A COMPARATIVE STUDY ON CERVICAL CANCER SCREENING METHOD: IS IMMUNO-MARKER A BETTER OPTION?

Cervical cytology by Papanicolaou (PAP) staining has been the backbone of primary screening of cervical cancer. For low resource countries, the major constraints in running a successful screening program are paucity of experienced personnel, requirement for multiple visits, economic considerations and inherent attributes of the test including a low sensitivity and specificity. The present study was designed to compare the efficacy of commonly available screening tests and feasibility of immuno-markers (p16 & Ki-67) as a primary screening tool. This was a cross-sectional analytical study. 100 patients were approached and agreed to participate in this study. They underwent cervical screening by multiple modalities including PAP smear, Liquid based cytology (LBC), HPV- DNA testing, cytology + HPV- DNA/p16/ Ki-67 and dual markers. Screening test results were compared with histopathology and statistical analysis done. The sensitivity and specificity of conventional cytology was 61.11% and 70%; LBC: 88.88% and 50%; Cytology + HPV DNA: 94.44% and 50%; Cytology + p16: 88.88% and 60%; Cytology + Ki-67: 88.88% and 100%; P16+Ki67: 88.88% and 60%. Combining Ki- 67 with Conventional cytology improved specificity and positive predictive value of cervical cancer screening.

Are there differences in oxidative stress and inflammatory processes between the autogenous and reactive subtypes of obsessive-compulsive disorder? A controlled cross-sectional study

Objective: To date, no study has investigated whether autogenous and reactive obsessive-compulsive disorder (OCD) types are different entities in terms of oxidative stress and inflammatory processes. The aim of this study is to compare them in terms of these features. Methods: The study was conducted in subjects with reactive OCD (n=19), autogenous OCD (n=14), and a control group (n=17). All participants were non-smokers. Sociodemographic data were collected and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Obsessive Beliefs Questionnaire (OBQ), and Overvalued Ideas Scale (OVIS) were administered. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) were measured. Results: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) between the OCD and control groups. PON1 and hs-CRP levels were higher in the OCD group, whereas IL-6 and IL-10 levels were lower. Comparison across the three groups revealed no differences in TAS, TOS, OSI, or PON1 levels; however, hs-CRP was significantly higher while IL-6 and IL-10 were significantly lower in the reactive group compared to controls. Conclusion: Our results show that, although inflammatory processes may play a role in OCD, the autogenous and reactive subtypes do not differ from each other in these respects. The classification of OCD into autogenous and reactive subtypes should be reevaluated.

Influence of foliar application of glycinebetaine on Tagetes erecta L yield cultivated under salinity conditions

Abstract Tagetes genus of Composite family consider one of the most favorite floriculture plants. Therefore, of particular interest examine the salt tolerance of this bedding and coloring agent plant. In this research, was report the role of glycinebetaine (GB) in attenuating the adverse impacts of salt stress in African marigold plant, along with their anti-oxidative capacities and biochemical attributes. The salt stressed African marigold (100 and 150 mM NaCl) was treated with GB at 200 mM, beside untreated control plants. According to the obtained results, the growth characters were negatively in salt stressed plants but a mitigate impact of GB were observed in this respect. Obviously, the morphological as well as some physiological characters were reduced with salinity treatments while GB treatment reverses these effects. Overall, the alleviate impact of GB on the negative impact of salt stress was enhanced through improving total phenolic and antioxidant enzyme activity. Further, it is concluded that GB concentration induces the activities of antioxidative enzymes which scavenged ROS increased under saline conditions.

Resumo O Tagetes, da família Composite, é um dos gêneros mais apreciados de plantas de floricultura. Portanto, é de particular interesse examinar a tolerância ao sal desta planta de substrato e corante. Nesta pesquisa, foi relatado o papel da glicinebetaína (GB) na atenuação dos impactos adversos do estresse salino na calêndula africana, juntamente com suas capacidades antioxidantes e atributos bioquímicos. A calêndula africana estressada com sal (NaCl 100 e 150 mM) foi tratada com GB a 200 mM, ao lado de plantas de controle não tratadas. De acordo com os resultados obtidos, os caracteres de crescimento foram negativos em plantas estressadas por sal, mas um impacto mitigado de GB foi observado neste aspecto. Obviamente, os caracteres morfológicos e fisiológicos foram reduzidos com os tratamentos de salinidade, enquanto o tratamento com GB reverteu esses efeitos. No geral, o impacto de alívio do GB no impacto negativo do estresse salino foi aprimorado através da melhoria da atividade das enzimas fenólicas e antioxidantes totais. Além disso, conclui-se que a concentração de GB induz as atividades de enzimas antioxidantes que sequestraram ROS aumentadas em condições salinas.

