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PubMedDate not supplied

Diagnosis of abdominal hydatid cyst disease: the role of ultrasound and ultrasound-guided fine needle aspiration cytology.

OBJECTIVE: To retrospectively analyze the role of ultrasound (US) imaging and US-guided fine needle aspiration cytology in the diagnosis and management of abdominal hydatid cyst disease (HCD). SUBJECTS AND METHODS: The medical records of 55 diagnosed cases of HCD seen between January 1986 and December 2000 at Mubarak Al-Kabeer Hospital and Al-Amiri Hospital in Kuwait were reviewed for demographic and clinical data, including radiology and serology. The US findings of the patients were classified into four types as follows: type I: single or multiple well-defined cysts, with or without detached or collapsed wall and with or without echogenic contents; type II: single or multiple cysts with peripheral cysts, with or without echogenic contents; type III: solid or semisolid lesions, and type IV: cysts with calcified walls. RESULTS: The overall accuracy of US in the diagnosis of HCD was 80% (44/55 cases). US examination was suggestive of HCD type I, 16/19 (84%), type II, 21/23 (91%), type III, 3/8 (38%), and type IV, 4/5 (80%). For the 11 remaining undiagnosed cases, US was useful for localizing the lesions for US-guided fine needle aspiration cytology. It established the diagnosis in all the 11 cases, without precipitating complications. CONCLUSION: US alone was valuable for diagnosing and localizing HCD in the abdomen except for solid-type lesions. US-guided fine needle aspiration cytology was useful in localizing and establishing the diagnosis of HCD in the cases where US alone was ineffective.

Abdomen↗
PubMedDate not supplied

Patient satisfaction with three dental speciality services: a centre-based study.

OBJECTIVE: To assess the level of patient satisfaction with three dental speciality services: oral surgery, periodontics, and fixed prosthodontics. SUBJECTS AND METHODS: A sample of 1,242 patients, aged 16 years and over who received dental care at least twice at the main dental centre, Al-Amiri, Kuwait, were interviewed during May-August 1998 by independent researchers concerning their experience of previous visits. Patients reported their level of satisfaction on a 5-point Likert scale for the items in the questionnaire, which focused on four areas: access, dentist's communication, staff helpfulness, and structural aspects of the practice. RESULTS: On average 49.4% (25.9-89.6%) of participating patients rated the level of care received as excellent. Areas rated poorest included waiting time for an appointment and waiting time in the clinic to access the dentist. Participants were less satisfied with doctor's explanation of illness, dental treatment and confidentiality of medical records. The areas that received excellent ratings by patients included: (a) communication (listening and understanding complaints 40.0% and courteous treatment 57.8%), and (b) structural aspects (availability of infection control and safety measures 89.6% and packed sterilized instruments 78.9%). CONCLUSION: Findings indicate that the level of patient satisfaction was reasonably high. Areas identified as needing improvement included: dentist-patient communication skills, medical records, appointment systems, and shortening of the waiting time to access the dentist.

Adolescent↗
PubMedDate not supplied

Comparison of lactose intolerance in healthy Kuwaiti and Asian volunteers.

OBJECTIVE: To study and compare the incidence of lactose intolerance among Kuwaiti and Asian healthy volunteers as measured by breath hydrogen level following challenge with lactose drink. SUBJECTS AND METHODS: The study involved 70 Kuwaiti and 79 Asian healthy volunteers. The volunteers were physicians, medical students and other hospital workers. The study was carried out prospectively at Amiri Hospital, Kuwait. None of the volunteers was sick or had taken antibiotics or any other drug that could influence breath hydrogen level 2 weeks prior to the study. After an overnight fast 20-ml baseline samples of exhaled air were collected from each volunteer prior to oral administration of 40 g of lactose drink. Following this, the same amount of exhaled air was collected at 30-min intervals for 2 h. All samples were analyzed for hydrogen level using a Quintron microlyzer. Hydrogen level of 20 ppm more than baseline value was considered positive. RESULTS: The basal breath hydrogen levels were 12.49 +/- 8.4 and 6.97 +/- 6.9 for Kuwaitis and Asians, respectively. Thirty-three (47%) of the 70 Kuwaitis and 46 (58%) of the 79 Asians were positive for the breath hydrogen test. The clinical symptoms of flatulence, abdominal pain, and diarrhea were associated with high levels of breath hydrogen. CONCLUSION: The findings indicate that the Kuwaiti volunteers had higher breath hydrogen levels than Asians, but the incidence of lactose intolerance was similar in both groups.

