Effect of dietary probiotics and prebiotics on the performance of broiler chickens.

The prolonged use of antibiotics has led to the development of resistant bacteria and also led to accumulation of antibiotic residue in the poultry feed, this ultimately led to the prohibition of antibiotics as growth enhancers in animal production. Thus, there was a dire need for alternate sources to help in poultry production. Recently, probiotics and prebiotics claimed to be effective alternatives to antibiotics in the poultry. The objective of this study is to investigate the effect of different probiotics and prebiotics on the performance of broilers. The study involved 2 broiler cycles, 1 during winter and 1 during summer with a total of 425 1-day-old Cobb 500 broiler chicks for each cycle. They were allotted to 5 experimental treatments. The probiotics were Bacillus coagulans (1 g/kg dried culture) and Lactobacillus (1 g/kg dried culture of 12 commercial strains). The prebiotics included fructo-oligosaccharides (FOS) (5 g/kg) and mannan-oligosaccharide (MOS) derived from Saccharomyces cerevisiae (5 g/kg). The results showed that there was no effect of the different probiotics and prebiotics on the production performance of broilers. There was increased weight of the thymus in the control group. In cycle 1, the panelists indicated that the smell, color, taste, and texture of the cooked meat were acceptable, and that there were no significant differences between the different groups. There was no significant effect of the different diets on the biochemical parameters of the blood among the experimental groups at 3- and 5-wk of age. Phytohaemaglutinin test showed that dietary FOS and MOS induced higher cellular response than the other treatments (P = 0.04) in the first cycle. In the second cycle, the results revealed that dietary FOS induced higher cellular response than the other treatments (P = 0.019). The used experimental treatments have a positive effect on microbial count in 5-week-old broilers. There was no Salmonella sp. recorded using the experimental treatments in the first cycle, and the growth of E. coli was reduced significantly. In the second cycle, all treatments in 3-week-old broilers did not affect the count of both lactic acid bacteria (LAB) and E. coli. At 5-week-old of the same cycle, the bacterial count of E. coli increased even with control, whereas Salmonella growth was inhibited. The pH value was driven toward acidity in all of the treatments. Probiotics and prebiotics can be used in chicken feed safely and without any adverse effects on the productive parameters and immune status of the flock.

Epidemiological profile of spinal cord injuries at a tertiary rehabilitation center in Kuwait.

STUDY DESIGN: Retrospective, descriptive study. OBJECTIVE: To describe the epidemiological profile of patients with spinal cord injury (SCI) in Kuwait. SETTING: Physical Medicine and Rehabilitation Hospital, Kuwait. METHODS: Review of medical records of 241 adult patients with SCI admitted during the period 2010-2015. The data collected included gender, age, etiology, neurological and vertebral level of injury and American Spinal Injury Association impairment scale (AIS). RESULTS: There were 155 (64.3%) traumatic SCI (TSCI) and 86 (35.7%) non-traumatic SCI (NTSCI) patients. In TSCI, the male to female ratio was 4.3:1, and in NTSCI it was 1.5:1. Road traffic accident was the most common cause of TSCI (52.9%), followed by fall from height (32.9%). Acute disc prolapse was the most common cause of NTSCI (29.1%), followed by degenerative disc disease (26.7%) and tumors (17.4%). Paraplegia (41.3%) was more common in TSCI, the level of injury being thoracic in 61% of cases. Cauda equina syndrome was the most common presentation in NTSCI (40.7%). CONCLUSION: Road traffic accident was found to be the main cause of TSCI in Kuwait, whereas acute and degenerative disc lesions were the leading causes in NTSCI. Prevention strategies should be directed toward these causes to reduce the incidence of SCI in Kuwait.

Cell transplantation and clinical reality: Kuwait experience in persons with spinal cord injury.