Influence of foliar application of glycinebetaine on Tagetes erecta L yield cultivated under salinity conditions / Influência da aplicação foliar de glicinebetaína na produtividade de Tagetes erecta L cultivada em condições de salinidade

Tagetes genus of Composite family consider one of the most favorite floriculture plants. Therefore, of particular interest examine the salt tolerance of this bedding and coloring agent plant. In this research, was report the role of glycinebetaine (GB) in attenuating the adverse impacts of salt stress in African marigold plant, along with their anti-oxidative capacities and biochemical attributes. The salt stressed African marigold (100 and 150 mM NaCl) was treated with GB at 200 mM, beside untreated control plants. According to the obtained results, the growth characters were negatively in salt stressed plants but a mitigate impact of GB were observed in this respect. Obviously, the morphological as well as some physiological characters were reduced with salinity treatments while GB treatment reverses these effects. Overall, the alleviate impact of GB on the negative impact of salt stress was enhanced through improving total phenolic and antioxidant enzyme activity. Further, it is concluded that GB concentration induces the activities of antioxidative enzymes which scavenged ROS increased under saline conditions.

O Tagetes, da família Composite, é um dos gêneros mais apreciados de plantas de floricultura. Portanto, é de particular interesse examinar a tolerância ao sal desta planta de substrato e corante. Nesta pesquisa, foi relatado o papel da glicinebetaína (GB) na atenuação dos impactos adversos do estresse salino na calêndula africana, juntamente com suas capacidades antioxidantes e atributos bioquímicos. A calêndula africana estressada com sal (NaCl 100 e 150 mM) foi tratada com GB a 200 mM, ao lado de plantas de controle não tratadas. De acordo com os resultados obtidos, os caracteres de crescimento foram negativos em plantas estressadas por sal, mas um impacto mitigado de GB foi observado neste aspecto. Obviamente, os caracteres morfológicos e fisiológicos foram reduzidos com os tratamentos de salinidade, enquanto o tratamento com GB reverteu esses efeitos. No geral, o impacto de alívio do GB no impacto negativo do estresse salino foi aprimorado através da melhoria da atividade das enzimas fenólicas e antioxidantes totais. Além disso, conclui-se que a concentração de GB induz as atividades de enzimas antioxidantes que sequestraram ROS aumentadas em condições salinas.

β-Aminobutyric Acid Raises Salt Tolerance and Reorganises Some Physiological Characters in Calendula officinalis L. Plant

Salt stress is one of the main factors limiting plant growth and yield globally. Seed priming technique with different chemicals including β-aminobutyric acid (BABA) is found to be effective in enhancing plant growth and development under biotic and abiotic stresses. Scarce reports have been found about BABA seed priming in medicinal plants under stress conditions; however, several studies have been conducted on other crops but have not made an in-depth study to investigate biochemical and physiological changes. In current study the shoot growth, relative water content (RWC), chlorophyll content, stomatal conductance, nutrient content (N, P, K, Na and Cl), proline, malondialdehyde (MDA), hydrogen peroxide (H2O2) content, antioxidants enzymes (CAT, SOD and POD), membrane stability index (MSI), total phenolic and flavonoids contents lipid peroxidation and membrane permeability were investigated in Calendula officinalis L. leaves due to BABA seed priming and/or salt stress treatment. Salt stress treatment significantly reduced the growth characters, inflorescence number as well as its fresh and dry weights, N, P and K contents in leaves, RWC, chlorophyll content, stomatal conductance, MSI and total phenolic and flavonoids contents of pot marigold. However, proline content, MDA accumulation, H2O2 content and antioxidant enzyme activity (CAT, SOD and POD) were increased due to salt stress. On the other hand, seed priming with BABA significantly improved the growth characters, inflorescence attributes and the previously mentioned physiological and biochemical parameters investigated relative to the control. Applying seed priming under salt stress conditions significantly mitigated the negative effects of salinity and enhanced the growth and productivity of pot marigold and therefore was suggested to be an effective technique prior to cultivation.

