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PubMed1985

Adverse drug reaction monitoring in Kuwait (1981-1984).

The methodologic, operational, and medical aspects of general population spontaneous adverse drug reaction (ADR) monitoring system organized in the State of Kuwait between June 1981 to June 1984 are described. The objectives of the study were to outline the procedures required for the establishment of a national ADR center in addition to studying the pattern of ADRs. Ethnic and sociocultural variables were factors influencing the frequency of adverse effects. A computer data base was created to handle incoming reports. A total of 704 reports were received from 26 hospitals and health clinics; the majority (90.5%) were classified as having a possible positive causal relationship. Anti-infectives were the most commonly reported drugs (32.2%), and cutaneous reactions were encountered most often (48.6%). Serious drug-induced reactions have been identified. Intake of nifedipine adversely affected glucose tolerance among diabetic and nondiabetic subjects. Bromocriptine causal sexual dysfunction was reported among women. Cimetidine and ethambutol were associated with optic neuritis and blindness. Metoclopramide and prochlorperazine resulted in dystonic reactions in children. Based on this study, the health authorities in Kuwait indicated their intention to establish a national ADR center.

Adolescent↗

PubMed1994

Acute sporadic hepatitis E in Kuwait.

Fifty-seven adult patients with acute hepatitis and 34 comparison patients without liver disease were evaluated using a newly developed Western blot assay for IgM antibody to hepatitis E virus. The mean age of patients with hepatitis was 32 years (range, 18-55 years); 88% were male. Among patients with acute hepatitis, hepatitis A (anti-HAV IgM positive) was diagnosed in two (4%), hepatitis B (anti-HBc IgM positive) in three (5%), and hepatitis E (anti-HEV IgM positive) in 34 (60%). One hepatitis patient had CMV IgM, another had EBV IgM, and 16 others (28%) were negative for all serologic markers of acute viral hepatitis. No patient with acute hepatitis A or B and none of the comparison patients without acute hepatitis had anti-HEV IgM. All but one case of acute hepatitis E were found among expatriates of Asian origin, and acute hepatitis E was associated significantly with recent travel to the Indian subcontinent. These data suggest that acute hepatitis E is common among foreign workers in Kuwait but that little HEV transmission is occurring directly in Kuwait.

Acute Disease↗

PubMed1990

Cystic hydatid disease: aspects of the incidence in man in Kuwait, Arabian Gulf.

Cystic hydatid disease (CHD) is endemic in Kuwait, but the exact extent of the disease in man has yet to be determined. The incidence was calculated by serological testing of sera from patients with a presumptive clinical diagnosis of hydatidosis and follow-up until the final diagnosis was determined. During a one-year period, 123 sera were received from two District General Hospitals serving a population of approximately 500,000. Eighteen patients had confirmed CHD, 17 were serologically positive in two tests, indirect haemagglutination (IHA) and counterimmunoelectrophoresis (CIEP), while another positive patient was identified through surgery and histopathology. These cases represent an estimated incidence rate of 3.6 per 100,000. Various factors, however, indicate that this is an underestimation of the true incidence. The infection rate of camels with hydatid cysts and dogs harbouring the adult worm, a possible measure of the true incidence in man, is considered high. Because of the nature of the population structure, the majority of patients were, in fact, non-Kuwaitis. Kuwaitis, who form 40% of the population, constituted about 30% of the CHD patients. Females were in the majority, the 21 to 50 yr. age-group being the most symptomatic. Hydatid cysts were most commonly present in the liver. Finally, compared to other countries at the time when a control programme was instituted, the incidence rate in Kuwait is moderate to high. However, the number of individuals with CHD does not appear alarming as the available capacity of the medical services is adequate.

Adolescent↗

PubMed1987

Phenylketonuria in Kuwait and Arab countries.

Seven cases of phenylketonuria including a pair of siblings were detected among 451 institutionalized mentally retarded individuals in Kuwait. A further 13 cases from eight Arab families of different nationalities were ascertained among referral cases. The occurrence of phenylketonuria in Kuwait and other Arab countries is discussed in view of the high consanguinity rate and large family size. Our findings stress the need for neonatal screening.

Adolescent↗

PubMed1992

Effect of Kuwait oil field fires on human comfort and environment in Jubail, Saudi Arabia.

The plumes from the Kuwait oil field fires reduced hemispheric (total) solar radiation by 26-36% during January-June 1991 in Jubail (300 km SE of Kuwait City), Saudi Arabia. Residents feel noticeably cooler even though air temperatures have not been lowered significantly (up to June 1991). These observations support human comfort theories and demonstrate the importance of shade to comfort. The desirability of complete solar radiation measurements, including those of diffuse radiation, is indicated.

Air Pollutants↗

PubMed1994

Mortality patterns in Kuwait: inferences from death certificate data.

