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PubMed1986

Economic recession and international labour migration in the Arab Gulf.

"The article examines the broad effects of economic recession on immigrant labour flows into the Arab Gulf states. Attention is focussed on Kuwait which has experienced a significant reduction in new expatriate labour inflows since 1983. At the same time, however, the increasing rate of work permit renewals and of job transfers within the labour market suggest a growing stability of the expatriate workforce. As a result it is concluded that the economic recession may not result in a significant draw-down on expatriate labour stocks."

Asia↗

PubMed1986

Migrant workers in the Arab Gulf: the impact of declining oil revenues.

"This article explores the relationship between government expenditure and labor immigration in the Arab Gulf states. This relationship was close and positive during the rapid growth of the 1970s. Using Kuwait as a case study, trends in immigrant labor movements over the period 1981-85 are considered in detail. This analysis shows that the current economic downturn, reflecting the collapse of the world oil prices, has not resulted in the large scale re-export of foreign labor which was envisaged. The reasons for this foreign labor retention are considered and the authors speculate on future migration trends in the region."

Asia↗

PubMedDate not supplied

Factors affecting employment in the Arabian Gulf region, 1975-1985.

"This paper attempts to shed light on factors contributing to the identification of the main employment patterns in the countries of the Arab Gulf region. It also seeks to answer the question of how determinants of employment vary between national and foreign workforces and whether these determinants have changed over time." The countries concerned are Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates.

Asia↗

PubMed1993

Indirect mortality estimates for children under five in six Arab countries.

"Data from various censuses and surveys covering the last two decades for six Arab countries (Bahrain, Egypt, Jordan, Kuwait, the Syrian Arab Republic, and the United Arab Emirates) are analysed using the Brass-Trussell methodology and the Coale-Demeny West model life tables. Overlapping levels and trends with respect to various infant and childhood mortality measurements since the mid-1950s are determined. The measurements show that these countries are not homogeneous with respect to mortality, as they reflect disparities in both health programmes, standards of living and quality of life."

Africa↗

PubMed1987

Development and human resources in the Islamic world: a study of selected countries.

"The present paper attempts to provide an analytical profile of development and human resources in [12] selected [Islamic] countries." The countries--Bangladesh, Somalia, Pakistan, Indonesia, Egypt, Turkey, Malaysia, Algeria, Iraq, Saudi Arabia, Kuwait, and United Arab Emirates--vary in income levels from low to high and in population size from 1 million to 159 million. Using data from the World Bank and the Population Council, comparisons are made on the basis of mortality and fertility levels, family size, income, urbanization, labor force size and growth, education, nutrition, and health. Governmental policy changes and future directions are discussed.

Africa↗

PubMed1989

A system for collecting vital statistics in Gulf Cooperation Council countries.

"This paper examines the four major sources of population data in the countries of the Arab Gulf Cooperation Council (GCC) viz., general population censuses, registration statistics, household surveys and permanent registration of population. The paper starts with an analysis of the status quo of these sources in each country of the GCC, then proceeds to examine their standards of accuracy and finally identifies the problems faced by the data collection process in each source separately and states some practical solutions to them." The countries concerned are Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates.

Asia↗

PubMed2002

15 Years in surgical management of pulmonary hydatidosis.

OBJECTIVES: Echinococcosis remains an endemic surgical problem in countries where sheep and cattle raising is carried out, particularly in many Mediterranean countries. This study aims to evaluate the management of different presentations of pulmonary hydatidosis and their outcome over 15 years. DESIGN: Retrospective study. SETTING: Thoracic surgical department, Chest Diseases Hospital, Kuwait. PATIENTS: Sixty patients operated upon for hydatid disease were evaluated pre- and post- operatively; 35 males, 25 females with a mean age of 28.4 years. Most patients were investigated by laboratory, serological and radiological studies. Different surgical techniques were used to remove the hydatid cyst from the lung. RESULTS: The most common presenting symptoms were cough (41 patients), and 12 patients were asymptomatic. Chest X-ray showed a rounded shadow in 42 patients; 19 cases were of vigorous size >10 cm. Thoracotomy was done in 57 patients; two chest wall cases were managed by minimal skin incision and enucleation, one hydatid cyst of the heart was approached through a median sternotomy. The mean hospital stay was 9 days. Postoperative complications occurred in 9 patients; prolonged air leak in 4 patients, pleural effusion in 3, pneumothorax, and wound infection in one patient each. One patient (65 years old) died on the 6th post-operative day most probably from pulmonary embolism. In a follow-up period of 2-15 years, 4 recurrences have been noted. CONCLUSION: Surgical excision of pulmonary hydatidosis with maximum preservation of the lung parenchyma is the main stay of treatment.