Diversity of Soil Cyanobacteria in Relation to Dominant Wild Plants and Edaphic Factors at Western Saudi Arabia

The study aims at evaluating cyanobacterial diversity along altitudinal gradient with respect to various edaphic factors at western Saudi Arabia. Thirty-one cyanobacteria species belonging to 17 genera were isolated and identified along the different sites of the study area. Nostoc and Spirulina had the highest number of species in the study area (four species each), followed by Chroococcus and Oscillatoria (two species each). The number of colonies had positive correlation with organic matter and phosphates. The application of the two-way indicator species analysis to the data set of the percentage presence of 31 cyanobacteria species in 40 stands resulted in agglomerating of 6 groups (communities) at 4th level of classification. The application of the detrended correspondence analysis (DCA) indicates reasonable segregation between these groups .The application of CCA on the cyanobacteria communities and environmental variables indicated that some cyanobacteria species are correlated positively with total number of associated plants, TSS and phosphates such as Woella saccata Wolle, Chroococcus minor Lemm, Chroococcus majore Lemm, Microcystis areuginosa, Smith Anabaena spiroides Lemm and Nostoc muscorum Agard, while others are negatively correlated with organic matter, chlorides, pH, EC, clay and silt such as Oscillatoria limosa Bory, Synchococcus sp., Spirulina major Kutz and Lyngbya borgertii Lemm. It is worthy to mentioned that, the soil samples dominated by Commicarpus sinaicus Meikle, Verbesina encelioides (Cav.) Benth &Hook. f. ex A. Gray, Argemone ochroleuca Sweet, Haloxylon salicornicum (Moq.) Boiss., Acacia tortolis (Forssk.) Galasso & Banfi and Morettia parviflora Boiss. had no cyanobacteria species.

Effects of Biochar Amended Saline Soil on Growth and Some Metabolic Activities of Two Soybean Cultivars in Saudi Arabia

Application of biochar to soil additionally restores soil Carbon and nutrients lost from bioenergy cropping systems as a result of biomass harvesting. This study was carried out to investigate the effect of biochar amended saline soil on plant growth, leaf chlorophyll, soil mineral contents and some physiological parameters of two Soybean cultivars in Saudi Arabia. The obtained results showed that plant height, fresh and dry weight, chlorophyll a and b content of both varieties (Giza-111 and Clark) were inhibited in saline soil while enhanced in biochar one which derived from Pomegranate trees or biochar two which obtained from acacia trees. The highest value of carbohydrate and protein contents observed in Giza-111 with the compare to Clark cultivars under salinity conditions. It was concluded that soybean is a sensitive plant to salinity stress, but the extent of this sensitivity varies among cultivars. As a result, Giza-111 cultivar showed more capability to survive under salinity condition compared with another variety regarding of almost all plant parameter examined. Considering, biochar one was found more appropriate under salinity condition.

Age Structure of a Red Fox [Vulpes vulpes] Sample from Egypt

Background: the Red Fox Vulpes vulpes is the most common and wide spread wild carnivore in Egypt

Materials and Methods: we examine a museum sample of 179 specimens from different parts of Egypt to determine age structure using dentine layers counting method. Specimens were grouped into three population groups according to their geographical region of origin

Results: the average age of foxes in the sample was 1.46 years and ranging from 1 to 7 years of age. Differences in age structure of populations from the three geographical regions and differences between sexes are presented and discussed