Abdominal Pain↗
PubMedDate not supplied

The expression of rheumatoid arthritis in Kuwaiti patients in an outpatient hospital-based practice.

OBJECTIVE: To describe the characteristic clinical, serologic and radiological features of rheumatoid arthritis (RA) in Kuwaiti patients in a tertiary outpatient hospital-based practice. SUBJECTS AND METHODS: An outpatient hospital-based study on 100 consecutive consenting Kuwaiti patients with RA was done at the Rheumatology Unit, Al-Amiri Hospital, one of the main teaching hospitals in Kuwait. The study group included 11 men and 89 women. The duration of their disease ranged from 2 to 30 years with a mean duration of 10.7 (SD 7.5) years. The age at disease onset ranged from 21 to 71 years with a mean age of 39.1 (SD 11.2) years. RESULTS: Joints most commonly involved in RA were metacarpophalangeal, wrist, knee, and proximal interphalangeal joints. Extra-articular manifestations were present in 24 patients; the most common was the sicca complex in 14 individuals. Rheumatoid factor seropositivity was found in 60 patients and erosive arthropathy in 42 patients. CONCLUSION: The findings indicate a low incidence of radiological erosive arthropathy in Kuwaiti patients. The sicca complex was the most common extra-articular manifestation of RA in these patients.

Adult↗
PubMedDate not supplied

Is low-back pain prevalent among Kuwaiti children and adolescents? A governorate-based study.

OBJECTIVE: To measure the magnitude of the problem of low-back pain among 10- to 18-year-old Kuwaiti schoolchildren in Hawalli Governorate. SUBJECTS AND METHODS: A cross-sectional multistage stratified random sample of 400 schoolchildren (199 males and 201 females) of ages 10-18 years were selected from two junior and two high schools in Hawalli Governorate, Kuwait. Data on age, gender and characteristics of low-back pain such as duration, location and frequency were collected through personal interviews using a questionnaire. Low-back pain was defined as pain in the back from the 12th rib to the buttock area. RESULTS: According to our definition, reported lifetime prevalence of low-back pain was found to be 57.8% (50.8% in male and 64.7% in female students), while the point prevalence was 35% (20.6% in male and 39.3% in female students). More female students reported low-back pain than male students, and the prevalence of low-back pain was found to increase with age in both sexes. The age of onset of low-back pain was 14 years in males and 13 years in females. The majority of students (92.1% in males, 84.6% in females) reported pain in the low back. Almost 46% of students related their low-back pain to accidents. A significantly higher proportion of male students (58.4%, compared to females 36.2%) reported low-back pain caused by accident or with duration of recovery less than a week (21.8% for males as compared to 16.2% for female students). Female students reported more recurrent or continual low-back pain. CONCLUSION: Low-back pain is common among Kuwaiti students in Hawalli Governorate. Prevalence of low-back pain increased with age in both sexes. Female students reported more frequent low-back pain than male students.

Adolescent↗
PubMedDate not supplied

Clear cell adenocarcinoma of the rectum.

