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PubMed1992

Polycyclic aromatic hydrocarbons, nickel and vanadium in air particulate matter in Bahrain during the burning of oil fields in Kuwait.

Inhalable air particulate matter (APM) was collected in Bahrain from July 31, 1991 to August 4, 1991, during the burning of the oil fields in Kuwait. The filters collected were black and the levels of APM ranged from 139 to 673 micrograms m-3 with an average value of 199 micrograms m-3. APM were analysed for their contents of PAHs, Ni and V. Analysis was carried out for 32 PAHs and total PAHs ranged from 3.1 to 9.1 ng m-3 and averaged 5.3 ng m-3. The highest individual PAH levels were benzo[ghi]perylene, benzo[b]fluoranthene, benzo[a]pyrene and indeno[1,2,3-cd]pyrene. The concentration of Ni and V ranged from 7 to 42 and 11 to 42 ng m-3, with an average value of 22 and 26 ng m-3, respectively. A strong correlation was found between Ni and V (r = 0.98, P less than 0.01). The results show that the smoke from burning oil wells in Kuwait has contributed to the concentrations of particulate matter, PAHs, Ni and V in APM in Bahrain.

Air Pollutants↗

PubMed1994

The epidemiology of leukemia in Kuwait.

This study reports the occurrence of leukemia subtypes in Kuwait between 1979 and 1989. The cases were analyzed by age, sex, Kuwaiti and non-Kuwaiti nationality status. Of the total 723 cases, acute lymphoblastic leukemia (ALL) was the most frequent (44.2%), exhibited a peak incidence in the 0-4 years age group and was also the most common leukemia of childhood (90.5%). Acute myeloblastic leukemia (AML) constituted 32.4% of leukemia and showed a progressive increase in incidence with age. Chronic myeloid leukemia (CML) constituted 14.8% and chronic lymphocytic leukemia (CLL) 8.6% of all cases. The incidence, age and sex distribution of ALL, AML and CML was similar to that in the developed Western countries while the lesser frequency of CLL was similar to that in the Orient. This pattern of leukemia subtypes may be related to the population structure consisting of the predominantly young in Kuwait, and the peak incidence of ALL in the very young to the socio-economic conditions.

Adolescent↗

PubMed1995

Pattern of non-insulin dependent diabetes mellitus in Kuwait.

The aim of this study was to examine distinctive clinical characteristics of non-insulin dependent diabetes mellitus (NIDDM) patients in Kuwait including mode of presentation at diagnosis, family history of diabetes, therapeutic management and response to treatment. We studied 3299 Kuwaiti patients (1454 male (M) and 1845 female (F) subjects) registered in Salmiya diabetic clinic, a part of the national network of diabetes control and care programme, and located in the urban Hawally Governorate, Kuwait. The mean age of the patients was 53 years (+/- 13.9 years), and 73.8% were in the age group 45-64 years. The majority of patients (53.6%) were diagnosed as they were clinically symptomatic; in contrast a significant minority (37.8%) were diagnosed by chance mainly during investigation for unrelated events. The 8.6% of the women diagnosed during pregnancy had a high parity index 6.5 +/- 2.9. A high percentage of the diabetic patients (63%) reported a positive family history in first degree relatives. The mean duration of diabetes mellitus was 7.8 years (range 2-28 years) and 70% of the patients had diabetes mellitus for 9 years or less. The mean body mass index (BMI) was 31.8 +/- 6.3 kg/m2 and 28.5 +/- 6.3 kg/m2 in women and men, respectively. Among the diabetic women 57.7% were obese (BM > 30 kg/m2) and 30.2% were overweight (BMI 25-30 kg/m2) as compared to 33.6% and 44.3% among diabetic men, respectively. High blood pressure (> or = 160/95 mmHg) was reported in 14.9%. The main therapeutic modality in the majority of patients, (63.2%), was the administration of oral hypoglycaemic agents (OHA), while 23.7% were on a diet regimen and only 13.1% were on insulin therapy. The study throws light on the pattern of NIDDM among Kuwaiti patients. Frequent association with obesity suggests that it may be a major risk factor. The strong familial aggregation reported paves the way for future research among these families for cosegregation of a defined genetic trait with NIDDM in the Arab population subset.

Adolescent↗

PubMed1993

Comparing nurses' and patients' pain evaluations: a study of hospitalized patients in Kuwait.