Adherence of type-2 diabetic patients to treatment

To determine the percentage of non-adherent patients with type 2 diabetes [T2D] attending primary health care [PHC] settings and to assess related factors Cross sectional case-control study Five primary health care centers [one from each health region in Kuwait] Six hundred and ninety-three T2D patients Comparison between cases and control was conducted using univariate analysis followed by a logistic regression analysis. The collected data included sociodemographic, Clinical, and patients' practice data. Adherence to T2D treatment recommendations Among 693 participants in this study, 181 were diagnosed as non-adherent to treatment recommendations with an overall 26.1% rate. They were compared with 512 adherent patients. Within socio-demographic variables, only education and family income were proved to be significantly associated with adherence to treatment. Among Clinical variables, poor glycemic state [OR = 2.1, 95% CI: 1.2 - 4.7], hypertension [OR = 1.9, 95% CI: 1.2 - 3.2], co-morbid conditions [OR = 3.2, 95% CI: 1.3 - 6.2] were significant determinants of the outcome of interest. Regular follow- up visits, compliance with diet recommendations and mild physical activity were significant protective determinants related to patients' practice [OR = 0.4, 95% CI: 0.1 - 0.9], [OR = 0.3, 95% CI: 0.1- 0.6], [OR = 0.3, 95% CI: 0.2 - 0.8], and [OR 0.5, 95% CI: 0.2 - 0.9] respectively. Many amenable factors were associated with non-adherence. Health education to diabetic patients should be emphasied to improve patients' knowledge, attitude and practice to encourage their adherence. Further studies are needed regarding physicians' practice and their relation with patients

Histological characteristics of botulinum neurotoxin-A on rat skeletal muscles

Botulinum neurotoxins-A [BT-A] are bacterial enzymes that block neurotransmitter release. BT-A is widely used to treat spasticity and dystonias, and also in pharmacocosmetic and in the management of various types of pain. It is therefore important to clarify the histological characteristics involved in muscular tissue postinjection and to reconcile its injection for cosmoses under scope. Fifteen adult albino rats were used in this study and divided into three groups [five rats each]. Group I served as negative control; groups II and III were injected into the right gastrocnemius muscle with BT-A in addition to saline into the left side to serve as positive control. Muscle harvest was examined by LM, EM, and morphometry at 28th day for group II with two rats of group I and at 56th day for group III with three rats of group I. Histological examination revealed neurogenic atrophy, target fiber change, hypertrophied fibers, and dilated aggregates of the sarcotubular system. Neurogenic muscle atrophy following a single BT-A injection should be taken into consideration when repeated BT-A injections into the same muscle are needed

Antibacterial effectiveness of low energy diode laser irradiation on management of periodontitis in Down syndrome

With the poor oral hygiene exhibited by patients with Down syndrome, the potential for a robust flora arises causing Periodontitis. Along with periodontal disease, the patient population has other medical conditions that limit treatment. This study was conducted to evaluate the antibacterial effectiveness of an 870-nm diode laser on periodontitis in patients with Down syndrome. Thirty five patients with Down syndrome suffering from periodontitis were included in this study and divided into two groups, Group I [25 patients] laser was applied to one half of the mouth and the other half was considered as a control and Group II included [10 patients] basic periodontal treatment was applied to evaluate the systemic effect of laser. Quantification of A. actinomycetemconcomitans, P. Gingivalis and Capnocytophaga were carried out using real-time PCR technique at baseline and at 2 weeks, at 6 weeks and at 12 weeks post periodontal and laser treatment. A. Actinmycetcomitans and P. gingivalis were the most common organisms found in the studied patients and Capnocytophaga was the least common organisms. In group I the quantitative results of A. actinomycetemconcomitans, P. Gingivalis at 2 weeks were significantly lower in both sides of mouth than that of baseline level. After 6 week, it was still significantly lower than that of the baseline in the right side of the mouth, but at 12 weeks no significant difference was observed in both sides. In group II, quantitative results of A. actinomycetemconcomitans, P. Gingivalis at 2 weeks were also significantly lower than that of baseline but not at 6 and at 12 weeks. As regards, Capnocytophaga there was no significant difference at baseline, at 2 weeks, at 6 weeks and at 12 weeks post periodontal and laser treatment in both groups I and II. Scaling and root planning plus laser therapy was better than scaling and root planning alone in the chosen patients and this antibacterial effect continues to be significant up to 6 weeks after therapy. Based upon the results of the study, it was found that Laser therapy could be used for the treatment of periodontitis as a complementary therapy not to replace mechanical intervention