OBJECTIVE: To document the first case of clear cell adenocarcinoma of the rectum (a rare entity) in Kuwait. CLINICAL PRESENTATION AND INTERVENTION: A 36-year-old female presented with a 1-year history of constipation and bleeding per rectum. Colonoscopy revealed an ulcerated mass 2 cm above the anal verge. After multiple biopsies an abdomino-perineal resection was performed for the rectal mass. Gross examination of the resected specimen revealed an anorectal mass measuring 5 cm in its long axis. Histopathological examination showed the tumor to be composed of lobules of mostly clear polygonal cells with round vesicular nuclei. Glandular formation was occasional. The tumor was rich in glycogen, focally displayed luminal mucin, and was associated with regional lymph node metastasis. CONCLUSION: This report illustrates a case of intestinal clear cell adenocarcinoma with lymph node metastasis that suggested a poor prognosis.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Prevalence of type 1 diabetes among 6- to 18-year-old Kuwaiti children.

OBJECTIVES: To determine the prevalence of type 1 diabetes among 6- to 18-year-old Kuwaiti children according to gender, age, and region. SUBJECTS AND METHODS: Children with type 1 diabetes aged 6-18 years were identified at 182 schools (50 primary, 63 intermediate, and 69 secondary) in Kuwait during the study period October 2000 to September 2002. Schools were randomly selected using the 2000/01 educational districts' registers as sampling frame proportional to the number of schools in each district. Prevalence rates were adjusted to the 2002 Kuwaiti population. Diagnosis of type 1 diabetes was based on the World Health Organization, and the American Diabetes Association criteria. RESULTS: Prevalence of type 1 diabetes was 269.9 per 100,000 (95% confidence interval, CI 241.6-298.3). There was no significant difference in prevalence between male (247.6, 95% CI 205.2-290.0) and female (285.5, 95% CI 247.5-323.5). Type 1 diabetes was more prevalent in the age group 10-13 years (347.3), and lowest in the age group 6-9 years (182.6) per 100,000; the difference was significant at p < 0.001. The overall age-adjusted prevalence rate was 252.9 (95% CI 234.6-271.2), 229.1 (95% CI 204.6-253.6) in male and 277.4 (95% CI 250.0-304.7) in female children in the 2002 Kuwaiti population. The mean age at onset was 9.2, and 8.1 years in male and female children, respectively (p = 0.018). There was no significant difference in prevalence between regions. CONCLUSION: Type 1 diabetes is a common chronic disease in Kuwaiti children.

Adolescent↗
PubMedDate not supplied

Contrast media extravasation: manual versus power injector.

OBJECTIVE: To compare the incidence and complications of extravasation of low-osmolar nonionic contrast media, injected manually and by the automatic power injector (API). SUBJECTS AND METHODS: Three thousand five hundred and sixty patients underwent contrast-enhanced abdominal and thoracic computerized tomography scan in the Department of Clinical Radiology, Al-Amiri Hospital, Kuwait, between June 1998 and December 2002. These patients were prospectively analyzed for contrast media extravasation, its relation to injection rate, cannula insertion and gauge and its complications. 920 patients were administered low-osmolar nonionic contrast media (Ultravist 300, Omni Paque 240 or 300) intravenously by manual injection and 2,640 patients by automatic power injector. RESULTS: Of the 3,560 patients contrast media extravasation occurred in 11 (0.3%). The symptoms were observed in 9 patients (0.3%) in the API group and 2 patients (0.2%) in the manual injection group, respectively. None of the patients had any soft tissue injury. CONCLUSION: The incidence of contrast media extravasation is not significantly increased by the use of the API. Low-osmolar nonionic contrast media extravasation resulting from the use of API does not cause any morbidity.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMedDate not supplied

Frequency of red blood cell alloantibody in Kuwaiti population.