STUDY DESIGN: Retrospective observational. OBJECTIVES: To compare objective (neurological examination) and subjective (patients perception) recovery in patients with spinal cord injury (SCI) who chose to undergo cell transplantation therapies (CTT) outside of clinical trials abroad. SETTING: Physical Medicine and Rehabilitation Hospital, Kuwait. METHODS: Nine patients with SCI who had undergone CTT outside Kuwait were identified and their neurological pre-transplantation evaluation according the International Standards for Neurological Classification of SCI (ISNCSCI) was collected from hospital records. Post transplantation ISNCSCI examination was conducted during follow-up visits and scores were completed between pre and post CTT. In addition to the ISNCSCI evaluation, change in disability status, and patient's perception of improvement after stem cell transplantation were examined. RESULTS: Overall, 8 males and 1 female with chronic SCI underwent CTT (42 ± 38.2 months post SCI) in various centers (China, Egypt, Germany, India, and Iran). On follow-up post CTT assessment (89.2 ± 36 months post SCI), 55.5% of individuals reported perceived improvement as follows: increased deep tissue sensation below the injury (100%) or increase in bladder sensation (11.1%). Objective examination after CTT revealed that none of the examined individuals demonstrated improvement in their motor scores or neurological level of SCI. CONCLUSION: We were not able to objectively document clinically useful improvements in sensorimotor, autonomic, or functional status in individuals after CTT.

Association between sleep hygiene awareness and practice with sleep quality among Kuwait University students.

University students are especially vulnerable to poor sleep quality. The aim of this study was to assess students' sleep hygiene awareness and sleep hygiene practices, and evaluate their sleep quality. The association of sleep quality with sleep hygiene awareness and practice was also explored. The median sleep quality score was 7; scores more than 5 indicate poor sleep quality. Hence, a large proportion of Kuwait University students experience a suboptimal level of overall sleep quality according to the Pittsburgh Sleep Quality Index criteria. Sleep hygiene knowledge among university students was relatively inadequate. Most respondents (60.9%) failed to recognize that taking a nap during daytime might be disruptive to sleep. Sleep quality was strongly correlated with sleep hygiene practice (Spearman rank correlation, rs=0.267, P<.001) but not with sleep hygiene knowledge. Medical students showed poorer sleep hygiene awareness and poor sleep quality compared with students from other universities. Logistic regression analysis showed that female sex (adjusted odds ratio [OR]=1.8, P<.001), college (OR=2.2, P<.001), grade point average (OR=2.8, P=.023), and sleep hygiene practice score were independently associated with sleep quality after adjusting for confounders. In conclusion, a large proportion of Kuwait University students experience poor sleep quality. Therefore, the development of sleep hygiene education programs as an intervention and prevention strategy is recommended. This will improve students' knowledge on the importance of adopting healthy sleep hygiene practices for better sleep quality and enhanced academic performance.

An efficient eco advanced oxidation process for phenol mineralization using a 2D/3D nanocomposite photocatalyst and visible light irradiations.

Nanocomposites (CNTi) with different mass ratios of carbon nitride (C3N4) and TiO2 nanoparticles were prepared hydrothermally. Different characterization techniques were used including X-ray diffraction (XRD), UV-Vis diffuse reflectance spectroscopy (DRS), X-ray photoelectron spectroscopy (XPS), transmission electron spectroscopy (TEM) and Brunauer-Emmett-Teller (BET). UV-Vis DRS demonstrated that the CNTi nanocomposites exhibited absorption in the visible light range. A sun light - simulated photoexcitation source was used to study the kinetics of phenol degradation and its intermediates in presence of the as-prepared nanocomposite photocatalysts. These results were compared with studies when TiO2 nanoparticles were used in the presence and absence of H2O2 and/or O3. The photodegradation of phenol was evaluated spectrophotometrically and using the total organic carbon (TOC) measurements. It was observed that the photocatalytic activity of the CNTi nanocomposites was significantly higher than that of TiO2 nanoparticles. Additionally, spectrophotometry and TOC analyses confirmed that degraded phenol was completely mineralized to CO2 and H2O with the use of CNTi nanocomposites, which was not the case for TiO2 where several intermediates were formed. Furthermore, when H2O2 and O3 were simultaneously present, the 0.1% g-C3N4/TiO2 nanocomposite showed the highest phenol degradation rate and the degradation percentage was greater than 91.4% within 30 min.