Chronic non-communicable disease Risk Factor Survey 2010 among University of the West Indies staff at Cave Hill, Barbados / Encuesta de 2010 Sobre Factores de Riesgo de las enfermedades no comunicables entre el personal de la Universidad de West Indies, en el Campus de Cave Hill, Barbados

OBJECTIVE: To determine the prevalence of risk factors for chronic non-communicable diseases (CNCDs) among staff of The University of the West Indies (UWI), Cave Hill campus, in Barbados. METHODS: A self-administered questionnaire comprising validated questions from the WHO STEPS NCD Risk Factor Survey, the Jamaica Healthy Lifestyle (JHL) Survey and the Behaviour Risk Factor (BRF) Survey, was conducted during the Staff Health Day in May 2010, and at four locations on campus during July 2010. Standardized measurements of weight, height and blood pressure were taken. Data were analysed using EXCEL and STATA and results were compared to the Barbados 2007 STEPS NCD survey. RESULTS: The target population was all staff at the Cave Hill campus of UWI. The coverage rate was 25.2% (269/1068); 63.8% of males and 75% of females were either overweight or obese. Ninety-seven per cent ate less than the recommended 5 fruits and vegetables per day. Low levels of physical activity were reported in 51.9% of males and 62.2% of females. Thirty-two per cent of males and 13% of females were binge drinkers. All participants had at least one of the risk factors (current daily smoker, < 5 fruits and vegetables/day, physical inactivity, overweight/obese and raised blood pressure) whilst 48% of males and 57.2% of females demonstrated three or more risk factors. These results are similar to those found in the Barbados STEPS NCD risk factor survey of 2007. CONCLUSION: The results confirm a similar high prevalence of NCD risk factors among Cave Hill UWI staff as among the Barbadian population. The study reveals opportunities to inform policy on strategies to positively impact the risk factors.

OBJETIVO: Determinar la prevalencia de los factores de riesgo de ENCs entre el personal de la Universidad de West Indies (UWI), en el campus de Cave Hill, Barbados. MÉTODOS: El Día de la Salud del Personal en mayo de 2010, y en cuatro localidades del campus durante julio de 2010, se aplicó un cuestionario auto-administrado formado por varias preguntas validadas de las encuestas conocidas como WHO STEPS NCD Risk Factor Survey, JHL Survey y BRF Survey. Se hicieron mediciones estandarizadas del peso, la altura, y la presión arterial. Los datos fueron analizados usando EXCEL y STATA, y los resultados fueron comparados como los de la encuesta de Barbados 2007 STEPS NCD. RESULTADOS: La población objeto del estudio estuvo formada por todo el personal en el campus de Cave Hill de la Universidad de West Indies (UWI). La tasa de cobertura fue 25.2% (269/1068); el 63.8% de los varones y el 75% de hembras tenían sobrepeso o eran obesos. Noventa y siete por ciento consumía menos de las 5 frutas y vegetales recomendados por día. Se reportaron bajos niveles de actividad física en 51.9% de los varones y 62.2% de las hembras. Treinta y dos por ciento de los varones y 13% de las hembras eran bebedores consumados. Todos los participantes tenían al menos uno de los factores de riesgo (fumador consuetudinario, < 5 frutas y vegetales/día, inactividad física, sobrepeso/obeso, y alta presión arterial) en tanto que el 48% de los varones y el 57.2% de las hembras mostraron tres o más factores de riesgo. Estos resultados son similares a los hallados en la encuesta Barbados STEPS NCD Risk Factor Survey del 2007. CONCLUSIÓN: Los resultados confirman una alta prevalencia de factores de riesgo de ENC entre el personal de Cave Hill de UWI similar a la existente entre la población barbadense en general. El estudio revela oportunidades de informar las políticas sobre estrategias de modo que puedan lograr un impacto positivo sobre los factores de riesgo.

predictive value of serum mannan-binding lectin levels for diabetic control and renal complications in type 2 diabetic patients

