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Biomedical subjects

N M Shah

Publications and source records attributed to N M Shah.

At least 37 records · Page 2Linked to original sources
PubMed1996

Predictors of non-urgent utilization of hospital emergency services in Kuwait.

Utilization of the emergency rooms (ERs) in Kuwait has increased considerably during the last decade. Such an increase is a concern for health planners because of the burden on ER services, lack of continuous service provided by the ER and the higher cost of such services. Based on a study of 2011 patients attending the medical ERs in the six government hospitals in early 1993, the predictors of non-urgent utilization were analyzed. Patients were asked about their reasons for visiting the ER rather than the primary health care (PHC) centre. Both patients and doctors were asked to rate the urgency of the visit. According to the doctors' judgement, 61% of the visits were for non-urgent problems that did not require emergency care, while 23% of the patients viewed their visits to be non-urgent. Multiple logistic regression analysis indicated that perceived urgency of the visit was the most important predictor of a non-urgent visit to the ER, after controlling for several predisposing and enabling factors. Patients who perceived their visit to the ER to be non-urgent were about four times more likely to visit the ER for a non-urgent condition as judged by the doctor. The level of education had a significant, positive effect on non-urgent utilization among both Kuwaiti nationals and expatriates. Several factors may explain the above finding. Employment of educated persons in the hospital was one route through which education facilitated ER use. It is also likely that educated persons had more influential contacts or wasta in the hospital. Also, the less educated might have delayed seeking care while the educated consulted for non-urgent reasons as soon as they noticed the symptoms. Like education, the level of non-urgent utilization was higher among Kuwaiti nationals with higher incomes. Thus, a higher social class seems to facilitate ER use for non-urgent reasons. Among the non-Kuwaitis, lack of registration at the PHC centre was a significant reason for non-urgent use of the ER. It is recommended that hurdles in the utilization of PHC facilities should be removed. Registration of non-Kuwaitis at the PHC must be improved, and referrals to the PHC back from the ER should be instituted to ensure the necessary follow-up care.

Adult↗
PubMed1996

Ethnicity, nationality and health care accessibility in Kuwait: a study of hospital emergency room users.

In mid-1994, non-Kuwaiti expatriates constituted 61.7% of the total population of Kuwait (1.75 million). Despite this numerical majority, non-Kuwaitis exist as a social minority. Non-Kuwaitis may be grouped into three broad categories along ethnic/nationality lines into Bidoon (without nationality), Arabs, and Asians. The objective of this paper was to compare the relative accessibility of the various groups to health care services in Kuwait. The study is based on data collected as part of a survey of 2184 Emergency Room (ER) users in January-February 1993. All patients attending the hospital ERs between 7:30 am and 9:00 pm were interviewed about their reasons for coming to the ER instead of going to the primary health care (PHC) centres, as required. The major reason given was low accessibility of the PHCs. Compared to Kuwaiti nationals, 92% of whom were registered at the PHC centres, only 62% of the Arabs and 39% of the Asians were registered. Multiple logistic regression of the factors in registration indicated that nationality was the most important reason for lack of registration, with Asians only about one-quarter as likely to be registered as Kuwaitis. Also, people who had been in Kuwait for shorter durations (< 5 years) were less likely to be registered than the Kuwaiti nationals or expatriates who had been here for 10 years or longer. In the absence of registration at the PHC centre, the civil identification card (ID) may be used as a valid means to enter the health system. Among the Arabs and Asians, 22% and 29% did not have a civil ID card. Thus, for many expatriates, the hospital ER, which does not provide the necessary follow-up care is often the only source of health care available.

Arabs↗
PubMed1996

Tubercular splenic abscesses in a patient with AIDS.

Opportunistic infections are common in patients with AIDS. There is an increasing incidence of tuberculosis, especially extrapulmonary tuberculosis. Splenic abscesses is one such, though rare, extrapulmonary manifestation. We report such a case discuss the diagnosis and treatment in these cases.

AIDS-Related Opportunistic Infections↗
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↗
PubMed1995

Redman syndrome.

Explore the source record for details and available documents.

Adult↗
PubMed1994

Glial growth factor restricts mammalian neural crest stem cells to a glial fate.

Growth factors and cytokines are thought to influence the development of uncommitted progenitor cell populations, but the issue of how these factors act on individual cells remains controversial. Such factors may act simply as selective mitogens or survival factors for cells that undergo lineage restrictions stochastically. Alternatively, they may instruct or bias multipotent cells to choose one lineage at the expense of others. Here we show that glial growth factor (GGF), previously defined as a Schwann cell mitogen, strongly suppresses neuronal differentiation of rat neural crest stem cells while promoting or allowing glial differentiation. Quantitative clonal analysis suggests that the action of GGF is likely to be instructive rather than selective. Taken together with the expression pattern of GGF, these data suggest a lateral signaling model for the diversification of cell types within developing peripheral ganglia.

Animals↗
PubMed1994

Arab labour migration: a review of trends and issues.

"The objectives set for this paper are to: provide an analysis of volume and trends in labour migration within the Arab region; discuss the major characteristics of the migrants, including demographic features, types of economic activity, wage levels and duration of stay in host countries; [and] outline and discuss the major issues in labour migration both from the sending and receiving countries. The time period covered by the study is from the mid 1970s to the present." (SUMMARY IN FRE AND SPA)

Demography↗
PubMed1992

Position of heart in relation to sternum and nipple line at various ages.