Brief Report: Social Support and Coping Strategies of Mothers of Children Suffering from ASD in Kuwait.

This cross-sectional study provides a general profile of mothers of children with ASDs in Kuwait and examines their use of social support resources and coping strategies (using the Brief COPE questionnaire). The majority of mothers reported decreased ability to perform social duties (62.4%) and take care of themselves (50.5%). Overall, 57.7% of mothers reported a decreased ability to enjoy life; this difference was more pronounced among non-Kuwaiti mothers compared to Kuwaiti mothers (p value = 0.03), and in mothers with a bachelor's degree or higher (p value = 0.011). There was a significant association between the mothers' ability to enjoy life and receiving support from the family (p value = 0.021) and support groups (p value = 0.003). "Religion", "Acceptance", and "Positive Reframing" were the 3 most common coping strategies.

Control of poliomyelitis in Kuwait.

The use of oral poliovirus vaccine (OPV) in the early 1960s marked the beginning of the State's effort in controlling poliomyelitis in Kuwait. During the next two decades, despite the vaccine's availability and use, the disease continued to cause disability and death. However, with the massive and sustained use of the trivalent OPV since 1963G and the introduction of neonatal supplementary immunization with monovalent type 1 (MOPV) in 1976G along with strengthening of the surveillance activities against poliomyelitis, the incidence of the paralytic disease began declining and by the mid-eighties it disappeared altogether. With no cases of paralytic poliomylelitis reported in Kuwait since 1986G, the disease is largely controlled. The epidemiology of poliomyelitis in Kuwait has been examined here in retrospect. The paper profiles about 3 1/2 decades (1958G to 1992G) of efforts that led to this impressive virtual elimination of poliomyelitis. In order to maintain this status and eventually achieve the goal of eradication without the rare occurrence of vaccine-associated paralysis, it is, in our opinion, necessary to adopt an approach of combined vaccination with the inactivated polio vaccine (IPV), preferably in the neonatal age, followed by OPV. Simultaneously, monitoring the presence and circulation of wild poliovirus in the environment and continuous surveillance should be carried out for timely intervention.

The role of hepatitis D virus in liver disease in the Middle East.

Hepatitis D virus appears to be endemic in the Middle East, but its distribution bears little relationship to that of HBV. Only in Jordan was an association between HDV-positive status and HBsAg-positive primary hepatocellular carcinoma found. Fulminant hepatitis and chronic sequelae were unusual in HDV-coinfection, while early mortality and a chronic outcome were commoner in HDV-superinfection. In established HBsAg-positive cirrhosis survival was not significantly different in the HDV-positive vs. the HDV-negative patients. In patients whose biopsies showed cirrhosis, severe necroinflammatory features were seen more often in the HDV-positive than in HDV-negative patients.

Leprosy in Kuwait: an epidemiological study of new cases.

The latency of infection in leprosy is long so that new cases may present several years after emigration from endemic areas. This is of concern to the health authorities in Kuwait, since there is a sizeable immigrant population. An epidemiological study of new cases was, therefore, conducted to assess the extent of the leprosy problem. A total of 121 (99 male, 22 female) consecutive new leprosy patients were diagnosed nationwide over a six-year period (1983-1988). Over 95% of the patients were foreign born, emphasizing that the problem in Kuwait is mainly a reflection of immigration patterns. There were 74 cases of Asio-Indian origin, 13 Oriental and 34 Arab (including two Kuwaiti). This represents a respective mean incidence of the disease in Kuwaitis and other nationalities of 0.49 and 18.92 per 100,000 per year. Polar lepromatous (LL) leprosy was the most frequent type in the Arab group (44.1%) and polar tuberculoid (TT) the most frequent in the Asio-Indian group (37.8%). LL and borderline lepromatous (BL) types of leprosy were significantly more frequent in patients over 45-years-old and in females (P less than 0.05), contributing to the higher rate of LL in the Arab cases. The mean lag time from symptoms onset to presentation to doctor was 9.4 (range 0-192) months, with lepromatous cases tending to present later than other types. The longest lag times occurred in Arab women with LL, suggesting that cultural influences may delay presentation of leprosy. The mean interval from presentation to diagnosis was 4.1 weeks. The mean latency from entry into Kuwait to diagnosis was 44.7 (range 0-180) months; which stresses the need for physicians to remain vigilant in considering leprosy, especially in any patient with dermatological, neurological or ophthalmic manifestations of disease.

