Volumetric comparison of autogenous bone and tissue-engineered bone replacement materials in alveolar cleft repair: a systematic review and meta-analysis.

The goal of reconstruction of the alveolar cleft in patients with cleft lip and palate is to improve the quality of tissue, the structural stability, and increase the volume of bone. This study is a systematic review with meta-analysis of volumetric bony filling using autogenous bone and various tissue-engineered bone substitutes. We made an electronic search on MEDLINE, EMBASE, SCOPUS, WEB OF SCIENCE, "grey" publications (materials and research produced by organisations outside traditional channels for commercial or academic publishing and distribution), and relevant cross references according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that reported the outcomes of volumetric grafting were included in the meta-analysis. Of 1276 studies, 26 were included in the meta-analysis. Pooled analysis of 25 studies that used autogenous bone showed a significant reduction in the volume of the cleft equivalent to 62.0% bone fill (95% CI 54.3 to 69.6), in contrast to 10 studies that used a tissue-engineered material and reported bone filling of 68.7% (95% CI 54.5 to 82.8). The estimated sizes of pooled effects across studies showed that there was no significant difference between the two major intervention groups (p value 0.901). Our statistical analysis showed that autogenous bone grafts did not differ significantly from tissue-engineered materials in their ability to fill clefts. Systematic review registration: International Prospective Register of Systematic Reviews, PROSPERO (CRD42017065045).

Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction.

The objective of this study was to assess changes in patient quality of life (QoL) after orthognathic surgery at the Kuwait University Dental Clinic. A self-administered Arabic version of the Orthognathic Quality of Life Questionnaire (OQLQ) and two different visual analogue scales (VAS) were used. Sixty-six patients participated (63.6% female). The deformities were corrected by bimaxillary jaw surgery (83.3%), Le Fort I (9.1%), and bilateral sagittal split osteotomy (7.6%). The most important reasons given for undertaking the surgery were facial aesthetics (80.3%) and bite correction (75.8%). Of the patients who had reported moderate to high levels of problems pre-surgery, the majority reported improvements in facial appearance (91.3%), appearance of the teeth (97.0%), biting (96.3%), chewing (92.3%), and eating function (76.5%). Overall, 93.9% of patients reported better conditions after surgery, and the satisfaction level was very high (VAS 91.6%). The VAS score for QoL increased significantly from pre-surgery (73.0%) to post-surgery (93.6%) (P=0.0001). The OQLQ score was also significantly decreased after surgery, reflecting improvements in the 'social aspects of dentofacial deformity', 'facial aesthetics', 'oral function', and 'awareness of dentofacial aesthetics' domains (P=0.0001). Overall, the patients who underwent orthognathic surgery were satisfied and had improved QoL. The satisfaction rate in the present study reflects successful treatment with orthognathic surgery.

Cancer in Kuwait: magnitude of the problem.

UNLABELLED: Cancer registry data obtained from the Kuwait Cancer Registry at Kuwait Cancer Control Center (KCCC) of Ministry of Health, State of Kuwait. The data covers the years 1974 to 2007. AIM OF THIS STUDY: was to estimate the magnitude of the cancer problem in Kuwait over the period 1974-2007. MATERIALS AND METHODS: Age-adjusted incidence rates (ASR) with standard error (er) and 95% confidence intervals (95% CI) of age-standardized rates were estimated. Statistical significance was assessed by examining the standardized rate ratio (SRR). RESULTS: It was noted that by following the Cancer registry data there was a trend of increase in adjusted rates among both males and females. Looking into specific cancers it was noticed that comparing the ASR of colorectal cancer among Kuwaiti males, it increased by about 5 folds over the last 33 years and ranked the 1st most frequent site on the years 2003-2007. Prostate cancer incidence increased by 3 folds (14.5 cases /100,000 populations) and ranked the 4th most frequent site among Kuwaiti males. The incidence of Non Hodgkin's Lymphoma (NHL) and leukemia had increased by 1.5 to 2 folds over the same time period. The rise of lung cancer incidence declined to similar rates compared to that observed in the early 70s and 80s. For Kuwaiti females breast cancer had the highest incidence among Kuwaiti population (15 cases /100,000 populations), it increased by 3 folds (50 cases /100,000 populations) over the last 33 years. The incidence of colorectal cancer increased by about 4 folds; (13 cases /100,000 populations). NHL and leukemia increased by 2-2.5 folds over the same studied duration. Meanwhile Thyroid cancer increased by one fold. CONCLUSION AND RECOMMENDATIONS: Some of the differences in cancer rates over the last 33 years are likely to be attributable to the variation in exposure to specific etiologic factors that are caused by differences in lifestyle and habits, such as dietary, physical activity and obesity. Further research with a view to understanding these changes in cancer incidence is warranted. The need for an interventional prevention programs that vigorously involve, diet, anti-smoking and physical activity among both sexes.

Incidence of cancer in Gulf Cooperation Council countries, 1998-2001.

We describe the patterns of cancer incidence for common cancers in Gulf Cooperation Council countries during 1998-2001. A total of 32,291 cases of cancer were diagnosed (16,342 in males; 15,949 in females). Male preponderance was observed only in Saudi Arabia and Oman. The age-standardized incidence of all malignancies per 100,000 in both sexes was highest in Qatar followed by Bahrain, Kuwait, Oman, UAE and Saudi Arabia. Paediatric cancer ranged from 9.5% of total cancers in Saudi Arabia and UAE to 4.0% in Bahrain. In all countries, the mean age at diagnosis was higher in males than females; cancer of the lung and prostate were commonest among males, and cancer of breast and thyroid among females. Lung cancer ranked second among Bahraini women.

Incidence of cancer in Gulf Cooperation Council countries, 1998-2001

We describe the patterns of cancer incidence for common cancers in Gulf Cooperation Council countries during 1998-2001. A total of 32 291 cases of cancer were diagnosed [16 342 in males; 15 949 in females]. Male preponderance was observed only in Saudi Arabia and Oman. The age-standardized incidence of all malignancies per 100 000 in both sexes was highest in Qatar followed by Bahrain, Kuwait, Oman, UAE and Saudi Arabia. Paediatric cancer ranged from 9.5% of total cancers in Saudi Arabia and UAE to 4.0% in Bahrain. In all countries, the mean age at diagnosis was higher in males than females; cancer of the lung and prostate were commonest among males, and cancer of breast and thyroid among females. Lung cancer ranked second among Bahraini women

A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis.

This preliminary study of Kuwaiti children confirms the significant impact of exposure to war atrocities on children. This pilot sampling provided evidence that: (1) many children who remained in Kuwait during the occupation had multiple war-related exposures; (2) more than 70 per cent of the children reported moderate to severe post-traumatic stress reactions; and (3) witnessing death or injury and the viewing of explicit graphic images of mutilation on television had measurable influence on severity of reaction. The highest mean Child Post-Traumatic Stress Disorder Reaction Index (CPTSD-RI) score was found for those children who reported hurting someone else. Older children had both greater exposure to atrocities and higher CPTSD-RI scores. Findings suggest the need for public policy to minimize children's exposure to graphic depictions of war-related injury, death and mutilation.

Brucellosis: atypical presentation with peritonitis and meningitis.

A case of brucellosis associated with peritonitis, intestinal obstruction, granulomatous hepatitis, inappropriate antidiuretic hormone (ADH) secretion and meningitis is reported. Initially, the patient was diagnosed as a case of disseminated tuberculosis and treated accordingly. However, the serologic tests for brucellosis were strongly positive and the patient was subsequently treated as a case of brucellosis and recovered fully. The gastrointestinal manifestations of brucellosis are reviewed.