Frontal X-ray pictures of 210 healthy children from birth to twelve years of age with radio-opaque markers at sternal ends and both nipples were reviewed. The position of centre of cardiac silhouette was correlated with sternal areas and internipple line. The heart was found to descend with age, its centre lying beneath mid-sternum during first six months of life and beneath lower sternum after infancy (p less than 0.001). The position did not vary with age in relation to internipple line (p greater than 0.05). In 77.6% of all children, it was below the internipple line and in 22.4% above or at the internipple line. Because of the erratic relationship of cardiac centre with internipple line, the latter should not be considered a landmark for cardiac position. External cardiac massage should be applied in relation to sternum and at different locations according to the age. Sites for optimal compression have been suggested. No sexual dimorphism was observed.

Anthropometry↗
PubMed1991

Asian women workers in Kuwait.

The author examines trends in the roles of immigrant Asian women workers in Kuwait, using data from published censuses and reports and from three national-level surveys conducted in 1977-1979, 1983, and 1986-1987. "The study deals separately with the two major types of migrants: the domestic servants and the clerical and professional (or semiprofessional) workers.... The policies of sending countries and of Kuwait are discussed to reach some conclusions about the likely future patterns of migration of Asian women workers to Kuwait."

Asia↗
PubMed1991

The relative economic progress of male foreign workers in Kuwait.

"A human capital framework is utilized to examine the economic progress of nine nationality groups of foreign workers [in Kuwait] using data from the 1983 national Labor Survey. The sources of earnings' variations of particular interest to us included different degrees of education and experience transferability, occupational affiliation and ethnic background. In general, the results derived from the analysis suggest that 1) foreign workers achieve a discernible economic progress as their residence lengthens; 2) the rate of economic progress varies depending on worker's education, home and Kuwait-specific experience, occupational status and ethnic background; and 3) about one third of the earnings inequality is due to unexplained factors including discrimination."

Asia↗
PubMed1990

Socioeconomic and health care determinants of child survival in Kuwait.

This paper analyses the socioeconomic and health care determinants responsible for the decline over the last two decades in infant mortality in Kuwait. Published data and the results of a national health survey conducted in 1984-85 show the following. With the overall affluence of the society, health care in terms of immunization has improved dramatically and more than 90% of all children are covered. Of all births, 99% now occur in a hospital or clinic. About half of the mothers continue to breast-feed their babies for about 16 months. Despite these favourable conditions, differences still exist between social classes. The risk of stillbirth remains much higher among the poorer women, those without any education and those who gave birth at home. These findings are consistent with developed countries like the USA and Japan, where the social class differences in mortality still persist.

Cross-Sectional Studies↗
PubMed1990

Allied health manpower in Kuwait: issues and answers.

This article focuses on the salient issues and problems regarding allied health manpower in Kuwait, an oil-rich Gulf country. The health system in Kuwait has expanded very rapidly since the country's independence 29 years ago. A major feature of the health system is its heavy reliance on expatriate workers, constituting 80% of all doctors and over 90% of all nurses. Local training facilities have started producing some of the required allied health professionals. Continued shortages of indigenous allied health professionals are, however, inevitable in most areas. The presence of a highly diverse expatriate workforce raises serious problems, concerning worker conflict, differential skills and competencies, and adjustment to the Kuwaiti culture. Standardizing local training facilities, curricular expansion to accommodate emerging health concepts, and improving the system of hiring expatriates are needed.

Allied Health Personnel↗
PubMed1986

Iodoprotein formation by rat mammary glands during pregnancy and early postpartum period.

Iodide organification by rat mammary glands was studied during the trimesters of pregnancy and early postpartum period. Organification was followed by measuring trichloroacetic acid (TCA) precipitation of delipidated tissue homogenates. The radiolabeled material was sensitive to proteolytic cleavage by a bacterial protease indicating that the 125I was protein-bound. Gel filtration column chromatography in the presence of sodium dodecyl sulfate (SDS) of delipidated mammary tissue homogenates of pregnant and postpartum rats reproducibly resolved several iodoproteins from free iodide. The Kav value for each iodoprotein peak was calculated and was used to estimate each subunit molecular weight which averaged 37,500, 25,100, and 8500. Another iodoprotein with a very large subunit molecular weight of greater than 300,000 was also detected in mammary tissue. Incorporation of 125I-iodide into the three smaller iodoproteins increased logarithmically from the start of the second trimester of pregnancy through the early postpartum period when approximately 20% of the total 125I uptake by mammary tissue was incorporated into protein. Hyperplasia, acinar development, and intracytoplasmic vacuolization of mammary tissue correlated with the increased incorporation of 125I-iodide into these iodoproteins. The characterization and quantitation of specific iodoproteins in mammary tissue may be important as organification of iodide is believed to be a marker for normal hormone-responsive cells.

Animals↗
PubMed1986

Foreign workers in Kuwait: implications for the Kuwaiti labor force.

An analysis of the foreign population in Kuwait shows that foreign nationals make up 60 percent of the population and 78 percent of the labor force in Kuwait. The implications of these figures for the Kuwaiti labor force are discussed by analyzing the occupational structures of Kuwaitis and non-Kuwaitis. "Structural analysis of the labor force indicates that 62 percent of Kuwaiti males are concentrated in administrative and service occupations while their percentage in sales and production work has declined during 1970-80. This demonstrates the need for reorienting educational/training programs and changing Kuwaiti attitudes towards manual work to ensure the realization of the 'Kuwaitization' process, and balance the nationals with foreign nationals." mortality has stabilized at relatively high levels and there is resistance to family planning. The author concludes that the main cause of the stalling of the demographic transition process is to be found in the role of the state and the dynamics of the social structure and that "demographic trends will depend more on the changes in social structure, land reforms, and response of the formal governing system to the needs of the underprivileged sections of the society, rather than on the health and family planning policies."

Asia↗