Hepatitis delta virus infection in acute hepatitis in Kuwait.

Over a period of 1 year, 254 patients presenting with acute hepatitis at the Infectious Disease Hospital, Kuwait were positive for hepatitis B surface antigen (HBsAg). Of these, 23 (9%) patients were found to have antibodies to hepatitis D virus (HDV) (anti-HDV). Eight of these anti-HDV positive patients were shown to have a coinfection with acute hepatitis B and 8 had a superinfection of HDV on a chronic HBsAg infection. The remaining 7 had had a previous HDV infection and were also chronic carriers of HBsAg. The cause of the acute hepatitis in this group was probably non-A, non-B virus(es). The prevalence of anti-HDV was 4% among patients with acute hepatitis B and 31% among carriers of HBsAg. In the coinfection group, 5/8 patients recovered completely, 1 developed chronic active hepatitis and 1 died due to fulminant hepatitis, while 1 patient was lost to follow up. 5/8 patients with superinfection developed chronic hepatitis on follow-up, 2 died while only 1 patient recovered completely. In the group of patients with previous delta infection, 5/7 recovered from the acute bout of hepatitis while 1 patient developed chronic active hepatitis and 1 was lost to follow-up.

Viral hepatitis and pregnancy in Kuwait.

The frequency and severity of viral hepatitis among pregnant and non-pregnant women in Kuwait was studied from 1980 to 1984. 542 female hepatitis patients were investigated, of whom 52 (9.6%) were pregnant. 35 of the 52 (67.3%) cases of viral hepatitis in pregnancy were due to hepatitis B virus while 11 of 52 (21.2%) and 6 of 52 (11.5%) had acute hepatitis non-A, non-B (NANB) and hepatitis A virus infections, respectively. The frequency and severity of viral hepatitis among the pregnant women was similar to that among non-pregnant women. Hepatitis did not have a deleterious effect on pregnancy and no death was recorded. Fulminant acute NANB hepatitis was seen in only one patient, who recovered completely.

Induced malaria and antibody titres in acute infections and in blood donors in Kuwait.

Concurrent with the increase in the number of imported cases of malaria into non-endemic Kuwait during the past 5 years, induced infections have been identified for the first time. We report 10 such cases over a 4-year-period. Of 8 transfusion-induced infections, 4 were due to Plasmodium falciparum and 4 to P. vivax. The mean incubation period for P. falciparum patients was 13 d and for P. vivax, 17 d. An accidental syringe-needle transmission and a congenital infection were due to P. falciparum and P. vivax respectively. Malarial antibody levels were assayed on commercially-available cultured P. falciparum schizonts by the indirect fluorescent antibody (IFA) test. To establish a base line, the sera of patients with blood film-confirmed P. falciparum and P. vivax were assayed. 96% of the P. falciparum sera were positive, the geometric mean titre (GMT) being 10,280. However, all sera from P. vivax patients were reactive but the GMT was lower at 505. 28% of sera from Kuwaitis and 45% of sera of a consecutive group of blood donors were also reactive, the respective GMTs being 38 and 51. The risk of transfusion malaria was calculated as 79 per million units drawn, an unacceptably high figure for a non-endemic country. We suggest a revised blood donor policy.

Acute non-A, non-B hepatitis in Kuwait.

