[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.

Occurrence of surgical pathogens and their antimicrobial susceptibility patterns.

OBJECTIVE: To assess the occurrence frequency of bacterial pathogens at the Surgical Wards, Casualty and Outpatient Department (OP) of major Kuwaiti hospital and to compare their antimicrobial susceptibility patterns. METHODS: The Automicrobic System (bioMerieux-Vitek) with respective ready-to-use cards were used for identification of isolates and their susceptibility testing. Vitek DataTrac software automatically tabulated the occurrence rate of pathogens or their antimicrobial susceptibility percentage--for defined periods of time and specified patient locations. RESULTS: The most common organisms for surgical inpatient isolates were E. coli, S. aureus, K. pneumoniae and P. aeruginosa; but for blood culture and sputum, by far, the most common were coagulase-negative staphylococci and K. pneumoniae, respectively. E. coli from wounds were less susceptible (for 12-26%) to ampicillin, co-amoxiclave, cephalothin and cefuroxime than surgical inpatient, OP or casualty E. coli isolates. Cephalothin and piperacillin susceptibility rates of K. pneumoniae of surgical in- and outpatients were twice higher than that of respective E. coli isolates. CONCLUSION: The occurrence frequency of bacterial pathogens were dependent on the surgical services. Overall, antimicrobial susceptibility rates were high for different surgical subcategories, especially for casualty and inpatients. The lowest susceptibility rate showed the wound isolates versus beta-lactams, except third generation cephalosporins.

Epidemiological features of complicated UTI in a district hospital of Kuwait.

Records from patients admitted to the surgical or medical department or examined in the respective outpatient departments in a Kuwaiti district hospital were reviewed retrospectively to discern the demographic characteristics of patients with complicated urinary tract infections (UTI), underlying conditions, pathogens and their antimicrobial susceptibility patterns. Kuwaiti nationals constituted the largest group, followed by Egyptians, which in the population of 225 patients studied comprised 41% and 27%, respectively; 65 of these 225 patients (29%) had urinary stones; 33 of the 92 Kuwaiti patients (36%) had diabetes mellitus; 38 of the 60 Egyptian patients (63%) had urinary stones and 18 had bilharziasis (30%). Pathogens were isolated 353 times from 225 patients. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and several other organisms in those patients with bilharziasis, urinary stones, and especially diabetes mellitus, displayed lower susceptibility frequencies to antimicrobials in comparison with other surgical and medical UTI isolates. Surgical and medical UTI organisms showed an overall higher antimicrobial resistance frequency than did UTI organisms from the maternity department or regional clinics. More than half of the population of Kuwaiti consists of expatriates from different countries. Such a population structure can exhibit peculiarities when health is considered. All this should be taken into consideration while dealing with disease management.

The minimum inhibitory concentration of seventeen antimicrobials for Salmonella isolates from septic patients.

Herein we are reporting, for the first time in Kuwait, the minimum inhibitory concentrations (MICs) of Salmonella blood culture isolates vs. 17 clinically relevant antimicrobial agents. The screening of blood culture specimens was performed with the most advanced Bactec 9240 (Becton Dickinson). From over 20,000 blood cultures, 112 Salmonella isolates were obtained from 67 patients. Their MICs were determined using the automated Vitek microdilution technique (Biomerieux Vitek Inc.). During the whole 1991-1995 study period, the MICs for cefotaxime, ceftazidime, aztreonam, amikacin, gentamicin, ciprofloxacin and imipenem were below their respective susceptibility breakpoints. Resistance to chloramphenicol, ampicillin and cotrimoxazole varied from year to year, from 18% to 50%, except in 1991 when it was nil (1991 was the first year after the Gulf War, with very few newcomers from the Indian subcontinent). All ampicillin-susceptible S. typhi isolates had extremely low MIC values (< or = 0.25 microgram/ml).

Ultrastructural changes in hepatocytes induced by pregnenolone-16a-carbonitrile (PCN).

Pretreatment with pregnenolone-16a-carbonitrile (PCN) protects the rat against the toxic effects of indomethacin, digitoxin, cyclophosphamide and many other injurious agents. In experiments in vivo Selye has recently shown that conditioning by higher PCN doses gives broader "protection spectra". In the present experiments, we studied the effect of different doses of PCN on the ultrastructure of the hepatocytes. PCN was administered to the groups of female rats at doses of 1.0, 0.1 and 0.03 mg, twice daily for three days respectively. Sixteen hours after the last dose, the specimens of liver tissue were fixed, dehydrated and embedded in Epon resin; the ultrathin sections selected from midzonal areas were negatively stained and studied under the electron microscope. We found that PCN produces morphological changes in rat hepatocytes mainly by smooth-surfaced endoplasmic reticulum (SER) proliferation and that the degree of ultrastructural alteration is dose dependent.