OBJECTIVE: The aim of this study was to analyze the alloimmunization against red blood cells (RBC) among Kuwaiti population. MATERIALS AND METHODS: Retrospective analysis of RBC alloimmunization among 179,045 Kuwaiti patients, pregnant women, and allogeneic blood donors was conducted for the period of 1992-2001. The frequency of 24 alloantibody specificities from 1,278 alloimmunized Kuwaitis was estimated. RESULTS: The prevalence of positive antibody screen in Kuwait was 0.49%. The five most frequently identified alloantibodies were anti-D (27.3%), anti-E (18.5%), anti-K (15.6%), anti-Le(a) (8.7%), and anti-Le(b) (6.6%). Frequency of alloimmunization was greater among Kuwaiti female than male patients (3.2 F to 1 M). Anti-D (p<0.001), anti-E (p=0.05), anti-K (p=0.04) were also more frequently identified alloantibody among Kuwaiti females. CONCLUSION: The results show higher predominance of RBC alloimmunization in females than males. Anti-D, anti-E, and anti-K were the most common clinically significant alloantibodies identified in the Kuwaiti population and were also more frequent among Kuwaiti females.

Blood Donors↗
PubMedDate not supplied

The use of locked nails in the treatment of humeral shaft: delayed union and nonunion.

OBJECTIVES: To assess the results and clinical outcome of delayed union and nonunion humeral shaft treatment using locked medullary nails. SUBJECTS AND METHODS: The Russel and Taylor humeral locking nail was used to treat 21 patients with humeral shaft fractures at Al Razi hospital, Kuwait, from 1997 to 2001. Of these, 8 had delayed union and 13 nonunion. Also, 13 had previous operative treatment, while 8 had nonoperative treatment. Antegrade nailing was done in all cases, and all nails were fixed statically. Autogenous iliac bone grafts were used in 17 cases. RESULTS: Of the 21 cases of fractures, 19 were united. Only 2 cases had persistent nonunion. Eighteen cases had satisfactory shoulder function, and 3 lost shoulder abduction between 40 and 65 degrees. CONCLUSION: Our data showed that humeral locked nails can achieve satisfactory clinical results in treating humeral shaft delayed unions and nonunions.

Adult↗
PubMed2005

Alpha-2-globin gene polyadenylation (AATAAA-->AATAAG) mutation in hemoglobin H disease among Kuwaitis.

OBJECTIVES: In the Arabian Gulf region, hemoglobin (Hb) H disease usually results from homozygosity or compound heterozygosity involving the alpha2-globin gene polyadenylation (poly A) signal (AATAAA-->AATAAG) mutation (alpha(T)alpha). Here we document the clinical and hemato logical characteristics of children with Hb H disease being followed in Kuwait. SUBJECTS AND METHODS: Twenty-four patients (0.5-12 years old, mean 4.7 +/- 3.5 years) with persistent microcytic, hypochromic anemia (and normal iron status as well as normal Hb A2 levels) were referred to the pediatric hematology clinic for further investigations. They were all screened for the alpha+-thalassemia (alpha+-thal; -3.7 kb) deletion using a standard PCR method. They were also screened for the alpha2-globin gene alpha(T)alpha allele and the 5nt deletion (-alpha5nt) in the first intervening sequence, which are common alpha-thal alleles in this population. They were followed up for periods ranging from 2 to 8 years. RESULTS: Of the 24 patients, 4 (16.7%) also had sickle cell trait (Hb-AS), while 7 (29.2%) were glucose-6-phosphate dehydrogenase deficient. Only 1 patient had significant hepatosplenomegaly and 1 developed gallstones. While none was on chronic transfusion therapy, 8 (33.3%) had been transfused at least once and, in 3 instances, this was secondary to parvovirus B19 +ve aplastic crisis. The alpha-globin genotype was successfully determined in almost all patients. The results showed that 17 (70.8%) patients were homozygous for the poly A mutation (alpha(T)alpha/alpha(T)alpha), 6 (25.0%) were compound heterozygotes for this and the alpha+-thal (-3.7 kb) deletion (-alpha/alpha(T)alpha) and 1 (4.2%) was undetermined. There were no significant differences in the phenotypes of the 2 genotypes and their hematological features were identical. CONCLUSIONS: Hb H disease involving the poly A mutation is a mild thal intermedia phenotype among Kuwaitis. There are no serious complications and there is no need for regular blood transfusion.