In a prospective study of acute hepatitis in Kuwait covering the period February 1983 to January 1984, a total of 1781 cases were diagnosed as having an acute viral hepatitis. 1,384 (77.7%) were found to be due to hepatitis A virus (HAV), 206 (11.5%) hepatitis B virus (HBV), 8 (0.4%) coinfection with HBV and delta virus (HDV), 8 (0.4%) superinfection of HDV on chronic HBsAg carriers and 157 (9%) non-A, non-B virus (NANB). 13 cases of CMV and 5 of EBV infections were also diagnosed. NANB viral hepatitis was a disease of young adults (mean age 29 years) with a male-female ratio of 3:1. A high incidence was noted among males from the Indian subcontinent (29.1/100,000 of population, compared to 5.4/100,000 among local Arabs), the majority of whom gave a history of recent visit to the Indian subcontinent. The clinical features and biochemical findings of acute NANB infection were found to be less severe than those of acute HBV infection and similar to acute HAV infection. Three patients (2.3%) with acute NANB virus infection developed chronic hepatitis (all women), and another 3 patients died because of fulminant hepatitis.

Hepatitis B virus perinatal transmission among Arab women.

One thousand five hundred and fifty-four Arab women were screened at delivery for the presence of hepatitis B virus (HBV) antigenaemia in their sera. Forty-five or 2.9% were found to be positive. Only three of 41 (7.3%) of these hepatitis B surface antigen-positive (HbsAg) mothers were found to be positive for the presence of hepatitis B e antigen (HBeAg), 27 (65.8%) had anti-HBe and the remaining 11 (26.8%) had neither HBeAg nor its corresponding antibody. These results, therefore, predicted a low rate of transmission of virus from mother to newborn. Follow-up for 4-13 months after delivery on 14 of these HBsAG-positive mothers and their infants indicated that in only one infant born to an HBeAg-positive mother did HBV antigenaemia develop. Another infant died from undetermined causes. Therefore, HBV perinatal transmission among Arabs, unlike that among populations in Southeast Asia, does not appear to contribute in an important way to the pool of carriers in this population.

Hepatitis A and B virus infections in children in Kuwait.

In a 1-year prospective study of 1788 cases of acute viral hepatitis, 26 (1.5%) presented with evidence of simultaneous hepatitis A (HAV) and hepatitis B (HBV) virus infection. Twenty-three of 26 (88.5%) of these cases had serological evidence of a recent HAV infection in a chronic HBV carrier. The remaining 3 (11.5%) showed serological evidence of a recent concomitant HAV/HBV infection. Twenty-four of the 26 (92.3%) patients with simultaneous infection were children with a mean age of 4.6 years. Clinical and laboratory data indicated that the disease in patients with a recent concomitant HAV/HBV infection was not different from that in patients who had HAV infection superimposed on a chronic HBV carrier or that in age and sex matched patients presenting with an acute viral hepatitis A infection alone. Furthermore, the outcome of the disease was not affected by the HBeAg/anti-HBe status of the hepatitis B positive patient. All patients recovered completely and on follow-up none showed any signs of chronic liver disease. Simultaneous HAV/HBV infection, therefore, does not result in a more severe disease.

Malaria in non-endemic Kuwait: resident status of patients with imported infections and the need for prophylaxis.

Kuwait is non-endemic for malaria but, with a large expatriate population, the number of imported infections has escalated from 87 in 1980 to 534 in 1984, an increase of over 613%. During a period of 1 year at the Infectious Diseases Hospital, where most of the cases were diagnosed each year, 16.7% of blood samples sent for microscopy were positive for malaria; 95.47% of these patients were hospitalized for an average of 4 days. In a 2-year period, only three (0.52%) Kuwaiti nationals imported the infection out of a total of 577 patients with malaria. About equal numbers of expatriate 'residents' and 'new arrivals' were responsible for the remainder, but over 80% of patients with Plasmodium falciparum were 'residents'. The proportion of residents among the patients is increasing and will be more pronounced with the downturn in the economy. To curtail the tide of imported malaria, the current data suggests the viability of an active campaign to offer chemoprophylaxis to travellers at risk who are essentially 'semi-immune visitors of a non-malarious area visiting a malarious area'. The benefits of simple prophylactic measures need to be emphasized. The disinfection of aircraft arriving from endemic zones should be mandatory.

