[Rates of stillbirths in Kuwaiti women with non-insulin-dependent diabetes]. / Stopa mrtvorodene djece kod kuwajtskih zena oboljelih od secerne bolesti neovisne o inzulinu.

The objective of the present study was to discern stillbirth rates in patients diagnosed as having NIDDM. Also, it describes sociodemographic characteristics, and diabetes related factors that distinguish women with established NIDDM who experienced repeated stillbirths from those who did not. The sample data by 99 Kuwaiti women with NIDDM who are still in the reproduction-age are from a cross-sectional survey carried out in 1995/96. A high prevalence of obesity, illiteracy, and reported physical inactivity was associated with NIDDM. Stillbirth rates (rate per thousand deliveries) were 76.5 in comparison to 6.9 from general population in 1996 in Kuwait. Logistic regression analysis showed that housewives were less prone to stillbirths and that repeated stillbirths were associated with abortions. Reproduction and diabetes were mainly researched in patients with Type I diabetes. A high prevalence (18.1%) of NIDDM (non-insulin-dependent diabetes mellitus) in women in Kuwait, and a younger age at diagnosis can have an impact on the reproduction pattern. There is a need to implement the appropriate interventions to reduce risk for stillbirths in women with special risk profiles.

Epidemiology of smoking among Kuwaiti adults: prevalence, characteristics, and attitudes.

INTRODUCTION: In 1996 we conducted a cross-sectional survey to study the epidemiology of smoking among Kuwaiti adults. METHODS: The 4000 participants were selected using a three-stage stratified cluster sampling design. Altogether 3859 participants (1798 males, 2061 females) returned a completed self-administered questionnaire. RESULTS: The prevalence of smoking was 34.4% (95% confidence interval (CI) = 32.2-36.6) among men and 1.9% (95% CI = 1.3-2.5) among women. Among men, the highest prevalence (56.5%; 95% CI = 36.2-76.8) was observed in the youngest age group (< or = 20 years). Among women the highest prevalence was observed in one of the older age groups (46-50 years) (7.1%; 95% CI = 3.1-11.1). Multiple logistic regression analysis showed that the following factors were independently associated with smoking: lower levels of education (odds ratio (OR) 3.5; 95% CI = 1.5-8.4), lower employment grade (OR = 4.1; 2.5-6.7), and being a separated, divorced, or widowed woman (OR = 4.9; 95% CI = 2.0-11.8). The majority of smokers (68%) began smoking when younger than 20 years; significantly more men (70%) than women (33%) began smoking at these ages (P < 0.0001). On average, men began smoking at an earlier age (18 years vs 21 years; P < 0.001) and therefore had smoked for a longer period (15 years vs 12 years; P < 0.05); men also consumed a higher number of cigarettes each day (26 vs 17; P < 0.05). A large proportion of smokers were ignorant about the health consequences of passive smoking: about 77% of those with children reported that they smoked in the presence of their children. Almost half (47%) of all smokers stated that they wanted to stop smoking, and about 56% had attempted to quit. The biggest perceived barrier to quitting was uncertainty about "how to quit". A total of 338 respondents (8.8%; 95% CI = 5.8-11.9) were classified as former smokers. About half of the former smokers had quit between the ages of 20 and 29 years; the average age of quitting was 28 years. Former smokers were more likely to have smoked fewer cigarettes per day and to have smoked for significantly less time than current smokers. DISCUSSION: Given the fact that free education is provided at all levels by the government, anti-tobacco education and awareness should be included as an integral part of the curriculum in schools and colleges.

Enterotoxin production by coagulase-negative staphylococci in restaurant workers from Kuwait City may be a potential cause of food poisoning.

Staphylococcus aureus and coagulase-negative staphylococci (CNS) were isolated from the hands of food handlers in 50 restaurants in Kuwait City and studied for the production of staphylococcal enterotoxins, toxic shock syndrome toxin-1, slime and resistance to antimicrobial agents. One or a combination of staphylococcal enterotoxins A, B or C were produced by 6% of the isolates, with the majority producing enterotoxin B. Toxic shock syndrome toxin-1 was detected in c. 7% of the isolates; 47% produced slime. In all, 21% of the isolates were resistant to tetracycline and 11.2% were resistant to propamidine isethionate and mercuric chloride. There was no correlation between slime and toxin production or between slime production and antibiotic resistance. The detection of enterotoxigenic CNS on food handlers suggests that such strains may contribute to food poisoning if food is contaminated by them and held in conditions that allow their growth and elaboration of the enterotoxins. It is recommended that enterotoxigenic CNS should not be ignored when investigating suspected cases of staphylococcal food poisoning.