Child↗
PubMedDate not supplied

Retinopathy in newly diagnosed type 2 diabetes mellitus.

OBJECTIVE: To study the prevalence of diabetic retinopathy and its association with risk factors in newly diagnosed type 2 diabetic patients in two primary care diabetic clinics in Kuwait. SUBJECTS AND METHODS: All newly diagnosed type 2 diabetes mellitus patients attending Ferdous and Yarmouk Health Care Diabetic Clinics in Farwaniya and Asma Health Areas, respectively, during the period of January 2002 to July 2004 were examined for the presence of diabetic retinopathy by color fundus photographs. Risk factors such as sex, age, hypertension, nephropathy, hyperglycemia, level of glycated hemoglobin, microalbuminuria and hyperlipidemia were evaluated by statistical analysis for their possible association with the presence of diabetic retinopathy at the time of diagnosis of diabetes. RESULTS: Of the 92 newly diagnosed type 2 diabetes mellitus patients studied, diabetic retinopathy was present in 7 (7.6%) patients. Two of the 7 patients had maculopathy that needed treatment by photocoagulation. High glycated hemoglobin in 51 patients (55.4%), microalbuminuria in 25 (27.2%), hypertension in 29 (315%), hyperlipidemia in 69 (75%), obesity in 45 (48.9%) and overweight in 37(40.2%) were noted in the study population. Microalbuminuria was weakly associated with the presence of retinopathy (p = 0.08) at the time of diagnosis of diabetes mellitus, but other risk factors were not statistically significant. CONCLUSIONS: Prevalence of diabetic retinopathy was 7.6% among the study population. Maculopathy was present in 2 of the 7 patients needing photocoagulation.

Adult↗
PubMedDate not supplied

Surgical treatment for ipsilateral fractures of femoral neck and shaft.

OBJECTIVES: To review the primary and the final results of surgical management of ipsilateral femoral neck and shaft fractures. SUBJECTS AND METHODS: Seventeen patients (2 female, 15 male, average age 37 years, range 20-60) with ipsilateral femoral neck and shaft fractures were treated by compression plate fixation for the femoral shaft fractures and dynamic hip screw or cannulated cancellous screw fixation for the neck fractures in Al-Razi and Al-Jahra Hospitals, Kuwait, from March 1996 to June 2002. The clinical and radiological primary and final results were analyzed retrospectively. RESULTS: The average follow-up for the primary outcomes was 3.6 years (range 2-6 years). 100% union of the femoral neck fractures, 0% osteonecrosis of the femoral head and 77% union of the shaft fractures were achieved. Complications of femoral shaft fractures, nonunion and metal failure, occurred in 4 (23%) patients and postsurgical infection occurred in 1 patient. At the final follow-up, 15 (88%) patients achieved good clinical outcome and 2 (12%) had fair outcome. CONCLUSION: Our results show that compression plate fixation for the femoral shaft fracture and dynamic hip screw or cannulated screw fixation for the neck fracture in combination injury is a reliable and adequate technique.

Accidental Falls↗
PubMedDate not supplied

Reference intervals for important serum sex steroid hormones, prostate-specific antigen, insulin-like growth factor-1 and IGF binding protein-3 concentration in a normal Kuwaiti adult male population.