Two main features of the mortality pattern in Kuwait are very low crude death rates, not exceeding 2.3 per 1,000, and a high frequency of traffic accidents, ranking as the second leading cause of death. In quantitative terms, mortality statistics in Kuwait have reached their objectives in that coverage approaches 100%. However, quality of data still suffers from apparent shortcomings, as exemplified by senility (without mention of psychosis) as the sixth leading cause of death. Huge oscillations in the frequency of some conditions from one year to the next one are even more indicative of the dubious reliability of the information on the death certificate. These variations occur across the board and do not characterize only a pre-war/post-war comparison. Coding inconsistencies are not restricted to the same group of diseases (e.g., cardiovascular disorders) but appear to comprise shifts in coding between different groups of diseases (e.g., pneumonia and disorders related to short gestation). Socially undesirable causes of death are, in particular, an area where reliability of data may be easily challenged on logical grounds. If raw mortality data were taken for granted, they could be very misleading. Providing for a cautious interpretation, however, these data may still be fairly informative.

Accidents, Traffic↗

PubMed1983

Fiberoptic colonoscopy. A report of findings in 481 patients from Kuwait.

The authors report 481 colonoscopic examinations, performed in the Amiri Hospital, Kuwait. The objective of this paper is to demonstrate the pattern of colonic diseases in this region and to compare our findings with those reported from elsewhere. Although these are preliminary results, they suggest that colonic diseases, in general, are uncommon in this area. Ulcerative colitis was the most common pathology detected on colonoscopy. Polyps and diverticulosis were less common than those observed in the west. The frequency of Crohn's disease in Indians and Pakistanis in Kuwait was found to be high, although it is reported to be a very rare disease in their native countries.

Adolescent↗

PubMed1999

Comparative study of desert truffles from Kuwait and other countries in the Middle East for radionuclide concentration.

Concentrations of some radionuclides, including 137Cs, in desert truffles in Kuwait were studied and compared with similar samples from other countries in the Middle East, namely Iran, Egypt, and Tunisia. In addition, sand samples from Kuwait were assayed to calculate the transfer factor of the radionuclides under consideration. The measured concentrations of 40K, 226Ra, and 137Cs show that 137Cs is much higher in Egyptian samples, whereas 40K is much lower in samples from Tunisia. The average effective dose equivalent calculated for the Kuwaiti population according to their diet habits was found to be in the range 0.14-0.23 microSv/a. The results are compared with values from other countries.

Ascomycota↗

PubMed2003

Epstein-Barr virus expression in Hodgkin's lymphoma in Kuwait.

The epidemiology of Hodgkin's lymphoma (HL) shows wide geographic variation in histological subtypes and in its association with the Epstein-Barr virus (EBV). The proportion of EBV positive HL is low in industrialized countries, high in non-industrialized countries and intermediate in early-industrialized countries. Reports from the Persian Gulf and Middle East are very limited. The aim of this study was to determine the epidemiology of HL in Kuwait, an early-industrialized country in the Persian Gulf, and to delineate the extent of its association with EBV. We reviewed 134 cases of HL for histological classification and demographic data. 107 cases were examined for the presence of EBV using immunohistochemistry (IHC) for the latent membrane protein I (LMPI) and in-situ hybridization (ISH) for EBVencoded RNA (EBER). 70.4% of the patients were males and 29.6% were females. The male: female ratio was 2.4:1. The mean age was 30.6 years (range, 4-71 years). Mixed cellularity HL (MCHL) was the most common subtype (45.5%), followed by nodular sclerosis (37.3%), nodular lymphocyte predominant (6.7%), lymphocyte rich (3%) and lymphocyte depletion (3%). 4.5% of cases were unclassifiable. EBV expression was seen in 56%, was significantly higher in MCHL, in children, and in males. Our findings suggest that the frequency of EBV expression in HL in Kuwait is similar to other early-industrialized countries. Further research from other countries in the Persian Gulf and the Middle East should shed more light on the epidemiology of HL and its relation to EBV in this region.

Adolescent↗

PubMed2005

Spatial distribution of polychlorinated biphenyls in coastal marine sediments receiving industrial effluents in Kuwait.

The concentrations of polychlorinated biphenyls (PCBs) were measured in surficial sediments receiving industrial and municipal effluents in Kuwait. The SigmaPCB concentrations varied by two orders of magnitude ranging from 0.4 to 84 microg kg(-1) dw. The homologue distribution in the study favored the more chlorinated congeners and generally followed the order: penta-PCBs > hexa-PCBs > tetra-PCBs approximately hepta-PCBs, with the dominant congeners being 138, 101, 110, 180, 153, 132, 149, and 118. The spatial distribution revealed significant intersite difference in concentration, with high levels encountered close to a harbor and several wastewater outlets suggesting that point source input is the primary delivery mechanism of PCBs to the sediment. This study suggests that atmospheric deposition of PCBs may not be a significant delivery mechanism to sediments in Kuwait possibly due to low annual precipitation and high annual temperatures that are experienced in the Arabian Gulf. The implication of this observation is that PCBs in air are likely to remain in the gas phase long enough to be subject to long-range atmospheric transport to other regions.