Factors associated with the initiation of smoking by Kuwaiti males.

PURPOSE: To estimate the age patterns in cumulative probability of smoking initiation among Kuwaiti adult males and to study the differentials in smoking initiation in relation to factors such as age-cohort, marital status, educational level, income, type of residence, and history of smoking among family members and friends. METHODS: A stratified three stage cluster sampling design was implemented for the selection of the sample. A self-administered questionnaire was completed by 1798 Kuwaiti adult males working in different ministries. RESULTS AND IMPLICATIONS: Of the 1798 respondents, 34.4% were classified as current smokers, 17.7% as former smokers and 47.9% as non-smokers. The highest probability of smoking initiation (among current and former smokers) was found for the age group 15-20 years, where almost 29% of the respondents initiated smoking. In the univariate analysis, marital status, education, income, type of residence, and history of smoking among family members and friends showed significant variation in the age-patterns of initiation. In the Cox proportional hazard regression model, education, type of residence, and history of smoking among family members and friends were found to be independently associated with the risk of initiation. The highest risk of initiation (Relative Risk (RR) = 1.85; 95% CI: 1.62-2.10) was found among those who had a history of smoking in family and friends. Individuals in the lowest education category (RR = 1.64; 95% CI: 1.32-2.04) and those residing in apartments (RR = 1.65; 95% CI: 1.43-1.92) were at a higher risk of initiation compared with those who had university education or those who resided in villas. The results of the study should prompt further efforts to develop tobacco control policies in Kuwait and the other Arabian Gulf countries to help establish norms for not initiating smoking through persistent messages to not start or to stop smoking. There is also a need to enhance awareness about the influence of smokers in family or friends on other people to initiate smoking.

Socio-demographic features and knowledge of diabetes mellitus among diabetic patients in kuwait.

OBJECTIVE: To determine the socio-demographic profile and assess knowledge about the nature, symptoms, complications, and treatment of diabetes mellitus among diabetic patients in Kuwait. METHODS AND RESULTS: A cross-sectional sample survey of 788 patients attending specialized diabetic clinics was conducted in 1995. Kuwaitis were significantly more represented in this sample than in the general population (52.5% versus 37%). Female to male ratio among Kuwait population was 1.07 and among non-Kuwaitis it was 0.28. Age at diagnosis ranged between sixteen to eighty years with a mean of 48 ± 10.8 years. Overall knowledge was assessed by percentage of correct responses for individual knowledge questions. There was no significant difference in knowledge of diabetes seen among Kuwaitis (66%) and non-Kuwaitis (64%). No sex difference in knowledge was seen. Knowledge about diabetes was highest among diabetic patients with increasing educational achievement but lowest with advantage age. CONCLUSION: Most patients lack a lot of information that could have a significant impact on their motivation and ability to remain healthy. To overcome this growing problem, instructing a standard diabetes education system was found to be one way of improving in morbidity due to diabetes and reduced hospital admission.

Antinociceptive action of intrathecally administered IGF-I and the expression of its receptor in rat spinal cord.

mRNA transcripts for insulin-like growth factor I (IGF-I) and its receptor are expressed in the lumbar region of the spinal cord. Accordingly, we examined the involvement of IGF-I in nociceptive transmission. An intrathecal injection of IGF-I (200-1000 ng) produced a dose-dependent elevation in nociceptive threshold as indicated by tail flick/withdrawal latency. In contrast, comparable doses of insulin had no significant effect. The time-response curve (15-75 min) revealed that the peak for IGF-I's antinociceptive effect is attained at 30 min. Our data provide evidence that the IGF-I system within the spinal cord may serve as a target for novel analgesics.

Nasal carriage of enterotoxin-producing Staphylococcus aureus among restaurant workers in Kuwait City.

Enterotoxin-producing Staphylococcus aureus is a common cause of staphylococcal food poisoning. To determine the incidence of carriage of enterotoxin-producing S. aureus in a sample of the healthy population in Kuwait city, restaurant workers in the city were screened for nasal carriage of S. aureus. 26.6% of 500 workers studied carried S. aureus and 86.6% of the S. aureus produced staphylococcal enterotoxins. 28% produced enterotoxin A, 28.5% produced enterotoxin B, 16.4% produced enterotoxin C and 3.5% produced enterotoxin D. Ten isolates produced both enterotoxins A and B or A and C. 73% of the isolates were untypeable with standard phages. However, 17.1%, 3% and 6% belonged to phage groups I, II and III respectively. The results demonstrated a high level of enterotoxigenic S. aureus carriage among restaurant workers which although lower than that reported for the general population and hospital workers may be important in the restaurant industry.