To evaluate the predictability of estimation of serum mannan-binding lectin [MBL] for the presence of infectious complications in type 2 diabetes mellitus [T2DM] and its relation to the extent of diabetes control. A comparative cross-sectional study was conducted at the Departments of Clinical Pathology and Internal Medicine, Faculty of Medicine, Benha University, Benha, Egypt from October 2009 to December 2010. Sixty adult patients with T2DM were divided into 2 groups: Group B and Group C and Group A as the control group. All subjects evaluation of insulin sensitivity [Homeostasis Model Assessment of Insulin Resistance [HOMA-IR]], and blood samples for estimation of fasting blood glucose [FBG], glycosylated hemoglobin Ale [HbAlc] and serum insulin, urea, creatinine, C-reactive protein [CRP],andMBL. All patients had significantly increased FBG, serum insulin, HOMA-IR index, serum CRP and MBL levels compared with the control group, with significantly higher levels in Group C. Levels of HbAlc, serum urea, and creatinine were significantly higher in patients than controls. There was a positive significant correlation between serum MBL and FBG, HOMAIR index, serum urea, creatinine, and CRP levels. The receiver operating characteristics curve analysis in infectious cases revealed high FBG, HOMA-index and serum levels of HbAlc, CRP, and MBL, while regression analysis defined elevated serum MBL levels as a significant independent predictor for the presence of infection. Elevated serum MBL in T2DM patients indicated a possible poor diabetic control and bad progression of the disease with possibility of the presence, or development of diabetic nephropathy especially in combination with elevated serum CRP

Vitiligo in a patient receiving infliximab for refractory ulcerative colitis

Infliximab is a chimerical monoclonal antibody that inhibits pro-inflammatory activity of tumour-necrosis factor alpha [TNF alpha] and it is the primary biological agent used in the treatment of moderate-to-severe ulcerative colitis [UC]. We report a case of vitiligo following infliximab administration in a patient with refractory UC. The case serves as a reminder of adverse cutaneous reactions induced by TNF alpha -antagonist therapy

Seroprevalence of toxoplasmosis among females in rural areas, Qalubeya governorate, Egypt

Toxoplasma gondii is an obligate intracellular protozoan parasite of significant public health importance, being a major cause of congenital infection and abortion as well as a significant and often fatal infection in the immuno-compromised hosts. Infection by T gondii is usually asymptomatic, but it can be life threatening in fetuses whose mothers are acutely infected during pregnancy. 10 determine the seroprevalence of Toxoplasma antibodies and the frequency of assumed associated complications among females in childbearing period in the rural community surrounding Benha Faculty of Medicine, Benha University, Qalubeya Governorate, Egypt. A total of 338 females were randomly selected from two villages scheduled in the routine Community Service Campaign Program [CSCP] of Benha Faculty of Medicine and from those attending Gynecology and Obstetrics Department, Benha University Hospital. Sera were screened for Toxoplasma IgG and IgM using enzyme immunoassay. One hundred and fifty females in the child bearing period aged from 15 to 49 years who fulfilled detailed history data, were chosen for assessment of the assumed associated risk of Toxoplasma complications, regarding unfavorable outcome of pregnancy. Of 338 sampled females, 165 [46.2%] and 17[5%] were seropositive for anti-Toxoplasma IgG and IgM, respectively, while out of 150 females in the childbearing period, corresponding results were 87 [58%] and 7 [4.7%], respectively. In the latter group, there was an observable difference in the age prevalence with peaks among 25-29 and 40-49 age groups for IgG positive females and among 25-29 and 45-49 years for IgM positive females, but this difference was statistically insignificant. There was a significant positive correlation between IgG positivity amid number of labors and also between IgM positivity amid history of congenital anomalies. The risk of abortion, congenital anomalies and stillbirth were insignificantly higher among IgG positive females. In IgM positive group, only an insignificant increased risk of congenital anomalies was observed. The IgG seroprevalence of T gondii among females in the childbearing age is relatively high [58%] indicating persistent favoring ecological circunistances. IgM seroprevalence [4.7%] suggested a potential considerable risk of primary infection during pregnancy with the subsequent risk of Toxoplasma congenital infection. Hence, it is worth considering routine antenatal screening of females as a mandatory measure, with follow up of seronegative case for possible seroconversion due to infection during pregnancy amid prompt treatment for sero-converted cases

