Treatment of psoriasis with etanercept: an experience from south Kuwait

To observe the efficacy and safety profile of etanercept in patients with moderate to severe plaque psoriasis. In this retrospective study, 56 patients were treated with etanercept between May 2005 and May 2008. All patients were screened for tuberculosis. They were started on etanercept 50 mg twice a week [BIW] for 12 weeks followed by 25 mg BIW for another 12 weeks. Response to treatment was assessed by Psoriasis Area and Severity Index [PASI] and Dermatology Life Quality Index [DLQI]. Patients were reviewed at 4-week intervals, when clinical response and adverse effects were noted and photographs taken. Forty-nine patients [87.5%] had chronic plaque psoriasis, three [5.35%] were erythrodermic and four [7.15%] had palmoplantar psoriasis. At least 75% reduction in PASI was achieved in 52% of patients at week 12 and 64% at week 24. Mean percentage of improvement from baseline in DLQI at week 12 was 47.6%, reaching 79% at week 24. The percentage of patients in the DLQI category correlating with 'no effect' on quality of life increased from 3.6% at baseline to 66% at week24, while the percentage in the category correlating with 'extremely large effect' decreased from 16% at baseline to 1.8% at week 24. In our study, a correlation was noted between DLQI and PASI score before treatment as well as at week 12 and 24. The adverse effects and laboratory abnormalities were minor. Etanercept was effective and well tolerated for moderate to severe psoriasis. It can be used intermittently without rebound, with psoriasis responding again on reintroduction

Evaluation of disability of occupational illness claims for worlers' compensation

Occupational physicians are faced with the challenge of estimating the contribution of occupational and non-occupational risk factors to a particular work-related illness for workers' compensation. This paper proposes guidelines for occupational physicians to evaluate claims for presentation to a compensation board. Occupational bladder cancer was taken as an example. Relevant literature was obtained and reviewed. A worksheet was designed to record pertinent information on occupational illness. The procedure for handling a claim is described. Failure to follow such an approach may lead to gross inequities

Diagnosis of occupational asthma: review

Work related asthma is a common problem and well documented in the literature. It results from exposure to an irritant or sensitizer agent at the workplace. The mechanism of occupational asthma is a complex process. The diagnosis of occupational asthma can be difficult but the combination of both occupational history and assessment of asthma is very helpful. Physicians should be aware of this serious and preventable medical condition

Diabetes mellitus among a population of bakers: a cross-sectional study

This study was carried out to estimate the prevalence rate of Diabetes Mellitus [DM] among a population of bakers exposed to high environmental temperatures, and contrast this with a comparison unexposed group. This is a cross-sectional study Bakers and control group at Al-Khobar area of Saudi Arabia 137 bakers [exposed group], working in 20 bakeries, and 107 comparable referents. Information was collected by means of an interview-administered questionnaire. A single sample of venous blood was collected once from each study participant and analyzed at a central laboratory for random blood sugar level. DM is higher among bakers as a result of heat exposure in the workplace. The prevalence rate of DM among the bakers was found to be 4.4% in six subjects, as compared to none in the referent group. The high rate of DM among bakers was found to be associated with the unfavorable hot working conditions in bakeries, after all possible confounding factors of DM had been considered