Carbon↗

PubMed2005

Serotype distribution and mother-to-baby transmission rate of Streptococcus agalactiae among expectant mothers in Kuwait.

INTRODUCTION: Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a formidable pathogen that is commonly responsible for early-onset and late-onset infections with high morbidity and mortality in the neonatal period. Since this organism is usually acquired via the mother's birth canal during labor, this study investigated the maternal carriage rate, mother-to-baby transmission rate, and the common GBS serotypes found among expectant mothers and their babies in Kuwait. METHODS: The setting was the Maternity Hospital, Kuwait. Low vaginal-anorectal swabs (LVRS) and urine specimens were collected from 847 pregnant women during labor. Ear and umbilical swabs from their new-born babies were also collected. Each specimen was cultured on selective Todd-Hewitt media. Isolates were identified and serotyped by established methods. RESULTS: Of the 847 mothers, 124 (14.6%) were colonized and 74 (8.7%) babies were colonized, mainly at the umbilicus. The 124 GBS-positive mothers gave birth to 44 babies that were colonized by GBS at one or both sites, which corresponds to a mother-to-baby transmission rate of (35.5%). A total of 193 isolates were serotyped. The majority of the GBS isolates belonged to serotypes III (47; 24.3%), V (42; 21.8%), Ia (25; 12.9%), II and VI (15; 7.8%) each, and VII (11; 5.7%). Only 4 (2.1%) and 1 (0.5%) isolates belonged to serotypes Ib and IV respectively. No isolate belonged to serotype VIII and 33 (17.1%) were non-typable (NT).

Female↗

PubMed2006

Awareness and perceptions of emergency contraception among retail pharmacists in Kuwait.

OBJECTIVE: To describe the awareness and perceptions of hormonal emergency contraception (EC) among retail pharmacists. SETTING: Private retail pharmacies in Kuwait City. METHOD: A self-administered questionnaire was developed to elicit pertinent demographic information as well as awareness of and concerns about EC and administered to the senior pharmacist in 51 randomly selected private retail pharmacies. MAIN OUTCOME MEASURE: Proportion of pharmacists aware of EC and who had recommended EC. RESULTS: The respondents had a mean (SD) age of 34.2 (7.7) years; 58.8% were male, and all but one were non-Kuwaiti. The median practice experience of the pharmacists was 6 years. Oral contraceptives and male condoms were universally available in the pharmacies, but none stocked emergency contraceptives, female condoms, or diaphragms. Twenty respondents (39.2%; 95% confidence intervals 25.5-53.9%) said they were aware of EC, and 4 (7.8%) that they had ever offered EC. Nine (17.6%) respondents saw EC as offering no advantages over other contraceptive measures and effectiveness was perceived to be low. Most cited concerns were of encouraging irresponsible behaviour and women relying on EC in place of regular contraceptive measures. Religious opposition (41.2%), lack of awareness by clients (51.0%) and lack of awareness by health providers (35.3%) were seen as the most significant obstacles to provision of EC. CONCLUSION: Knowledge of EC is poor among community pharmacists in Kuwait. Action is needed to address this deficit and to make EC more accessible to women who wish to use it.

Adult↗

PubMed1990

Facial clefting in Kuwait and England: a comparative study.

A retrospective study of all new cases of facial clefts seen between January 1985 and December 1987 was carried out at the lbn Sina Hospital, Kuwait, and West Midlands Regional Plastic and Jaw Surgery Unit at Wordsley Hospital, Stourbridge, England; 234 arab children in Kuwait and 181 white Caucasian children in the West Midlands were studied. Despite vast differences in racial characteristics, environment and customs the pattern of clefting was very similar in the two groups. The incidence of clefts was calculated for the two regions and this demonstrated an increase in the incidence of cleft lip and palate (CL/P and CP) in the West Midlands since the last study was reported from this region in 1953.

Cleft Lip↗

PubMed1993

Post Gulf war explosive injuries in liberated Kuwait.