Adult↗

PubMed2002

Instructional skills of surgical tutors.

AIM OF STUDY: This study was aimed at evaluating the pattern of instructional skills of surgical tutors in a university hospital and the effect of feedback on this pattern. METHOD: Students who followed three clinical rotations at the Department of Surgery, Mubarak Al-Kabeer Teaching Hospital, Kuwait, responded anonymously to a structured questionnaire on the instructional skills of their tutors immediately after the rotation was completed. The questionnaire included six statements related to teacher-centred instructional skills and six statements related to student-centred instructional skills. The students indicated their perception on a five-point rating scale (very poor, poor, fair, good and very good). A summary of students' opinions was made available to the teachers soon after each rotation. RESULTS: The percentage of good/very good categories was significantly higher in the teacher-centred skills compared with the student-centred skills (median (range), 87.05% (85.9-91.7) compared with 79.6% (76.6-80.6), (p = 0.004, Mann Whitney U test). This difference was significant in the first two rotations (p < 0.005) but not in the third rotation (p=0.59). CONCLUSIONS: This study shows that behaviours of teachers which dealt directly with the learner's role in learning received lower emphasis than the teacher-centred activities and that feedback may modify this behaviour.

Adult↗

PubMed2003

Angiotensin converting enzyme gene insertion-deletion polymorphism is associated with juvenile rheumatoid arthritis.

OBJECTIVE: To investigate the incidence of angiotensin converting enzyme (ACE) gene insertion-deletion (I/D) polymorphism genotypes in children with juvenile rheumatoid arthritis (JRA), a heterogeneous chronic disease with autoimmune pathology. ACE gene I/D polymorphism influences the plasma and tissue levels of ACE and has an involvement in inflammatory mechanisms. METHODS: The incidence of ACE gene I/D polymorphism genotypes was determined in 82 children with JRA from Kuwait and compared to that in 48 ethnically matched healthy controls using polymerase chain reaction. RESULTS: A considerably higher incidence of II genotype was observed in the JRA patients compared to controls (p < 0.003). In contrast, no statistically significant difference was detected in the incidence of DD and ID genotypes in JRA patients and controls (p = 0.276 and 0.460, respectively). The incidence of ACE gene polymorphism genotypes was also studied in clinical subclasses of JRA patients and controls. There was no significant difference in the incidence of DD and ID genotypes in either of the 3 JRA subclasses (oligoarticular, polyarticular, and systemic) when compared to controls. However, the incidence of II genotype was found to be significantly higher in all the 3 JRA subclasses compared to controls. The strongest association between II genotype and JRA subclasses was detected in systemic JRA, followed by oligoarticular and polyarticular JRA. This was also reflected in a higher prevalence of I-allele in the systemic JRA cases (13/26, 50%) compared to the D-allele (11/26, 42%). In contrast, D-allele of the ACE gene was more prevalent in oligoarticular and polyarticular JRA cases, than the I-allele (61% and 58%, respectively). CONCLUSION: Our data suggest a significant association of the I-allele of the ACE gene I/D polymorphism with the 3 clinical subclasses of JRA in children, and the highest association was observed in systemic JRA cases.

Arthritis, Juvenile↗

PubMedDate not supplied

Musculoskeletal pain, disability and health-seeking behavior in adult Kuwaitis using a validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire.

OBJECTIVE: The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We investigated data on musculoskeletal pain, disability and health-seeking behavior in the first community-based COPCORD study in Kuwait. METHODS: The validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire was used in 2,500 randomly selected Kuwaiti households. The target population comprised Kuwaiti nationals aged 15 years and older. Twenty-four trained field workers completed the survey in 8 weeks. Those subjects reporting musculoskeletal pain were identified (Phase 1), and were asked to complete a self-evaluation questionnaire (Phase 2) prior to rheumatological examination (Phase 3). Phase 2 included questions on the site and severity of pain, traumatic events, functional disability, and treatment. Patients marked their pain sites on a mannequin during their interviews. "Sufferers" were defined as those with musculoskeletal pain and no history of trauma. RESULTS: A total of 7,670 adults were interviewed (response rate 88%), of whom 2,057 had musculoskeletal pain not related to trauma. Knees, back, and shoulders were the common sites of pain. Most of the sufferers reported the severity of pain as being moderate to severe. Functional disability was reported in 39.1% of the sufferers. The age-sex population adjusted prevalence rate for musculoskeletal pain was 35.7% in females and 20.2% in males. The most common sources for advice on treatment were physicians in hospitals (68.8%) and general practitioners (30.4%). 82% had prescriptions for their medications, while 19.4% had self prescribed tablets. CONCLUSION: Musculoskeletal pain is a major health problem among Kuwaitis and deserves intense government attention.