Job satisfaction among physicians in Al-Sabah hospital, Kuwait

The prevalence of dissatisfaction among doctors has been given considerable importance in recent years as it affects the quality of health care. The aim of the present study was to determine the level of job satisfaction among doctors working at AL-Sabah Hospital in Kuwait, identify aspects of dissatisfaction and factors that could be associated with. All sixty physicians currently working in the department of internal medicine were asked to participate. A self-administered close-ended questionnaire was used to obtain personal data and information from the physicians on various aspects of job satisfaction. It included 20 items divided into 5 aspects that are relevant to a number of job facets. A 5-point, Likert-scale was used. Analysis was carried out using Chi-square and Fisher Exact tests. The response rate was 83.3%. Overall, 50% of participating physicians were generally satisfied with their job. Higher scores of satisfaction were reported among male, married, with longer experience, with higher qualification. Proportions of satisfaction with each item were presented. No significant difference could be detected according to personal factors and working conditions regarding these items except for nationality. Higher proportions of satisfied non Kuwaiti physicians were recorded regarding the freedom to use their own judgment [62.2% versus 14.4%, P = 0.004] and to do their own method to do the job [59.5% versus 23.1%, P = 0.02], whereas only 18.9% of non-Kuwaiti physicians were satisfied with their payment as compared with 69.2% in Kuwaiti physicians [P= 0.002] It is urgent and necessary to improve physician working conditions and their working pattern to maintain job satisfaction. Physicians themselves, hospital administrators and the government should take the initiative to improve the working conditions in Kuwait hospitals. Larger multi-centric research about this issue is needed

Prevalence and factors associated with chronic diabetic complications among patients attending primary health care, a multi-centric study in Kuwait

A substantial proportion of patients with diabetes develop long-term macrovascular and microvascular complications. Many risk factors have identified for development and progression of these complications. The aim of the present study was to determine the prevalence of these complications among adult diabetic patients attending primary health care centers in Kuwait and to identify factors that could be associated with especially those factors that can be considered avoidable. This study was carried out in five primary health care centers representing the five health regions in Kuwait. The sample included 704 adult diabetic patients who had been diabetic for at least 2 years. The first phase of study was a cross sectional study to determine the prevalence of chronic diabetic complications. The second one was a case-control study, whereas all patients with chronic diabetic complications [case group, n = 434] were compared to diabetic patients free from chronic complications [control group, n = 270] to determine the associated factors with cases. Analysis was initially carried out based on a series of univariate comparisons followed by multiple logistic regression analysis. Out of 704 diabetic patients 61.6% n= had one or more chronic diabetic complications. Cardiovascular complications were diagnosed in 30.3%, nephropathy in 12.4%, neuropathy in 32.1%, lower limb complications in 21.9%, and retinopathy in 30.7% of patients. Logistic regression analysis revealed that age, nationality, type and duration of diabetes, glycemic control, hypertension, obesity, physical exercises, and compliance with diet recommendations were proved as significant predictors of these complications. The high economic burden raised by diabetes and its complications challenges the Kuwaiti health care system to prevent the development and progression of diabetic complications. The study identified a group of predictor factors as hypertension and hyperglycemia, enhancement of patient' compliance with regular follow-up visit, the role of health care providers in supplying patients with health information groups of patients who needed priorities of screening programs for development of complication

Adenomatous colorectal polyps in patients referred for colonoscopy in regional hospital in Kuwait