All eligible patients hospitalized on the general medical, surgical and pediatric wards of a district hospital in Kuwait during the first 2 weeks of April 1990 (N = 199) were interviewed about their pain and the medical care provided. Patients rated their current pain using a 0-10 visual analogue scale (VAS) on which 0 was labelled 'no pain' and 10 'unbearable pain', and also the least and worst levels of pain which they had experienced during the previous 24 hr. Pediatric patients rated their mood at these times using a cartoon faces scale ([1]: McGrath P.A., DeVeber L. L. and Hearn M. T. Advances in Pain Research and Therapy, pp. 387-393. Raven Press, New York, 1985). Patients were asked to describe the most painful procedure which they had experienced whilst hospitalized, to detail their reactions to any uncontrolled pain, and recount the outcome of any requests made for additional analgesics. Whichever nurse on duty had had prime responsibility for caring for the patient was asked to furnish comparable VAS ratings of the patient's pain, and to categorize the patient as providing an accurate picture of, exaggerating, or understating his/her pain. Overall, nurses returned significantly lower pain estimates than their patients. Pediatric patients and patients described by their nurses as 'understating their pain', however, were exceptions. The vast majority of patients approved of the medical care provided and the pain management, and considered that nurses are well able to judge patients' pain and are concerned about what pain patients experience. And yet the VAS reports from patients indicated that uncontrolled pain was common. Also, when specifically questioned, a substantial proportion of patients stated that pain had had a negative impact on their mood and activity. Various explanations for these findings are discussed, and their implications for effective pain management. Some of the special problems facing nurses in Kuwait are considered.

Adolescent↗

PubMed1995

Ethnic differences in contraceptive use in Kuwait: a clinic-based study.

The Arab, Muslim, oil-rich nation of Kuwait has achieved unusually high levels of knowledge and use of contraception for a developing, high fertility country. Almost all women know of contraceptive pills without prompting, and 57-86% report having ever used a method (usually the oral pill or IUD) in recent studies. Based on a survey of six randomly selected clinics the present study compares the knowledge and use levels of two major ethnic groups--the Beduins and non-Beduins. It also analyses preference for various contraceptive methods and probable reasons for this. While Census or Survey data do not provide information about the size of ethnic groups analyzed in this paper, it is estimated that at least one-third of the population of Kuwait is Beduin. There is a significant difference between the levels of knowledge and use of contraception between the Beduin and non-Beduin women; current use being 42% and 65%, respectively. The differentials between the two groups are particularly marked among women of lower socioeconomic status, and tend to reduce notably once variables such as education and income are controlled. Within the subgroup of non-Beduins, socioeconomic differences in contraceptive use have virtually disappeared; the illiterate and relatively less affluent women are as likely to use a contraceptive method as the university educated, and richer women. However, among the Beduins, the usually expected differences by socioeconomic characteristics still persist. The oral pill is the best known and most commonly used method. Male sterilization is the least known and not practiced at all.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1987

Treatment of alcoholism in Kuwait: a prospective follow-up study.

The outcome of routine drug-supportive psychotherapy treatment of 100 patients with alcohol-related problem in Kuwait's only psychiatric hospital was evaluated in four 6 month's intervals. Patients were assessed on 9 post-treatment questions reflecting improvement or deterioration. Correlation of follow-up changes to pre-treatment data shows that non-Kuwaitis do better than Kuwaitis in resuming employment and social reintegration. Patients on chronic benzodiazepine prescription were less likely to become abstinent, had poor social re-integration and more re-admissions. Good relationships with the family were clearly associated with a better treatment outcome. Scores of weighted follow-up findings were calculated to assess patients' status at each follow-up. Progress during the whole follow-up period was measured by the direction of slope calculated from linear regression model for individual scores. The relationship between pre-treatment conditions and patterns of follow-up was evaluated cross-sectionally (answers distribution) and longitudinally (direction of slope). A pattern of shift emerged where different patient groups crossed over to the opposite end of the score scale. Kuwait society's indulgent attitudes towards Kuwaiti patients with alcohol-related problems in employment have to be changed and utilization of the role of the Arab extended family in therapy is stressed.

Adult↗

PubMed1989

Prospective study of alcoholism treatment in Kuwait: a 5-year follow-up report.