Adolescent↗

PubMed2004

Abortion in Islamic countries--legal and religious aspects.

The debate over abortion is still controversial as ever. As one of every four people in the world is of the Muslim religion, it is important to learn more about the Islamic point of view toward this dilemma in medical ethics. The first part of this paper gives a general view of the sources of Islamic law and discusses modern developments in Islamic medical ethics regarding abortion. The second part focuses on the legal aspects of abortion in different Islamic states, dealing with the need to supply solutions to women who for different reasons wish to abort and at the same time enact laws that would not contradict Islamic principles. A study of three Muslim states (Egypt, Kuwait and Tunisia) demonstrates three different approaches toward legalizing abortion--a conservative approach, a more lenient approach, and a liberal one--all within Islamic oriented states. This leads to a conclusion that a more liberal attitude regarding abortion is possible in Islamic states, as long as traditional principles are taken into account.

Abortion, Induced↗

PubMed1992

[Injuries from mines].

In autumn 1991, 157 patients injured by mine explosions were taken care of by a Norwegian military medical unit attached to the United Nations mission in the demilitarized zone between Iraq and Kuwait. 146 of the patients were seen during a three week period of Iraqi mine harvesting in the desert. The detachment worked according to the principles of a second echelon surgical installation. The patients were operated upon if necessary, stabilized and evacuated to Iraqi hospitals. 20 patients in all (13%) died primarily. Four of 109 patients evacuated to the field hospital died (4%). 68 patients had major amputations, in seven of them two extremities were blown off. One patient had an open chest wound, two had tracheal puncture wounds, and one had penetrating head injury. 27 patients had eye injuries, 13 of which were penetrating. 64 major surgical procedures were performed. When evacuation times are long after mine injuries, approximately six hours, almost only patients with injuries to the extremities can be expected to reach hospital for treatment. The pattern of injury was regular, with crushed extremities, amputations and damaged eyes.

Adult↗

PubMed1992

[Not a tourniquet, but compressive dressing. Experience from 68 traumatic amputations after injuries from mines].

In autumn 1991, 68 patients with traumatic amputations after injuries caused by mines were evacuated to the United Nation's field hospital in the demilitarized zone between Iraq and Kuwait. Most were seen during a three week period when civilians harvested mines. During the first days of this period, continuous bleeding distally to applied tourniquets was frequently observed. Orders were issued to remove any tourniquets and cover the wounds with a very tight elastic bandage. Prehospital intravenous infusions were decreased. Three out of 18 patients died prior to the change of routine compared with one out of 50 afterwards. The new directives led to visibly less haemorrhage. Haemoglobin on admission was mean 8.6 g/100 ml during the first part of the observation period compared with mean 10.5 g/100 ml with the new routine. 23 patients received blood transfusions. Fewer patients needed transfusions after the use of tourniquets was discontinued. A tourniquet should not be used in the treatment of bleeding extremity injuries. In extensive crush injuries and traumatic amputations a compressive dressing should be used, applied from the end of the extremity in a proximal direction.

Adult↗

PubMed2004

Impaired gestational glucose tolerance. Its effect on placental pathology.

OBJECTIVE: The aim of this study was to investigate several macroscopic and microscopic features of placenta in cases with impaired gestational glucose tolerance. METHODS: Seventy-five gm World Health Organization criteria for the diagnosis of gestational diabetes and impaired gestational glucose tolerance were followed during the period June 1999 through to June 2000, at the Maternity Hospital of Kuwait. Macroscopic and microscopic examinations of 95 placentas were carried out. Sixty-five were from the control patients and 30 were from cases with impaired gestational glucose tolerance. RESULTS: Mean maternal age, maternal weight and parity was significantly higher in the impaired gestational glucose tolerance (IGGT) group compared to the control group. Mean birth weight of the baby was significantly higher in the IGGT group compared to the control group. Mean placental weight and the percentage of the cesarean delivery was higher in the IGGT group but did not reach the level of significance. There was no significant association between the microscopic features of the placenta in the control and IGGT groups. CONCLUSION: Impaired gestational glucose tolerance is related to increased neonatal and placental weight, which may lead to a higher number of cesarean deliveries, stressing the similarity between impaired gestational glucose tolerance and gestational diabetes mellitus. More stringent criteria may be necessary to define gestational diabetes. Microscopic features of placenta both in the control and IGGT groups did not show any significant difference.

Adolescent↗

PubMed2003

Seroprevalence of three emerging arboviral infections in Kuwaiti nationals.

