorder of intestinal motility with a multifactorial and polygenic etiology. The objective of this study was to document the clinical and pathological features of HD in Kuwait, which has an estimated consanguinity rate of 54%. METHODS: We analyzed all rectal and colonic biopsies (n=268) for suspected HD identified from the records in the Pathology Department of Al-Sabah Hospital for the period between 1994 and 2004. RESULTS: One hundred and two patients (87 males and 15 females) had histologically confirmed HD. Fifty-eight (57%) were neonates (<1 month of age), while 21% were more than 4 months old. The diagnosis was based on open biopsy in 11 cases and rectal biopsies in 91 cases. Nine patients with open biopsies presented as intestinal obstruction, necrotizing enterocolitis, or perforation. The extent of the disease was unknown in 13 patients. There were 67 males and 3 females with short segment HD. Nine had long segment, two ultra-short segment and eight total colonic aganglionosis (TCA). Five TCA cases involved the small intestine. A skip area was observed in two cases. Six patients had other anomalies. A positive family history for HD was established in three patients. Two of these were male siblings from a consanguineous marriage and had Waardenburg syndrome. CONCLUSION: This study has highlighted an exceptionally strong male predominance of short segment and a relatively high frequency (5.6%) of small intestinal involvement in HD in Kuwait. These data call for a more detailed epidemiological study with special emphasis on genetics.

Adolescent↗

PubMed2000

The surgical pathology and cytopathology of US Persian Gulf War military veterans.

BACKGROUND: Tens of thousands of Persian Gulf War veterans (GWVs) have presented with medical symptoms since Operation Desert Shield and Operation Desert Storm. The Kuwait Registry at the Armed Forces Institute of Pathology was established to act as a repository for surgical pathology, cytopathology, and autopsy material from GWVs. OBJECTIVE: To identify conditions known to be endemic to the theater of operations in our cohort of GWVs. METHODS: The Kuwait Registry database was searched by computer for listed conditions endemic to the Persian Gulf region included in the registry through December 31, 1997. RESULTS: Of the 2582 patients in this cohort, 1 patient with hepatitis B and 15 patients with hepatitis C were identified. Other known endemic conditions of the Persian Gulf region were not found. CONCLUSIONS: Viral hepatitis (B and C), which is prevalent in the US population, was the only listed endemic condition identified in surgical pathology or cytopathology specimens in our cohort of GWVs.

Adult↗

PubMed2000

[Rates of stillbirths in Kuwaiti women with non-insulin-dependent diabetes].

The objective of the present study was to discern stillbirth rates in patients diagnosed as having NIDDM. Also, it describes sociodemographic characteristics, and diabetes related factors that distinguish women with established NIDDM who experienced repeated stillbirths from those who did not. The sample data by 99 Kuwaiti women with NIDDM who are still in the reproduction-age are from a cross-sectional survey carried out in 1995/96. A high prevalence of obesity, illiteracy, and reported physical inactivity was associated with NIDDM. Stillbirth rates (rate per thousand deliveries) were 76.5 in comparison to 6.9 from general population in 1996 in Kuwait. Logistic regression analysis showed that housewives were less prone to stillbirths and that repeated stillbirths were associated with abortions. Reproduction and diabetes were mainly researched in patients with Type I diabetes. A high prevalence (18.1%) of NIDDM (non-insulin-dependent diabetes mellitus) in women in Kuwait, and a younger age at diagnosis can have an impact on the reproduction pattern. There is a need to implement the appropriate interventions to reduce risk for stillbirths in women with special risk profiles.

Adolescent↗

PubMed2000

Assessment of posttraumatic stress disorder four and one-half years after the Iraqi invasion.

In the earliest formulations of posttraumatic stress (PTS) and even posttraumatic stress disorder (PTSD), it was clear that war could engender PTSD within both primary and secondary victims. The clinical course of PTS and PTSD is not always clear, but the disorder may persist months and even years after the precipitating traumatic event. The current study was undertaken in an effort to assess the prevalence of PTSD in a sample of 404 Kuwaiti citizens 4.5 years after the invasion and occupation of Kuwait by the Iraqi Army. Results indicate a psychometrically assessed prevalence of PTSD of 28.4%. A subsample of 195 students revealed a prevalence of 45.6%. If correct, these data are worrisome indeed and point to 1) a significant public health challenge facing the government of Kuwait, as well as, 2) the increased sensitivity of the young to traumatic stress, both personally and vicariously. Based upon the current data, there may exist a virtual epidemic of posttraumatic stress disorder within the Kuwaiti population 4.5 years after the end of the Iraqi occupation. These data argue the need for a comprehensive confirmatory epidemiological investigation in the current prevalence of posttraumatic stress disorder within the Kuwaiti population so that appropriate resources may be further directed to address what may be a significant public health problem.