The outcome of a 5-year prospective follow-up study of 100 patients treated in the Kuwait Hospital for alcohol-related problems is reported using two parameters computed from weighted follow-up variables, i.e., Offset Score measuring patients' initial follow-up status and Direction of Slope summarizing consequent follow-up scores. Nineteen patients had died representing 14 times the age-corrected national rate. Univariate and multivariate analyses of outcome measures against prefollow-up patients' characteristics revealed that variables indicating heavy alcohol use independent of each other predicted negative outcome and mortality. The tendency of the group score distribution towards normalization uninfluenced by treatment is demonstrated. The pertinence of these findings to the medical profession in Kuwait is stressed.

Alcoholism↗

PubMed2005

Spatial distribution of polybrominated diphenyl ethers in coastal marine sediments receiving industrial and municipal effluents in Kuwait.

Polybrominated diphenyl ether (PBDE) concentrations were measured in surficial sediments from coastal sediments receiving industrial and municipal effluents in Kuwait. The summation PBDE concentrations varied by two orders of magnitude ranging from 80 to 3800 pg g(-1)dw. The congener distribution was dominated by BDE 183, with minor contributions from BDEs 154 and 153. The similarity between the congener profile to that of the technical octa formulation (Bromkal 79-8DE) suggests a source of this product in Kuwait. The observed gradient in concentration distribution, with high summation PBDE concentrations near the shore and an exponential decrease seaward, indicates that wastewater discharge from industrial activities in the study area is the primary source of these compounds in the sediments.

Environmental Monitoring↗

PubMed2005

The occurrence of rare rpoB mutations in rifampicin-resistant clinical Mycobacterium tuberculosis isolates from Kuwait.

Mutations associated with rifampicin (RIF) resistance in two regions of the rpoB gene were studied by line probe (INNO-LiPA Rif. TB) assay (LiPA) and/or DNA sequencing in 32 RIF-resistant and 21 RIF-susceptible Mycobacterium tuberculosis strains isolated from 53 tuberculosis patients in Kuwait. The LiPA identified all susceptible strains as RIF sensitive, and the DNA sequences of the 81bp rifampicin resistance-determining region (RRDR) and the N-terminal region of the rpoB gene from five isolates were identical to the wild-type sequences from M. tuberculosis H(37)Rv. The LiPA identified 24 of 32 (75%) phenotypically documented RIF-resistant M. tuberculosis isolates as RIF resistant, with specific detection of mutation in 19 isolates, whilst 8 strains were identified as RIF susceptible. DNA sequencing of the RRDR confirmed the results for the 19 RIF-resistant isolates and identified precise mutations in five isolates for which specific base changes could not be determined by LiPA, as well as identifying a mutation (insertion 514TTC) in three isolates and no mutation in five of the eight isolates that were detected as RIF susceptible by LiPA. Two of the latter five isolates contained a V146F mutation in the N-terminal region of the rpoB gene and were recovered from patients of Middle Eastern origin. These analyses identified 11 different mutations in two regions of the rpoB gene. The majority of the isolates carrying identical or no mutations in the rpoB gene exhibited unique DNA banding patterns in fingerprinting studies. The occurrence of rare mutations in the rpoB gene, namely insertion 514TTC in 3 (9%) and V146F in 2 (6%) of 32 RIF-resistant M. tuberculosis isolates from Kuwait, is the highest reported so far.

Anti-Bacterial Agents↗

PubMed2003

Impact of safety belt use on road accident injury and injury type in Kuwait.

The enactment of Kuwait's seat belt law in January 1994 provided an opportunity to examine the impact of seat belt use on road accident fatalities and injury types in this affluent Persian Gulf nation. Via a structured data form, the results of injurious/fatal road accidents for more than 1200 accident victims were gathered from the files of the six major government hospitals which treat most traffic accident victims. Statistical analysis of the data showed that seat belt use has had a positive effect in reducing both road traffic fatalities and multiple injuries in Kuwait. The use of seat belts has also affected the nature of the injuries resulting from road traffic accidents. Non-users of belts experienced higher frequencies of head, face, abdominal and limb injuries. Users of belts, on the other hand, suffered higher frequencies of neck and chest injuries. The interrelationship between the victim, his age, and the type of injuries resulting from road traffic accidents is also investigated.