Maternal sexuality during pregnancy and after childbirth in Muslim Kuwaiti women.

The sexuality of Kuwaiti Muslim women before pregnancy, during pregnancy, and 6 months after childbirth was studied. A group of 220 women attending the prenatal clinic of the Maternity Hospital Kuwait were randomly selected; 40 (18.2%) declined at the outset, 10 (4.6%) withdrew due to miscarriage and 10 (4.6%) due to failure to attend interviews. The semistructured interview was conducted by a female obstetrician at 4-week intervals starting from 12 weeks pregnancy to 6 months after childbirth. The study led to the following observations: (i) All the women were religious and abided by the Islamic rules and way of life. (ii) The diagnosis of pregnancy led to a decline in sexuality that continued throughout the pregnancy, with a second and early third trimester increase in sexuality but still below the prepregnancy baseline. (iii) Each woman had a consistent pattern of sexuality during pregnancy reflecting her prepregnancy level of sexuality. (iv) Younger age group, multiparity, low-level of education, lesser duration of marriage, and intention of breast-feeding characterized the sexuality pattern positively, as did attitudes towards sexuality during pregnancy and after childbirth. Breast-feeding mothers exceeded their prepregnancy level of sexuality earlier than bottle-feeding mothers.

Smoking or health? International trends and marketing of tobacco and possible interventions.

This article focuses on the trends in cigarette smoking in both developed and developing countries. There is a change in the smoking patterns from developed to the developing countries due to the shift of emphasis upon marketing of tobacco in the developing countries by the transnational tobacco industry. This is achieved due to the tobacco company's advertising strategies and its impact on the population. The harmful effects of tobacco production and its impact on the environment and health levels in these countries is discussed. Intervention strategies for smoking cessation and the benefits of such interventions is also discussed. This article focuses on these changes from a political economic of illness approach rather than just focusing on individual smokers and holding only them responsible for their healthy or non-healthy conditions.

Socio-economic and demographic factors influencing breast-feeding among Kuwaiti women.

Data about breastfeeding practices were collected from a sample of 1553 Kuwaiti married women during June 1985 to November 1985. The survey results show that Kuwaiti population is similar to other populations in the Middle East in having moderate incidence and duration of breastfeeding. The findings of a strong positive association between duration of breastfeeding and parity of the infant, and age of the mother at the time of birth of the child were observed which was expected. Further negative association between breastfeeding and family income, education of the mother and age of mother at marriage was confirmed by the data. Survey findings also support the general expectation that housewives have higher incidence and duration of breastfeeding relative to working mothers. Contrary to the practice among developing societies, Kuwaiti women did not show any preferential treatment for male infants. The survey findings call for concerted efforts through mass media, and education to promote breastfeeding practices for the benefits of infants as well as mothers.

Potential gains in life expectancy of Kuwaiti nationals through partial and complete elimination of infectious and parasitic disease mortality.

This study attempts to estimate potential gains in life expectancy in 1984 through partial and complete elimination of infectious and parasitic diseases among Kuwaiti nationals. For deriving these estimates, a multiple decrement life table approach was applied. The results of the study show that complete elimination of infectious and parasitic disease mortality would further add 0.45 years to the life expectancy at birth of Kuwaiti males and 0.54 yr to that of Kuwaiti females. A partial reduction by 50% would result in gains of just one-half of the years gained through complete elimination of these causes. Also, as partial reduction is increased from 10% to 90%, the gains in life expectancy at birth would go up from 0.04 yr to 0.40 yr in the case of Kuwaiti males and 0.06 to 0.48 yr for Kuwaiti females.

Attitudes and practice of kuwaiti women toward breastfeeding.

A survey was conducted to assess the attitudes towards breastfeeding, its prevalence and duration among Kuwaiti married women. Five hundred eighty-five women from different regions of the country with at least one child of their own, willing to furnish data were included in the survey. The results of this study show that 71 percent of newborns are breastfed at birth. The percentage of breast-fed infants declines to 50 percent by the time they are one month old, and to 10 percent among five-month-old infants. The expected duration of breastfeeding is about two months. This study also reveals a wide gap existing between the attitudes, knowledge and practice of breastfeeding among Kuwaiti women. Their attitude towards breastfeeding is largely positive. This study emphasizes that with appropriate health education and supportive measures sensitive to the needs of this community, breastfeeding can retain its integral part in the process of human reproduction and child development.