Adult↗

PubMed1999

The impact of parental disruption on Kuwaiti adolescents: a comparative study on children from intact and broken families.

Divorce, which was once a rare phenomenon in Kuwait, now occurs in nearly one third of all marriages. The purpose of this study was to compare the differences in self-esteem, locus of control, and attitude toward parents between Kuwaiti adolescents from divorced and intact families. The results revealed that adolescents from divorced families showed higher self-esteem than adolescents from intact families. Within the divorced families, females showed higher self-esteem compared to males. There was no difference in locus of control between divorced and intact families nor were there any gender differences. Divorced fathers were evaluated negatively by their children whereas divorced mothers were evaluated positively. These data are believed to be the first of its kind from divorced families in Kuwait or the Middle East.

Adolescent↗

PubMed1983

A note on the accuracy of count of Kuwaiti population. 1980.

"This note shows that a reason for the annual rate of growth of Kuwaiti population between 1975 and 1980...being lower than the projected value...is the improved accuracy of the count of Kuwaiti population of Kuwait, resulting from the requirement of production of proof of Kuwaiti Nationality, insisted [on] at the 1980 Census of Kuwait."

Asia↗

PubMed2005

Middle East aircrew use of alcohol, tobacco, coffee, and medicaments.

OBJECTIVE: The purpose of this study was to assess the prevalence of the use of alcohol, tobacco, coffee, and various medications among flying crew and clerks working in a ministry in Kuwait. METHODS: In a cross-sectional study, a self-administered questionnaire was filled in by 277 flying crew and 302 clerks of a comparable age and gender ratio. RESULTS: Frequencies of using alcohol, tobacco, coffee, and various medications were much higher among flying crew as compared to clerks. Flying crew were a very homogenous group in terms of exposure to the substances studied with only two exceptions: younger people were more likely to drink alcohol abroad (but not in Kuwait), and cabin crew relied on herbal medicine more than pilots. CONCLUSIONS: Flying crew differ very much from a socially comparable segment of the local population, but it is not possible to discern the impact of occupational risks (jet leg and night shifts) from exposure to foreign influences and, as for alcohol and sedatives, from easier availability.

Adult↗

PubMed2006

Dental caries experience of Kuwaiti schoolchildren.

OBJECTIVE: This study was designed to measure the dental caries experience of Kuwaiti schoolchildren. METHODS: A national epidemiologic survey of the 5-14 year old children (n = 4,588) was conducted in the 5 governorates of Kuwait in 2001. Eight trained and calibrated dentists examined the children. Dental caries was scored using WHO criteria. RESULTS: In the primary dentition, the percentage of 5- and 6-year-old children with dft = 0 was 12.6% and 14.4% respectively. The corresponding mean dft/dfs for 5- and 6-year-olds were 4.6/9.7 and 4.6/9.9. For the permanent dentition, the percentage of 12- and 14-year-old children with DMFT = 0 was 26.4% and 21.7% respectively. The corresponding mean DMFT/DFS figures for 12- and 14-year-olds were 2.6/3.4 and 3.9/4.2. The d/D component was the major contributor to these mean scores. Poor oral hygiene (OR = 2.0; 95% CI = 1.7 - 2.4) and increasing age (OR = 1.4; 95% CI = 1.3 - 1.5) were significantly associated with caries risk in the permanent dentition. CONCLUSIONS: Caries levels are similar to those in neighbouring and other Middle East countries. There is a clear need for expanding the national school oral health programme to reach those children who are not yet receiving systematic preventive and curative services. Further studies are required to monitor the effect of the extensive caries preventive programme now in place in Kuwait.

Adolescent↗

PubMed1978

Poliomyelitis survey in Middle-East countries.