Accidents, Traffic↗

PubMed2001

The status of rubella immunity among pregnant women in Kuwait: screening in childbearing age should be reintroduced.

The objective of this study was to investigate the immunity against rubella in the obstetric population in Kuwait by testing 600 pregnant women at a prenatal clinic, using the haemagglutination inhibition technique. In addition, a comparison was made between this study and one done in 1978 at the same clinic; its relation to the vaccination programme is also discussed. 7.7% of the population under study were non-immune. Statistically significant effect was demonstrated for maternal age but not for parity and nationality. Though it has been almost 20 years since an intense rubella vaccination programme was implemented, the percentage of non-immune pregnant women has not decreased. In Kuwait, termination of pregnancy for congenital rubella syndrome is prohibited. As a result, it is recommended that women be screened and vaccinated at the time of marriage.

Adolescent↗

PubMed1999

The prevalence of antibody to human parvovirus B19 in pregnant women in Kuwait.

Infection with parvovirus B19 during pregnancy is known to be associated with various fetal damage, such as aplastic anemia and hydrops fetalis. Our objective was to study the seroprevalence of parvovirus B19 in the obstetric population in Kuwait and to compare this with that in the adult population in other regions. Blood samples from 1047 pregnant women were used in this prospective study. Information regarding patient's age, parity, nationality and symptoms was obtained at the time of collection of the sample. Blood was tested for IgG and IgM antibodies specific for parvovirus B19 using the ELISA technique. The overall prevalence for IgG and IgM was 53.3 and 2.2%, respectively. IgG seropositivity was higher in non-Kuwaiti women, while IgM antibodies was more frequent in Kuwaiti women. A total of 17.4% of the acutely infected patients were symptomatic. Prevalence of parvovirus B19 infection in Kuwait is comparable with that in the other countries.

Adult↗

PubMed2002

Violence against nurses in healthcare facilities in Kuwait.

A national cross-sectional survey was conducted to document the prevalence and determinants of violence against nurses in healthcare facilities in Kuwait. It involved all nurses employed in all types of health-related facilities and available in the country in May 1999. The questionnaire was completed by 5876 nurses (85% females, 88% non-Kuwaitis). Verbal violence had been experienced in the 6 previous months by 48% of the group, and physical violence by 7%. There was no physical harm reported in 63% of cases of physical violence. Physical abusers were mostly patients (51%). Compared to nurses who had never experienced physical violence, those who had experienced some were more likely to be male, non-Kuwaiti, to have had a shorter professional experience, and to be working in a hospital rather than in a primary healthcare center. The experience of nurses with violence is still relatively rare in Kuwait. Communication with patients and their entourage of family members and/or close friends is needed to clarify expectations and to avoid frustration and angry verbal outbursts.

Adult↗

PubMed1998

Recruitment and retention of nursing students in Kuwait.

This study describes the problems of recruiting and retaining student nurses in Kuwait. Based on a social definition paradigm, a convenience sample of 54 respondents made up of 25 final year high school students, 20 adults from the community and 9 nursing students who dropped out of the program were interviewed. Data were analyzed by comparing the responses of the three groups. Constant comparative analysis yielded one major societal proposition on which the recruitment and retention behaviors are anchored. This proposition states that nursing is a low status and non-respectable profession in Kuwait. Five key defining characteristics of the proposition were also identified. Furthermore, findings also showed that two prominent barriers to recruitment were lack of social support and lack of information about nursing. Similarly, social pressure, poor staff welfare and academic problems were some of the major factors responsible for poor retention of students. Suggestions for improvement include provision of awareness programs, career guidance and innovative policy on staff welfare.

Adolescent↗

PubMed1985

Septicaemia in a teaching hospital in Kuwait--II: Factors influencing the outcome in III episodes.

The case fatality rate (CFR) among III episodes of septicaemia in Kuwait was 22.5%. It increased with age but was not influenced by sex. Gram-negative, polymicrobial and hospital-acquired septicaemia carried a high mortality rate. Due to the influence of the more common, but less fatal salmonella infections, however, mortality from septicaemia caused by Gram-negative bacteria was lower than that reported from more developed countries. Patients with underlying conditions, such as malignancy, chronic liver disease, diabetes mellitus, renal transplant and conditions requiring surgery, as well as those with unknown sources of infection or infection originating from the respiratory tract or from surgical wounds had high mortality rates. The chances of survival increased with the use of appropriate antibiotic therapy and the absence of underlying disease. None of the patients with underlying conditions survived after receiving inappropriate therapy as compared with 50% who were previously healthy. The changing aetiology and the emergence of immuno compromised patients are possible causes for the failure to reduce significantly the mortality from septicaemia in Kuwait.

