Audit of physicians' adherence to the antibiotic policy guidelines in Kuwait

To audit physicians' adherence to the local antibiotic policy guidelines in government hospitals in Kuwait. The study was a retrospective review of patient records in nine hospitals between July 1 and December 31, 2008. Clinical notes and medication charts of the latest hospital admissions were checked for antibiotic prescribing. On the audit form, aspects of the prescribed antibiotic were benchmarked to the hospital antibiotic policy guidelines to evaluate adherence. Of 2,232 reviewed records, 1,112 [49.8%] patients had 1,528 antibiotic prescriptions. Patients who received antibiotics were significantly younger than those who did not [median age: 26.3 vs. 29.8 years, p < 0.001] and their hospital stay was significantly longer [median: 4 vs. 2 days, p < 0.001]. The choice of an antibiotic was appropriate and matched the policy in 806 [52.7%] prescriptions. Of such appropriate antibiotics, adherence to route of administration was observed in 768/806 [95.3%], to dose in 758 [94%], to frequency in 746 [92.6%] and to duration in 608 [75.4%]. Full adherence to all aspects of antibiotic choice, dose, route, frequency and duration was achieved in 464 [30.4%] prescriptions. In 382 [25%], the antibiotics administered were not indicated. There was low adherence to the local antibiotic policy guidelines. Physicians' antibiotic prescribing practices should be optimized. Adherence to, and update of, the policy is recommended

Pre-hypertension and hypertension in college students in Kuwait: a neglected issue

To determine the proportion of pre-hypertension and hypertension in college students in Kuwait and their related risk factors. A total of 803, randomly selected students aged 17 to 23 years [346 male, 457 female] from different colleges in Kuwait, were included in the study between 2009 and 2010. Systolic and diastolic blood pressure measurements were taken by trained personnel. Pre-hypertension was defined as systolic pressure between 120 and 139 mm Hg or diastolic pressure between 80 and 89 mm Hg. Risk factor measurements that were determined, included smoking, body mass index [BMI], and family history of hypertension. Blood samples were collected and impaired glucose tolerance [IGT] and lipid profile levels were determined. There were no hypotensive students. Normotensives constituted 53.5% [n = 430], pre-hypertensives formed 39.5% [n = 317], and hypertensive students comprised of 7% [n = 56]. The overall proportions of hypertension and pre-hypertension were higher among male students [85.7 and 64.4%] than female students [14.3 and 35.6%], respectively. Hypertensive and pre-hypertensive students versus normotensive students had significantly higher levels of BMI-based obesity, smoking, glycated hemoglobin [HbA1c], and IGT. Also, hypertensive and pre-hypertensive, compared to normotensive students, had significantly higher proportions [21.4, 18.3, and 4.0%, respectively] of risky high-density lipoprotein [HDL] level [< 1 mg / dL], cholesterol [7.1, 3.8, and 1.4%, respectively], and triglycerides [TG] [17.9, 9.1, and 7.9%, respectively] where p was< 0.001, 0.016, and 0.051, respectively. Hypertensive and pre-hypertensive students showed elevated levels of lipids and BMI-based obesity more than normotensive students. TG, HDL, HbA1c, and cholesterol appeared to influence pre-hypertension

Genetical and electron microscopical studies on cryptosporidia

The present work was to clarify whether C. parvum oocysts have different strains in human patients by using different staining, electron microscopical and genetical techniques. A trial to induce a vaccine against Cryptosporidial infection in mice was carried out using killed autoclaved Cryptosporidial oocysts. The results obtained were satisfactory. Two genotypes of C. parvum. viz: human and zoonotic genotypes were detected and described. The killed vaccine used orally gave promising results

Intracavernosal pharmacotherapy; Comparative study of the 3Ps solution with prostaglandin E1 [PGE1]