The poliomyelitis survey was started in 1976 in Bahrain and Kuwait. For each paralytic case, diagnosis was done by virus isolation, neutralizing antibody titration and specific IgM characterization. More than 90% of the infants who were ill were less than 2 years old. In Bahrain, 17 paralytic cases in 1976 and 12 in 1977 occurred between January and July (annual incidence was respectively 7.7 and 5.4/100,000). The first epidemic was due to poliovirus type 2, the second one to poliovirus type1. From 29 cases, 13 occurred in vaccinated infants of which 9 received 3 or 4 oral vaccine doses. For 3 infants, paralysis occurred less than one month after vaccination. All the isolates were wild polioviruses (rct). In Kuwait, 119 cases were examined, and of them, 57 occurred between August 76 and May 77 (incidence 5.7/100,000). Poliovirus type 1 was responsible for 61% of cases, type 2 for 5% and type 3 for 12%. From October 1976 to December 1977, 350 stools samples were collected from contacts: 19% of them carried poliovirus (12% type 1, 1% type 2 and 6% type 3). All the viruses isolated from both paralytic cases and contacts were wild strains (rct). Of 119 cases, 35 occurred in vaccinated infants from which 4 had received 3 or 4 oral vaccine doses. For 11 infants paralysis occurred less than one month after vaccination. The virus spread was evaluated (i) just before vaccination in 337 infants or children from June to December 76: 8% carried poliovirus Sabin-like strains (and 18% non polioviruses), and (ii) one month after vaccination in 75 infants: 37% carried poliovirus Sabin-like strains.

Adolescent↗

PubMed1989

Solitary caecal diverticulitis. Recognition and management.

Nine cases of solitary caecal diverticulitis treated in Kuwait are presented and the literature is reviewed. The preoperative diagnosis was acute appendicitis in all cases, but diverticulitis was detected during surgical exploration and histologically confirmed. The surgical management in seven cases was simple excision of the diverticulum with closure of resultant defect or invagination of the mucosal bulge with suture of the colonic wall. Right hemicolectomy was performed in two cases because of gangrenous patches in the caecal wall and suspicion of carcinoma. Recognition of solitary caecal diverticulitis requires considerable experience, especially in order to avoid more radical procedures such as right hemicolectomy. Solitary caecal diverticulum does not seem to occur in the indigenous people of Kuwait. All nine patients were of other nationalities, including five from countries of the Far East.

Adult↗

PubMed1986

[Hepatocellular carcinoma--its echographic characteristics and diagnostic potentials].

Echography is an approved method for establishing focal processes in liver. Forty five patients, from Bulgaria and Kuwait, with confirmed hepatocellular cancer (HCC) were studied by echographies aiming at the elucidation of the possibilities of ultrasound examination in making the diagnosis of HCC in patients with and without cirrhosis of the liver. Five types of images have been established--hyperechogenic (29%), hypoechogenic (27%), mosaic (24%) mixed (11%) and type "bovine eye" (9%). The echographic characteristics that could suggest the character of the lesion are low-echogenic zone in the periphery and non-homogenous (mosaic) tissue structure. HCC, in 55.6 per cent of the patients, proved to be with multiple localization in liver. The comparison of the patients from Kuwait and Bulgaria revealed no differences in the mean age, carriership of HBsAg, but in the latter--the HCC was significantly more often combined with cirrhosis of the liver. Serum alpha-fetoprotein was increased in 15 out of 20 patients with HCC. The establishment of the tumour in part of the patients by ultrasound initially, suggests that echography is a useful method for the early diagnosis of HCC and for a systematic follow up of the patients with cirrhosis of the liver. Guided fine-needle biopsy was performed in 15 patients, and in 86.7 per cent of the cases--accurate cytologic diagnosis was obtained. Echography, combined with guided biopsy and determination of alpha-fetoprotein, guarantee in a considerable part of the cases, also the correct diagnosis of HCC in patients with and without cirrhosis of the liver.

Aged↗

PubMed1978

Some effects of ingested petroleum on seawater-adapted ducks (Anas platyrhynchos).

Male Pekin ducks adapted to seawater and maintained under sheltered conditions (27 degrees C) in the laboratory may consume considerable volumes of petroleum without showing overt symptoms of distress. Under these conditions, birds consuming petroleum-contaminated food have shown a persistent hyperphagia; this was most apparent among those given food contaminated with South Louisiana crude oil, least apparent among birds given No. 2 fuel oil, and intermediate among those that consumed food contaminated with Kuwait crude oil. When maintained at 27 degrees C, some mortality occurred among the birds given South Louisiana crude oil (22.2%) and No. 2 fuel oil (35.7%), whereas none of the freshwater- and seawater-maintained birds given uncontaminated food and none of the birds given Kuwait crude oil died during this period. Following their exposure to chronic mild cold stress (3 degrees C), mortality occurred in all groups of birds; the birds that had consumed petroleum-contaminated food tended to die earlier and in larger numbers than either the seawater- or freshwater-maintained control birds. These effects suggest that the mortality in all groups of birds was due primarily to the additive effects of a series of nonspecific stressors. Thus, at autopsy, birds that had succumbed to the effects of these stressors frequently showed adrenal hypertrophy and severe involution of the lymphoepithelial tissues. The consumption of petroleum-contaminated food seemed to constitute only one of a series of environmental stressors, and, among birds that were already exposed to stressors such as hypertonic drinking water and persistent cold, the ingestion of petroleum seemed to render them more vulnerable and death frequently ensued.