Adolescent↗

PubMed2004

Impact of the Gulf war on congenital heart diseases in Kuwait.

BACKGROUND: There has been concern over the increase in the number of babies born with congenital heart diseases (CHD) in Kuwait after the Gulf War. METHODS: We evaluated retrospectively the number of Kuwaiti infants who were diagnosed to have CHD within the first year of life. The comparison was made between those presented from January 1986 to December 1989 (preinvasion) and those presented after the liberation of Kuwait (from January 1992 to December 2000). The number of cases was considered per 10,000 live births in that year. RESULTS: The numbers of cases were 2704 (326 before the invasion and 2378 after liberation). The mean annual incidence of CHD was 39.5 and 103.4 (per 10,000 live births) before and after the Gulf War, respectively (P<0.001). There was an increase in the number of babies with CHD during the immediate 3 years postliberation with a relative reduction in the trend from 1995 to 2000, in some types of CHD. CONCLUSIONS: In our series, there was an increased incidence of CHD almost immediately following the end of the Gulf War period. The cause of this increase remains relatively obscure. Environmental pollution may be a contributing factor; others such as possible psychological trauma remain subject to speculation.

Biological Warfare↗

PubMed1998

Non-insulin-dependent diabetes in Kuwait: prevalence rates and associated risk factors.

Non-insulin-dependent diabetes mellitus (NIDDM) is a major clinical and public health problem in Kuwait. The objective of the study was to determine prevalence rates of NIDDM among a representative sample of the Kuwaiti adult population aged 20 and older in two out of five governorates and identify the associated risk factors for the disease. A total of 3003 subjects (1105 men and 1898 women) were interviewed and examined by the research team during the period September 1995 to June 1996. A specially designed questionnaire was completed and the physical examination included height, weight and blood pressure measurements. Fasting blood samples were withdrawn, centrifuged immediately and refrigerated. Interpretation of oral glucose tolerance tests were based on the World Health Organisation diagnostic criteria for diabetes mellitus (1985). The denominator used for computing the prevalence was obtained from the 1995 Kuwait census. The overall prevalence of NIDDM in this study was found to be 14.8% (14.7% in men, 14.8% in women). Diabetic subjects presented at a relatively young age, prevalence rate in the age group 20-39 was 5.7% (95% confidence interval, 4.4-7.0) and in the age group 40-59 was 18.3% (95% confidence interval, 16.1-20.6). Obesity was found to be a significant risk factor, P < 0.001. The strong association of family history of NIDDM (adjusted odds ratio = 1.80, P < 0.001) suggests a genetic component. Hypertension was markedly associated with NIDDM and IGT (P < 0.001). With the demographic transition which already started among the Kuwaiti population and if the prevalence of NIDDM remains the same, aging of the population will contribute to even more upward trends in prevalence of abnormal glucose tolerance with its serious impact on morbidity and mortality among the Kuwaiti population. The strong association between hypertension and NIDDM may suggest a common approach to the prevention and control of these two conditions.

Adult↗

PubMed1998

Age patterns of smoking initiation among Kuwait university male students.

The present study is a detailed evaluation of age at smoking initiation among university male students in Kuwait based on a random sample of 664 students selected from all students during 1993. The Acturial Life Table analysis revealed that almost one tenth of the students initiated cigarette smoking between ages 16 and 17 with the rate of initiation increasing rapidly thereafter and reaching 30% by age 20 and almost 50% by the time they celebrate their 24th birthday. The most important environmental risk factor positively associated for smoking initiation was observed to be the history of smoking among siblings with a relative risk of 1.4. Compared to students of medicine and engineering, the students of other faculties revealed a higher risk in smoking initiation with an RR = 1.77 for sciences and commerce and 1.61 for other faculties (arts, law, education and Islamic studies). The analysis revealed a rising generation trend in cigarette smoking. There is a need for reduction of this trend among young adults in Kuwait and throughout other countries in the region.

Adolescent↗