Intracavernosal pharmacotherapy has revolutionized treatment of erectile dysfunction. In this study, 84 patients with impotence were classified into two groups [42 for each] and they were injected with PGE1 alone [20 ug/ml] and "3Ps" solution containing papaverine [12 mg/ml], PGE1 [9 ug/ml] and phentolamine [1 mg/ml] in a double blind-crossover maneuver of treatment. Prostaglandin El alone induced full rigid-satisfactory erection in 71.4% of treated patients, with mean time of latency between injection of the drug and start of tumescence of 14 minutes and average duration of erection of 131.8 minutes. In the "3Ps" solution, full rigid-satisfactory erection was obtained in 90.5% of the treated cases, with a latency period of 8.4 minutes and duration of erection of 182.8 minutes. Penile self stimulation was required in the PGE1-alone treated group in 76.2% of cases, while it was only required in 52.4% of cases in the "3Ps" treated group of patients. Side effects of both drug regimens were minimal and not severe, and they were less frequently occurring in the "3Ps" solution treated group of patients. It was concluded that the use of PGE1 in combination with other vasoactive drugs makes the combination more durable in action and with less side effects than if the drug was used alone. Also, the dosage required for each vasoactive agent is less than that if each drug is used alone

Epidemiological study of pityriasis alba among school children in Alexandria

Pityriais able is one of most common skin diseases affecting school children. The main objectives of the present study were to reveal magnitude of the problem among school children in Alexandria as well as to study various factors that could possibly affect the prevalence of pityriasis alba. The cross sectional strategy was chosen to screen a representative sample of 5854 [1% of urban and 2% of rural] of primary and preparatory school children in Alexandria during scholastic year 1987-1988 for presence of pityriasis alba. An ecual number of control subjects free from the condition was selected from the same class matched by age. The overall prevalence rate of pityriasis alba was 7.16% being significantly more in rural [17.67%] than in urban [5.25%] school children. The overall mean age of cases was 9.07+2.52 year. Male cases of pityriasias alba out- numbered female cases in a ratio of 2.1:1. cases sighnifisantly differed from their controls as regards intestinal parasitic infestation and prolonged exposure to sun light. The mean level of serum IGE was insignificantly higher than in the control group. The multiple regression analysis revealed that practicing of frequent face washing with water only through wudu a was associated with decrease in liability of the condition. It could be concluded that pitryirasis alba is common especially among rural echool children and prolonged exposure to sunlight as well as frequent use of soap for face washing were associated with an increase in the likelihood of occurrence of condition

Personal and family characteristics of injured and poisoned children [1-6 years] attending emergency departments in Alexandria University Hospitals

Accidents are emerging strikingly and assuming a proportionately greater importance with the more efficient control of infectious diseases. The present study aimed at revealing the personal and family characteristies, clarifying the different types fo accidents for he children 1 < 6 years. To accomplish this aim, a descriptive epidemiologic approach as used for a sample [totalled 309] of injured or poisoned children 1 < 6 years attending the emergency departments of the Main and Hadara Orthopeadic and Traumatology University Hospitals in Llexandria, during the period between 1st December, 1985 to 28th february, 1986. Data collected were then transferred, tabulated and statistically analysed at 5% level of significance. the results of the study are the following: Two-thirds of cases were boys [62.14%], the remaining were girls. The mean age of boys [3.82 + 1.39 years] was significantly higher than that of girls [3.40 + 1.51 years], where t=2.4929. The types of accidents were: Falls [40.13%], Wounds [14.24%], Bums [13.59%], Traffic accidents [9.71%], Foreign body in-gestion [9.06%], Poisoning [7.77%], Violence [4.85%] and Animal bites [0.65%] Each of the first and second birth ordered cases constituted less than one third [30.42%. and 28.48%] No significant differences were observed between the type of accident and mean age of fathers [F=0.6887] or mothers [F=2.0367], family size [F=0.7736] crowding index [F=0.7716] and sleeping index [F=1.4050]. Illiterate parents constituted the majority [72.76%. for fathers and 82.68%. for mothers]. Cases belonging to manually-working fathers represented more than half [52.22%], while those belonging to non-working mothers represented 92.81% Less than half of the patients [41.53%] were not receiving parental supervision no significant differences were observed between type of accidents and type of family [X[2][5]=2.2134] and type of housing [X[2][5]=2.7413]. only 19.42% of all cases had major health problems among their family