Animals↗

PubMed2004

Asthma and sensitization in a community with low indoor allergen levels and low pet-keeping frequency.

BACKGROUND: Little is known about causes of asthma and sensitization in desert countries. OBJECTIVE: To investigate risk factors associated with asthma and sensitization in Kuwait. METHODS: One hundred sixty children (9-16 years) with physician-diagnosed asthma were recruited and matched (age, sex) with 303 healthy controls. Risk factors were assessed by questionnaires, determination of sensitization status (skin tests and IgE), and home allergen exposure (mite, cat, dog, cockroach; ELISA). RESULTS: Home allergen levels and frequency of pet ownership were very low (cat, 4.1%; dog, 1.5%). The risk of cat sensitization increased significantly among cat owners (odds ratio [OR], 3.53; 95% CI, 1.33-9.41; P = .01), and in children with reported contact with cats during the first year of life (OR, 2.60; 95% CI, 1.17-5.80; P = .019). In the multivariate analysis, maternal atopy (OR, 1.77; 95% CI, 1.13-2.75; P = .01) and cat ownership (OR, 3.32; 95% CI, 1.19-9.25; P = .02) remained significant associates of cat sensitization. Current dog ownership significantly increased the risk of sensitization to dog (OR, 6.05; 95% CI, 1.33-27.54; P = .02). In the multivariate analysis, dog ownership remained the only significant associate of dog sensitization (OR, 6.02; 95% CI, 1.30-27.96; P = .02). Sensitization to Alternaria was the strongest independent associate of the asthma group. Family history of asthma, history of whooping cough, current cat ownership, and breast-feeding <2 months were other significant and independent risk factors for asthma. CONCLUSIONS: Pet ownership markedly increased the risk of sensitization to pets. Despite low allergen exposure, the pattern of childhood asthma in Kuwait follows that described in Western communities (strong association with sensitization).

Adolescent↗

PubMed2004

Environmental and health consequences of depleted uranium use in the 1991 Gulf War.

Depleted uranium (DU) is a by-product of the 235U radionuclide enrichment processes for nuclear reactors or nuclear weapons. DU in the metallic form has high density and hardness as well as pyrophoric properties, which makes it superior to the classical tungsten armour-piercing munitions. Military use of DU has been recently a subject of considerable concern, not only to radioecologists but also public opinion in terms of possible health hazards arising from its radioactivity and chemical toxicity. In this review, the results of uranium content measurements in different environmental samples performed by authors in Kuwait after Gulf War are presented with discussion concerning possible environmental and health effects for the local population. It was found that uranium concentration in the surface soil samples ranged from 0.3 to 2.5 microg g(-1) with an average value of 1.1 microg g(-1), much lower than world average value of 2.8 microg g(-1). The solid fallout samples showed similar concentrations varied from 0.3 to 1.7 microg g(-1) (average 1.47 microg g(-1)). Only the average concentration of U in solid particulate matter in surface air equal to 0.24 ng g(-1) was higher than the usually observed values of approximately 0.1 ng g(-1) but it was caused by the high dust concentration in the air in that region. Calculated on the basis of these measurements, the exposure to uranium for the Kuwait and southern Iraq population does not differ from the world average estimation. Therefore, the widely spread information in newspapers and Internet (see for example: [CADU NEWS, 2003. http://www.cadu.org.uk/news/index.htm (3-13)]) concerning dramatic health deterioration for Iraqi citizens should not be linked directly with their exposure to DU after the Gulf War.

Environmental Monitoring↗

PubMed2005

Modulation of cytokine production by dydrogesterone in lymphocytes from women with recurrent miscarriage.