OBJECTIVES: The purpose of this study was to determine the age-specific reference ranges for some important male sex steroid hormones, prostate-specific antigen (PSA), insulin-like growth factor-1 (IGF-1), and IGF binding protein-3 (IGFBP-3), for the Kuwaiti population. SUBJECTS AND METHODS: Blood samples were taken from 398 consenting, fasting, healthy Kuwaiti males aged 15-80 years between 8.00 a.m. and 12.00 noon. The serum concentrations of total testosterone (TT), dehydro-epiandrosterone sulfate (DHEAS), androstenedione (ADT), sex hormone binding globulin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, PSA, IGF-1 and IGFBP-3 were determined. A distribution curve was plotted and age-specific reference levels were determined for each analyte. The reference interval for parameters with a normal distribution (Gaussian) was mean +/- 2 SD, while for the non-normal distribution (non-Gaussian), it was 2.5-97.5 percentile. The reference intervals for the analytes obtained from this study were compared with those suggested by the kit manufacturers and currently used by the Ministry of Health, Kuwait Laboratories (MOHKL). RESULTS: Serum IGFBP-3 and ADT had normal distribution while other analytes had non-normal distribution. The reference intervals from this study, manufacturers kit and MOHKL were as follows: TT 3-31, 9-60, 8-35 nmol/l; DHEAS 0.9-11, 1.0-7.3, 2.2- 15.2 micromol/l; ADT 0.5-4.3, 0.8-2.8, 2.0-9.2 nmol/l; LH 1-11, 0.8-7.6, 0.4-5.7 mIU/l; FSH 0.5-11, 0.7-11.1, 1.1-13.5 mIU/l; prolactin 42-397, 53-360, 80-230 nmol/l; IGF-1 41-542, 78-956, 71-261 ng/ml; IGFBP-3 88- 2,090, 900-4,000, 900-4,000 ng/ml, and PSA 0-3.1, 0-4, 0-4 ng/ml, respectively. CONCLUSION: These data indicate that for Kuwaitis lower reference ranges must be used for serum TT, DHEAS, ADT, IGFBP-3 and PSA. There is no need to change the currently used reference interval for FSH whereas higher values must be used for LH, prolactin, and IGF-1.

Adolescent↗
PubMed2006

Antibacterial resistance and molecular typing of methicillin-resistant Staphylococcus aureus in a Kuwaiti general hospital.

OBJECTIVE: To investigate antibiotic resistance and genetic relatedness of methicillin-resistant Staphylococcus aureus (MRSA) isolated in a general hospital in Kuwait over a period from 1996 to 1998 and 2001. MATERIAL AND METHODS: The isolates were characterized by antibacterial susceptibility testing, coagulase serotyping, coagulase gene polymorphism (coag-RFLP) and pulsed-field gel electrophoresis (PFGE). RESULTS: The MRSA isolates were highly resistant to gentamicin, kanamycin, ciprofloxacin, tetracycline, fusidic acid and mupirocin. The prevalence of gentamicin, kanamycin, streptomycin, tetracycline and erythromycin resistance remained high (80-96%) throughout the study period, but the prevalence of resistance to ciprofloxacin, fusidic acid and mupirocin steadily increased. The already high mupirocin resistance level increased from 12.5 in 1996, to 85.7% in 2001, and the fusidic acid resistance varied between 70.8 and 85.7%. In contrast, chloramphenicol and trimethoprim resistance declined from 25 and 29% in 1996 to 4.7 and 14.2% in 2001, respectively. The majority (91.5%) of the isolates were coagulase serotype 4. AluI restriction endonuclease analysis of amplified coagulase gene generated four coag-RFLP patterns: 92% of them were coag-RFLP type 1, while types 2, 3 and 4 were 3.5, 4.6 and 1.1% respectively. PFGE differentiated them into seven pulsotypes (PFGE types 1-7). The PFGE type 1 pulsotype constituted 90.2% of the isolates. Isolates with the type A coag-RFLP also had the type1 PFGE pulsotypes. CONCLUSION: The concordant results of PFGE and coag-RFLP demonstrated the presence of a persistent MRSA clone in the hospital during the study period.

Anti-Bacterial Agents↗
PubMed2006

Penetrating cardiac injury.