We collected the statistics of the victims affected by explosive injuries in liberated Kuwait during the period March to December 1991. Included were 1679 patients treated at nine different hospitals in Kuwait. As members of a trauma team, we, the plastic surgeons, were involved in the care of 152 victims of explosive injuries admitted at Al-Razi Orthopaedic Hospital. The records of these patients were reviewed in detail and the results were analysed. Of the patients, 58 had penetrating wounds and 94 explosive blast wounds. In all, 69 patients (45.3 per cent) were found to have associated fractures, 8 (5.3 per cent) had vascular injuries and in 10 (6.5 per cent) a nerve was also involved. There were 41 patients (26.9 per cent) who required amputations. The mainstay of surgical treatment was adequate wound excision, skeletal fixation and soft tissue coverage. Split-skin grafts were used in 34 patients, local flaps in seven and free flaps in four. Most patients healed within 2-3 weeks. There were 10 patients with explosive blast wounds who developed infection and needed staged wound excision before providing final coverage.

Adolescent↗

PubMed1985

Imported malaria in Kuwait.

The number of imported malaria cases in Kuwait rose from 87 in 1980 to 504 in 1983, an increase of 579%. The continued resurgence of malaria in endemic zones, improved diagnostic techniques and a heightened awareness of imported malaria have contributed to the increase in the number of microscopically proved cases. Thick blood films fixed in acetone and stained in Giemsa proved a rapid method of diagnosis; species identification on the basis of a thin film on the same slide was performed with ease. Malaria was acquired in 38 countries. Most patients were young male adults. Most of the cases were due to Plasmodium vivax originating from India, although an increasing number of P. falciparum cases are also now being diagnosed from there. P. falciparum infections were evenly distributed throughout the year and most cases presented within 14 days of their arrival in the country. The highest number of P. vivax cases were diagnosed between May and October, when heat stress might have been a factor in precipitating a clinical attack of an infection previously acquired in the endemic zone. Attention is drawn to the importance of delayed attacks of P. vivax and, in semi-immunes, of P. falciparum. The time interval involved in establishing a history of "recent" travel in clinically suspected cases of malaria needs to be more clearly defined in each geographical area. Cases of induced malaria due to transfusion, accidental and congenital infections were identified. The fatality rate due to P. falciparum infections was low. In terms of the risk of renewed transmission, Kuwait may be considered a vulnerable area.

Adolescent↗

PubMed1987

Brucellosis in Kuwait: a clinico-epidemiological study.

The 160,000 population in Adan area, Kuwait, is served by Adan Regional Hospital. During the 6 months period mid-December, 1983 to mid-June, 1984, 68 cases of brucellosis were admitted to the hospital, an annual incidence of 85/100,000 population. Of these, 84% were Kuwaitis and Bedouins. The mean age was 32 years, range 12-70 years. The male female ratio was 1.4:1. 55 patients gave histories of consuming raw milk and 4 had close contact with animals. The highest incidence of the disease coincided with the animal delivery season and the desert camping period of Kuwaiti families. It appears that air transmission of contaminated soil is one of the main routes of Brucella infections in Kuwait.

Adolescent↗

PubMed1991

Traffic air pollution in Kuwait: preliminary results for nitrogen oxides and carbon monoxide.

At 21 locations within the city of Kuwait, continuous weekly measurements were made of oxides of nitrogen (NOx) and of carbon monoxide (CO): analyses were made using a chemiluminescent NOx analyser and a gas filter correlation ambient CO analyser. At 90% of the locations, the daily mean NOx concentrations exceeded 50 ppb, and in peak traffic hours the levels often reached 500 ppb. Similarly, the daily mean concentration of CO at 88% of the locations was greater than or equal to 8 ppm, and at three locations the CO concentrations were greater than 20 ppm. Throughout the week, daily differences were noted, with the lowest concentrations of pollutants recorded at the weekends. The influence of meteorological parameters was examined. The results showed that traffic was a major source of pollution in the city of Kuwait.

Air Pollution↗

PubMed1992

Clams as pollution bioindicators in Kuwait's marine environment: metal accumulation and depuration.

This study has developed and verified clam transplantation for marine pollution monitoring in Kuwait and has assessed its reliability for monitoring pollution by heavy metals through laboratory and field transplantation experiments. In field experiments, live specimens of the clam Circenita callipyga were transplanted, either suspended in seawater or buried in sand, to 11 coastal sites in Kuwait; subsamples of transplanted clams were recovered at intervals over a 6-month period. In laboratory experiments, heavy metal accumulation for 36 days and depuration (body's release of pollutants) for 60 days in small and big clams were investigated. Clams subsampled in laboratory and field experiments were analyzed for Hg, Cu, V, Cd and Pb. Results showed the ability of clams to survive under the transplantation conditions. Accumulation of biofouling materials was a problem at only two transplantation sites and was overcome by periodic cleaning. Statistical analysis of laboratory experimental data showed significant accumulation of all test metals and significant depuration of Hg, Cu, V and Cd. Rates of metal accumulation and depuration differed in relation to clam size class. Field experiments indicated statistically significant increases in Hg and Cu concentrations in the transplanted clams at most stations, no change in Cd concentrations and an increase or, occasionally, a decrease in V and Pb concentrations.

Analysis of Variance↗