Imported malaria in Kuwait.

The number of imported malaria cases in Kuwait rose from 87 in 1980 to 504 in 1983, an increase of 579%. The continued resurgence of malaria in endemic zones, improved diagnostic techniques and a heightened awareness of imported malaria have contributed to the increase in the number of microscopically proved cases. Thick blood films fixed in acetone and stained in Giemsa proved a rapid method of diagnosis; species identification on the basis of a thin film on the same slide was performed with ease. Malaria was acquired in 38 countries. Most patients were young male adults. Most of the cases were due to Plasmodium vivax originating from India, although an increasing number of P. falciparum cases are also now being diagnosed from there. P. falciparum infections were evenly distributed throughout the year and most cases presented within 14 days of their arrival in the country. The highest number of P. vivax cases were diagnosed between May and October, when heat stress might have been a factor in precipitating a clinical attack of an infection previously acquired in the endemic zone. Attention is drawn to the importance of delayed attacks of P. vivax and, in semi-immunes, of P. falciparum. The time interval involved in establishing a history of "recent" travel in clinically suspected cases of malaria needs to be more clearly defined in each geographical area. Cases of induced malaria due to transfusion, accidental and congenital infections were identified. The fatality rate due to P. falciparum infections was low. In terms of the risk of renewed transmission, Kuwait may be considered a vulnerable area.

Measles and age of vaccination.

Measles is responsible for high morbidity and mortality in children particularly in developing countries. Infants, found by analytical studies to constitute a high risk group, are usually not covered by current vaccination programmes. In Kuwait in the epidemic years during the period 1976-1982, the incidence of measles in infants under one year was found to be more than five times that in the population over one year of age, ranging between 758 and 992 per 100000 live births. During this period as many as one fifth of the total cases (13.3-21.7%) and about one-third of the total deaths (35%) occurred in infants. The mean fatality rate for infants under one year was 3.3 while for the population one year and above it was 1.4. As the immunity derived from the mother declines markedly a large majority of children over six months of age become susceptible to measles. There is a strong case for lowering the age of vaccination against measles to protect the infants, at least in the developing countries, and to control and eventually eradicate the disease.

Frequency of delta agent infections in Kuwait.

Antibodies to delta antigen have been found among all populations in the world studied so far. The prevalence is high (40%-47%) in chronic HBsAg carriers in southern Italy. In other parts of the world, the prevalence is low (less than 5%); however, 30%-75% of polytransfused hemophiliacs and drug addicts in Europe and the United States have antibodies to delta antigen [2]. Most Arab nationalities are well represented in the population of Kuwait. Among 144 HBsAg-positive sera studied, 58 (40%) were positive for antibodies to delta antigen. Data regarding diagnosis, age, sex, and nationality were available for 80 of the patients investigated. Among these, 32 (40%) were antibody-positive. The highest number of positive patients was among those with chronic liver disease; all except two of the positive patients were Gulf or Mediterranean Arabs. Thus, infection with delta agent is an important cofactor in the pathogenesis of chronic liver disease in this region, because delta agent is known to become chronic [2]. The patients who had chronic liver disease and those who had illnesses other than liver disease or acute hepatitis are probably all chronic HBsAg carriers; however, it was not possible to differentiate between chronic and transient carrier states. Some of the patients with acute hepatitis also probably carried HBsAg with a superimposed delta infection. The carriage rate of HBsAg in the normal population in Kuwait is 2.8%-4% [3]. The only fatal case of acute hepatitis in this study occurred among the patients who were positive for delta antibody.(ABSTRACT TRUNCATED AT 250 WORDS)