Diseases caused by dengue, sandfly fever and hanta viruses pose a major health risk in many countries. We determined the threat of these arboviral infections through a serologic using enzyme linked immunosorbent assay (ELISA) based tests. Hantavirus-specific antibodies were also detected using immunofluorescence. Of 499 samples tested for dengue virus IgG antibodies l4% were as positive for dengue positive by all the ELISA tests. Among the 42 showing strong IgG reactivity, only 1 was positive for dengue virus IgM antibodies. All samples tested for IgG antibodies to sandfly fever virus were negative. Hantavirus antibodies were detected in 11% of the 46 samples from high-risk individuals. The low prevalences suggest that at present these infections are not a serious problem in Kuwait.

Adolescent↗

PubMed2005

Chronic renal disease in Kuwaiti nationals: a prospective study during the past 4 years.

Our study is a prospective one conducted at Al-Amiri Hospital and including all new cases of chronic renal disease (CRD) seen at the capital area of Kuwait between 1 January 1999 and 30 December 2003. Diagnosis of CRD was based on clinical, laboratory, and radiological features. Kidney biopsies were done when indicated. A total of 271 cases of chronic renal failure (CRF) were diagnosed, of whom 143 were women. The median age was 40 years (range, 5 to 80 years; mean +/- SD: 40 +/- 14). The most common cause of CRF was glomerulonephritis (32%), of which systemic lupus erythematosis and vasculitis constituted 5% and 4%, respectively. Diabetic glomerulosclerosis was the second leading cause of CRD (24%), followed by tubulointerstitial disease (11%) and nephroangiosclerosis (10%). Less frequent causes included renovascular/ischemic disease (6%), obstructive nephropathy (3%), and adult polycystic kidney disease (3%). One hundred and seven patients had 121 incidents of acute deterioration of underlying renal disease. This was mostly due to drugs (22%), infection (21%), and volume depletion (13%). Antiinflammatory drugs were the most common drugs (63%) responsible for the acute decline in renal function. By the end of the study, 18 (7%) patients died, 55 (20%) required maintenance dialysis, and 40 (15%) had received a kidney allograft. Diabetic patients did not differ from nondiabetic with regard mortality, although had more renal replacement therapy (p = .002). Using the Cox regression model, analysis of the relative risk factors likely to contribute to mortality, viz. age, gender, original kidney disease, fitness for transplantation, and mode of presentation, did not show significant factors except for less hazard to death in those diagnosed early with CRD (i.e., on routine testing; relative risk 0.06, p = .01). In conclusion, our study indicates that early diagnosis and management of CRD can improve the patient's quality of life and decrease the cost of frequent hospitalization, morbidity, and even mortality associated with end-stage renal disease.

Adult↗

PubMedDate not supplied

Life expectancy and cause of death in the Kuwaiti population 1987-2000.

Census and health data were analysed to determine changes in life expectancy at birth during 1987-2000 in the Kuwaiti population and to correlate these with cause-specific annual mortality rates. Life expectancy at birth rose from 73.3 to 75.5 years with a gap between females and males, which increased from 2.2 to 4.5 years. For all causes of death except hypertension and ill-defined conditions, males had higher mortality than females. The leading causes of death in males were ischaemic heart diseases, traffic accidents and cancer, while in females they were cancer, ischaemic heart diseases and hypertension. The problems of an ageing population will need to be considered in planning the health policies of Kuwait.

Accidents, Traffic↗

PubMed1991

Sarcoidosis in Arabs: the clinical profile of 20 patients and review of the literature.

Sarcoidosis is being increasingly recognised in Kuwait. Twenty patients were studied over three years and the clinical, biochemical and radiological data were analysed. The clinical profile revealed thoracic involvement in all the patients as well as constitutional symptoms (50%), arthralgia (55%), arthritis (15%), chest infection (35%), tuberculosis (10%), hypercalcaemia (5%), angina (15%) and hypertension (20%). None had central nervous system manifestations. Other clinical signs were erythema nodosum (25%), hepatomegaly (30%) splenomegaly (15%) and chest signs (25%), together with salivary gland (15%), skin (15%), eye (15%), and cardiac involvement (5%). The tuberculin test was negative in all those tested. The patients were classified radiologically into stage I (55%), stage II (40%) and stage III (5%) of the disease. The clinical profile was similar to the Western pattern of the disease, but there were several differences including an older age group, more frequent constitutional symptoms, the rarity of ocular and central nervous system involvement, and initial presentation as a chest infection. Therapy with steroids alone or steroids and azathioprine was used when appropriate and the response to therapy monitored.

Adult↗