Adenomatous colorectal polyps [ACPs] are known to be the precursor lesions for colorectal cancer. The aim of the study was to determine the prevalence, endoscopic and pathological features of ACPs in patients referred for colonoscopy. The endoscopic and histological reports of adult patients who underwent complete colonoscopy in the gastroenterology unit of a regional Kuwaiti hospital between January 2008 and December 2008 were retrospectively studied. The specimens of polyps were reviewed by an experienced pathologist who was blinded to the clinical or endoscopic information. Non-neoplastic polyps were not included in the analysis. Of 530 eligible patients [mean age, 45 years; male-female ratio, 2:1], 54 [10%] had 103 ACPs. Of the patients with ACPs [mean age, 57 years], 43 [80%] were males and 36 [67%] were Kuwaitis. Histopathological examination of the most significant polyp in each patient revealed that 40 [74%] polyps were tubular adenomas [TAs]; 11 [20%], tubulovillous [TV] adenomas; and 3 [6%], villous adenomas. High-grade dysplasia was noticed in 4 [10%] adenomas. Fifteen [2.8%] of the 530 patients had advanced ACPs. Logistic regression analysis of some variables and their association with ACPs found that age [P<0.001; OR, 1.9; CI, 1.5-2.3], history of adenoma [P=0.001; OR, 6.4; CI, .2.1-19.4] and being Kuwaitis [P=0.029; OR, 2.1; CI, 1.1-4.1] to be independently associated with ACPs. The most common histological type of ACPs was tubular adenoma. Advancing age, being Kuwaiti nationals and prior removal of ACPs were significantly associated with the occurrence of ACPs

Endoscopic nodular gastritis in dyspeptic adults: prevalence and association with helicobacter pylori infection

To determine the prevalence and histological features of endoscopic nodular gastritis [NG] in adult dyspeptic patients and its relation to Helicobacter pylori infection. A retrospective endoscopic report review of 2,142 patients identified 67 patients with NG during the period from 1 September 2006 to 31 August 2007. A subset of 32 NG patients [group 1] who had had gastric biopsies during upper gastrointestinal endoscopy and had been evaluated for H. pylori infection were compared to 32 age- and gender-matched dyspeptic patients. They had undergone endoscopy during the same period, which yielded normal results, and had available biopsies that were similarly evaluated for H. pylori infection [controls, group 2]. Pertinent clinical data were obtained from the patients' records. An experienced pathologist assessed the biopsies for the presence and grade of inflammation, activity, glandular atrophy, intestinal metaplasia, presence and density of H. pylori and presence of lymphoid follicles or aggregates. NG was identified in 67 [3.1%] patients. On histological examination, group 1 had a significantly higher grade of gastritis [p<0.001]. The presence and density of H. pylori infection was significantly higher in group 1 [p <0.001]. The H. pylori density correlated significantly with the severity of gastritis [r = 0.57, p <0.001]. The endoscopic performance of NG on H. pylori infection had high specificity [96.8%] and positive predictive value [93.3%]. This study outlined the clinicopathological features of NG identified among a cohort of dyspeptic patients in Kuwait and confirmed the close association with H. pylori infection. However, our study has a limitation in that histopathologic assessment of all NG patients was not feasible

Epidemiological, clinical, and biochemical profile of type 2 diabetes in Kuwait

Type 2 diabetes mellitus is considered as one of the major public health problems in Kuwait. Many factors affect the standard of health care and achieving preset specific targets particularly patients' practice and utilization of health care facilities. The current study was formulated to describe the epidemiological features of type 2 diabetics and to reveal the common complications of type 2 diabetics as well as the extent of achieving the intended medical care targets. The study design is a cross sectional descriptive one whereas 64] type 2 diabetics were randomly selected from 5 diabetes health centers that represent the five health regions of Kuwait. The results of the study showed that the mean age of the studied population was 54.3 +/- 10.4 years, with almost equal proportions for males and females [49.9% and 50.1%]. Only 31.3% could achieve the targeted fasting blood glucose level while just 19% could achieve the targeted Hb[A1c]. level. Also, 14% could demonstrate a "good" body mass index. The majority were adherent to regular use of drugs [85.5%] and regularly visiting the diabetes center [80%]. Only 17.3% were practicing moderate physical activity while 6.2% were self monitoring their blood glucose and 29.3% were testing blood for glucose at home. Those suffering from cardiovascular complications constituted 31.2% of the sample while 11.5% were suffered from nephropathy and 32.4% from peripheral neuropathy. Retinopathy was detected among 32.1% while vascular lower limb complications were revealed among 43.6%. In general, the available medical resources and facilities need to be more and properly utilized. More effort is needed to achieve the targeted health care levels