OBJECTIVES: To report a case of penetrating cardiac injury with patient's survival. CLINICAL PRESENTATION AND INTERVENTION: A 23-year-old man stabbed with a knife to the epigastric area just below the right costal margin was brought to the Emergency Room, Al-Adan Hospital, Kuwait, in a state of shock. Aggressive resuscitation was performed, chest X-ray showed no evidence of hemo- or pneumothorax. Exploratory laparotomy was performed revealing a severely congested liver, with no intraperitoneal hemorrhage to explain his being in a state of shock. Left thoracotomy revealed pericardial tamponade with perforation in the right ventricle and hemorrhage. A mattress suture was used to control bleeding from the right ventricle. Postoperative echography revealed a tear in the interventricular septum and papillary muscle. Open-heart surgery was performed to repair the injured tissues. The patient made an uneventful recovery. CONCLUSION: This report shows that patients with penetrating cardiac injuries and detectable vital signs on arrival at the hospital can be salvaged by prompt surgical intervention.

Adult↗
PubMed2006

Plasmid-mediated high-level ceftriaxone resistance in a Salmonella enterica serotype typhimurium isolate.

OBJECTIVE: To present the first documented case of acute infectious gastroenteritis caused by high-level ceftriaxone-resistant Salmonella enterica serotype typhimurium in Kuwait. SUBJECT AND METHODS: Isolation from stool specimen and species identification of current enteric pathogen was carried out according to standard methods. Susceptibility to antibiotics was determined by the disc diffusion method on Mueller-Hinton agar. Minimal inhibitory concentrations (MICs) were measured with E-test strips. The production of extended spectrum beta-lactamase (ESBL) was studied by the double disc synergy method and E-test ESBL strips. Plasmid DNA isolation was performed by the rapid alkaline lysis method. Plasmid DNA was transferred by conjugation to a recipient strain of Escherichia coli. RESULTS: The isolate of S. enterica serotype typhimurium was resistant to ceftriaxone (MIC >256 mg/l), cefotaxime and ceftazidime, and produced ESBL. Ceftriaxone and cefotaxime resistance were co-transferred on a 3.2-kb plasmid to the E. coli recipient strain. Loss of the 3.2-kb plasmid from the transconjugant resulted in the co-loss of ceftriaxone and cefotaxime resistance confirming the carriage of ceftriazone resistance on the 3.2-kb plasmid. CONCLUSION: Plasmid-mediated high-level resistance to ceftriaxone and ESBL production in Salmonella serotype typhimurium is an emerging problem among Salmonella that requires closer monitoring of antimicrobial resistance among these bacterial species.

Anti-Bacterial Agents↗
PubMed2006

Estimation of radiation dose during diagnostic X-ray examinations of newborn babies and 1-year-old infants.

OBJECTIVE: It was the aim of this study to investigate radiation doses for commonly performed paediatric X-ray examinations (skull, chest, abdomen and pelvis) in public hospitals in Kuwait in order to establish national reference or guidance dose levels. MATERIALS AND METHOD: Exposure factors used for six commonly performed X-ray examinations - antero-posterior (AP) chest, lateral chest, AP abdomen, AP skull, lateral skull and AP pel vis - were obtained from various hospitals, and entrance surface doses (ESD) were measured using a Victoreen model 660 survey meter. Effective doses (E) and the corresponding risk of developing fatal malignancies were calculated using published conversion factors and methods recommended by the International Commission of Radiological Protection for newborn babies to 1-year-old infants. RESULTS: The range of ESD values was 26- 668 microGy for newborn babies and 40-700 microGy for 1-year- old infants. The range of E values was about 4-150 microSv for the two age groups. The risk of developing long-term stochastic effects due to radiation exposure ranges between 0.6 and 23.4 per million. CONCLUSION: The range of ESD values, E values and risk of development of fatal malignancies obtained in this study can be used as a guide for the risk-benefit analysis of an X-ray examination for newborn babies and 1-year-old infants. Tube voltages used for these examinations should be kept above 60 kV, whenever possible, to minimise the radiation dose.

Hospitals, Public↗