OBJECTIVE: To examine the effects of dydrogesterone on the production of Th1 and Th2 cytokines by lymphocytes from women undergoing unexplained recurrent spontaneous miscarriage (RSM). DESIGN: Controlled prospective, clinical study conducted in a maternity hospital and a university-based immunology laboratory. SETTING: Faculty of Medicine, Kuwait University and Kuwait Maternity Hospital. SAMPLE: Thirty women with unexplained RSM. METHODS: Peripheral blood mononuclear cells (PBMC) from women with unexplained RSM were isolated from venous blood by density gradient sedimentation and stimulated with phytohaemagglutinin (PHA). Culture supernatants assayed for interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha, interleukin (IL)-4, IL-6 and IL-10 by ELISA. Levels of the progesterone-induced blocking factor (PIBF) were also measured. MAIN OUTCOME MEASURES: Cytokine production in the presence and absence of progesterone and dydrogesterone. RESULTS: Dydrogesterone significantly inhibited the production of the Th1 cytokines IFN-gamma (P= 0.0001) and TNF-alpha (P= 0.005) and induced an increase in the levels of the Th2 cytokines IL-4 (P= 0.03) and IL-6 (P= 0.017) resulting in a substantial shift in the ratio of Th1/Th2 cytokines. The effect of dydrogesterone was blocked by the addition of the progesterone-receptor antagonist mifepristone, indicating that dydrogesterone was acting via the progesterone receptor. Dydrogesterone induced the production of PIBF. CONCLUSION: Dydrogesterone inhibits the production of the Th1 cytokines IFN-gamma and TNF-alpha from lymphocytes and up-regulates the production of the Th2 cytokines IL-4 and IL-6, inducing a Th1 to Th2 cytokine shift.

Abortion, Habitual↗

PubMed2001

Characterization of OXA-25, OXA-26, and OXA-27, molecular class D beta-lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii.

Carbapenem resistance in Acinetobacter spp. is increasingly being associated with OXA-type beta-lactamases with weak hydrolytic activity against imipenem and meropenem. Such enzymes were characterized from Acinetobacter isolates collected in Belgium, Kuwait, Singapore, and Spain. The isolates from Spain and Belgium had novel class D beta-lactamases that were active against carbapenems. These were designated OXA-25 and OXA-26, respectively, and had >98% amino acid homology with each other and with the OXA-24 enzyme recently described by others from an Acinetobacter isolate collected elsewhere in Spain. The isolate from Singapore had OXA-27 beta-lactamase, another novel class D type with only 60% homology to OXA-24, -25, and -26, but with 99% homology to OXA-23 (ARI-1), described previously from an Acinetobacter baumannii isolate collected in Scotland. Sequence data were not obtained for the carbapenem-hydrolyzing OXA enzyme from the isolate from Kuwait; nevertheless, the enzyme was phenotypically similar to OXA-25 and -26. The enzymes OXA-23, -24, -25, -26, and -27 retained the STFK and SXV motifs typical of class D beta-lactamases, but the YGN motif was altered to FGN. The KTG motif was retained by OXA-27 and -23 but was replaced by KSG in OXA-24, -25, and -26. OXA-25 and -26 enzymes were strongly active against oxacillin, but unusually for an OXA-type beta-lactamase, OXA-27 had apparently weak activity, although measurement was complicated by biphasic kinetics. None of the new enzymes was transmissible to Escherichia coli recipients. Many Acinetobacter isolates are multiresistant to other antibiotics, and the emergence of class D enzymes with carbapenem-hydrolyzing activity is a disturbing development for antimicrobial chemotherapy.

Acinetobacter↗

PubMed1996

Phylogenetic analysis of hepatitis D viruses indicating a new genotype I subgroup among African isolates.

Genetic analysis was performed on 13 hepatitis D virus (HDV) isolates from Ethiopia, Somalia, Jordan, Kuwait, Bulgaria, Moldavia, and Sweden. The complete nucleotide sequence and genomic organization are described for the first time for two African HDV isolates. Phylogenetic analysis showed all the African isolates to be intrarelated and to form a novel group within HDV genotype I; the suggested designation for this group is IC. The genetic distance to previously described type I isolates was about 0.15. The HDV genotype I isolates (total of 22 examined) phylogenetically formed three clusters, each of them corresponding to certain geographic regions; the "western" group consisted of six HDV isolates from western Europe and the United States plus one from Kuwait; the "eastern" group consisted of two isolates from Moldavia and one each from Bulgaria, Nauru, mainland China, and Taiwan; and the "African-Middle East" group consisted of six HDV isolates from Ethiopia and one from Somalia, Jordan, and Lebanon.

Adolescent↗