Audit of glycemic control in patients with type 1 diabetes referred to a pediatric clinic in a specialized center in Kuwait.

INTRODUCTION: Intensive glycemic control reduces the risk of microvascular and macrovascular complications. Furthermore, optimal glycemic control is essential for normal growth and development. Thus, there is a need to monitor and evaluate glycemic control in patients with type 1 diabetes (T1D). Our aim was to audit glycemic control in patients with T1D in a specialized center as per the Society of Pediatric and Adolescent Diabetes (ISPAD) Hemoglobin A1C (HbA1C) target recommendations published in 2014. METHODS: This is a retrospective cross-sectional study reporting on glycemic control (HbA1C) of patients younger than 21 years of age and with T1D treated at Dasman Diabetes Institute (DDI) between January 2013 and December 2015. RESULTS: A total of 470 patients with T1D (250 males and 220 females) were included. Only 53 (11.3%) patients met the ISPAD target for optimal glycemic control with HbA1C < 7.5% (58 mmol/mol). Older age was positively associated with poor glycemic control (p = 0.001) while Continuous Subcutaneous Insulin Infusion (CSII) therapy was negatively associated with poor glycemic control, adjusted Odds Ratio (OR) 0.33 (95% confidence interval (CI): 0.16-0.66) for CSII and adjusted OR 0.42 (95% CI: 0.27-0.64) for shifting to CSII (p < 0.001). CONCLUSION: Achieving optimal glycemic control is a significant challenge for young patients with T1D. Glycemic control goals should be individualized to achieve such goals safely, realistically and with a better quality of life for patients with T1D.

Referral pattern of children with short stature to a pediatric endocrine clinic in Kuwait.

BACKGROUND: The aim of the study was to describe the referral pattern, baseline characteristics, and etiological profile of children referred with short stature in Kuwait. METHODS: This is a cross-sectional retrospective review of children referred to the Endocrine Clinic with short stature. Short stature was defined as height or length below the 3rd centile or <-2 standard deviation score (SDS). RESULTS: A total of 221 children were referred with no gender difference (p=0.346). Almost one fifth of these children had normal stature. Median (interquartile) age was 7.7 (4.7, 10.3) years and mean height SDS was -2.67 (0.68). The most common diagnoses were normal variants of growth, growth hormone deficiency (GHD). CONCLUSIONS: Our study highlights the need to improve the referral process in order to avoid unnecessary investigations and alleviate parental anxiety. There is no gender bias in short stature referrals in Kuwait. There is a need of further investigation of short stature in the region.

Low back pain among female nurses in Yemen.

OBJECTIVES: This study aimed to investigate the prevalence of Low Back Pain (LBP) among female nursing staff and explore the potential risk factors associated with LBP. METHODS: An analytical cross-sectional study was conducted on randomly selected female nurses using payroll as a sampling frame in all public hospitals in Sana'a City, Yemen. Data was collected through face-to-face interview using a structured, pre-coded questionnaire that was available in Arabic and English. Weight and height of the nurses were measured using weight and height scales and body mass index was calculated. Multiple logistic regression was used to identify the factors associated with LBP. RESULTS: Out of 696 female nurses selected, 687 (98.7%) responded. The life-time, the 12-month and one-week prevalence rates of LBP among female nurses were 512 (74.5%; 95% CI: 71.1-77.7%), 411 (59.8%; 95% CI: 56.0-63.5%) and 249 (36.2%; 95% CI: 32.6-39.9%), respectively. The prevalence was significantly lower in Indian nurses compared to other nurses. Three out of every 10 nurses with LBP had sick leave because of LBP in the last 12 months. Factors that showed significant association with LBP among nursing staff in the multivariate analysis were age, nationality, menstrual disorders and stress level at work. CONCLUSION: LBP is common among female nurses in Yemen. The role of menstrual disorders in developing LBP among female nurses seems to be important. Although sharing the same working conditions, Indian nurses were less likely to report LBP, which highlight the importance of cultural differences in willingness to report LBP.