Novel concept for water scarcity quantification considering nonconventional and virtual water resources in arid countries: Application in Gulf Cooperation Council countries.

The lack of perennial streams or surface water in most arid countries necessitates input modification and water scarcity/security equation calculation as per the water resource systems and physiographic conditions in these countries. The contributions of nonconventional and virtual water resources to water security have been disregarded or undervalued in previous research on global water scarcity. This study addresses this knowledge gap by developing a new framework for estimating water scarcity/security. The proposed framework considers the contributions of unconventional and virtual water resources and the roles of economics, technology, water availability, service accessibility, water safety and quality, water management, and resilience to threats on water and food security, and considers institutional changes required to adjust to water scarcity. To manage water demand, the new framework incorporates metrics for all categories of water resources. Although the framework was specifically designed for arid regions, particularly the Gulf Cooperation Council (GCC) countries, it is applicable to non-arid nations too. The framework was implemented in GCC countries, which are suitable examples of arid countries with notable virtual commerce. The ratio of abstraction from freshwater resources to renewability from conventional water sources was calculated to determine the extent of water stress in each country. The values obtained from measurement varied from 0.4 (the optimal threshold level for Bahrain) to 22 (severe water stress/low water security in Kuwait). Considering the nonconventional and abstracted nonrenewable groundwater volumes from the total water demand in the GCC, the minimum water stress value measured was 0.13 in Kuwait, suggesting considerable reliance on nonconventional water resources along with little domestic food production to achieve water security. The novel water scarcity/stress index framework was found to be appropriate for arid and hyper-arid regions, such as the GCC, where virtual water trade has a major positive impact on water security.

A multi-isotopic evaluation of groundwater in a rapidly developing area and implications for water management in hyper-arid regions.

Management of water resources in hyper-arid areas faces vital challenges in a global climate change context. Consequently, understanding the effects on groundwater sources can help mitigating the problem of water scarcity and the negative impact of human intervention on the environment. A case study area in the hyper-arid climate of the United Arab Emirates, was tackled here with the focus on applying stable isotopes as tools for evaluating groundwater sources and quality assessment. The results of major ions indicate variable increase in groundwater salinity moving away from Al Hajar Mountains recharge areas to the discharge areas (Arabian Gulf coast). The data of stable isotopes (δ18OH2O, δ2HH2O, δ18ONO3, δ15NNO3, δ18OSO4, δ34SSO4, δ11B) suggest impact of paleo-groundwater in the abstractions of the wells nearest to the coast. Nitrate isotopes indicate farming activities sources that can be masked due to the contribution from the nitrate-poor paleo-groundwater. Nitrate reduction processes are expected near to the recharge front. Sulphate and boron isotopes further suggest that influence of ancient evaporite dissolution in salinization. Management efforts should be focused on the diffuse sources of quality mitigations that can be vital in fingerprinting local and regional (transboundary) effects.

Evaluation of Groundwater Quality in the Eastern District of Abu Dhabi Emirate, UAE.

Water samples were collected to evaluate the groundwater quality in the shallow unconfined alluvial aquifer in the eastern part of Abu-Dhabi Emirate, UAE. The chemical monitoring revealed some spatial variability in chemical parameters as influenced by matrix aquifer changes in geological formations. Results show that changes in groundwater chemistry in the aquifer is mainly controlled by evaporation, silicate mineral dissolution, evaporite dissolution, and cation exchange. The concentration increases were accounted for primarily by dissolved sodium, chloride, and sulphate. The high value of total dissolved solids of shallow groundwater is mainly controlled by evaporation. The dominance of sodium ion was evident among the cationic compositions with an average of 2621.1 mg/L, while the chloride ion was the dominant among the anionic constituents with an average of 6249 mg/L. The prevalence of those two elements in most water samples contributes to the existence of saline water occurrence in the study area.

The impact of Helicobacter pylori on the complications of laparoscopic sleeve gastrectomy.

Helicobacter pylori (H. pylori) is a very common bacterium present in the gastric tissue of up to 50 % of people, and the mucosal damage it causes can predispose to multiple comorbid conditions. This study aims to observe the prevalence of H. pylori infection in patients undergoing laparoscopic sleeve gastrectomy (LSG) and its correlation with postoperative complications. A retrospective study was done on the gastric pathology specimen results of 682 patients who underwent LSG at Amiri Hospital from 2008 to 2012. Symptomatic patients had preoperative upper gastrointestinal endoscopies (UGIEs) based on the decision of the treating surgeon, along with campylobacter-like organism test (CLO test) for H. pylori detection. The intraoperatively excised gastric specimen was sent for histopathological assessment of H. pylori, and the patients were followed up for complications. Of the 682 patients, 629 (92.2 %) were found to be H. pylori negative intraoperatively, while 53 (7.8 %) were positive. A total of 32 (4.7 %) patients were found to have postoperative complications, of which 2 (6.3 %) had H. pylori intraoperatively. No statistical significance (p = 0.71), however, was seen between the overall complication rate and H. pylori. Specifically, there were five (0.7 %) cases of leak and eight (1.2 %) cases of neuropathy, both of which were not significantly associated with H. pylori (p = 0.33 and p = 0.12, respectively). All the other complications had no evidence of H. pylori. There appears to be no association between H. pylori infection and post-LSG complications.

Gastric histopathologies in patients undergoing laparoscopic sleeve gastrectomies.

BACKGROUND: With 80 % of its population overweight, 47.5 % obese, and having the eighth fattest population worldwide, Kuwait has a serious obesity problem. This has led to widespread practice of bariatric surgery, with little or no studies regarding operative findings and patient follow-up. This study aims to identify the prevalent gastric histopathologies of the patients who have undergone laparoscopic sleeve gastrectomy (LSG) at Amiri Hospital, Kuwait. METHODS: A retrospective study was done of the gastric pathology specimen results of 656 patients who underwent LSG at Amiri Hospital from 2008 to 2012. RESULTS: Of the 656 patients, the average age was 33 years, and 480 (73.2 %) were female while 176 (26.8 %) were male. The histopathology results identified 488 (74.4 %) cases with chronic gastritis, 63 (9.6 %) with follicular gastritis, and 12 (1.8 %) with atrophic gastritis. A total of 12 (1.8 %) cases showed findings other than gastritis, including four (0.6 %) cases of gastric polyps, three (0.5 %) cases of granulomatous disease, and one (0.2 %) case each of the following: gastro-intestinal stromal tumor, gastro-intestinal autonomic nerve tumor, intestinal metaplasia, collagenous gastritis, and crypt cell apoptosis. Helicobacter pylori was discovered in 48 (7.3 %) of the patients. CONCLUSIONS: The majority of gastric histopathology results after LSG in this study had an element of chronic gastritis (74.4 %), which is in keeping with previous studies showing its high prevalence among the obese population. However, a few cases had clinically significant pathologies, and this may alter post-operative management. In view of these results, routine histological examination of the gastric specimens is highly recommended.

The significance of elevated serologic markers of celiac disease in children with juvenile rheumatoid arthritis.

AIM: The aim of this study is to determine the frequency of celiac disease (CD) in a group of children with juvenile rheumatoid arthritis (JRA) and determine the correlation between the presence of the serologic markers and the histological diagnosis of CD. PATIENTS AND METHODS: Forty-two children (24 females) with JRA, aged between 5-15 years underwent study of serologic markers for CD (gliadin-IgA, gliadin-IgG, reticulin and endomysium-IgA antibodies). Endoscopic intestinal biopsy was performed in patients who had positive serologic markers for CD. The diagnosis of CD was based on the classic finding of villous atrophy and crypt hypertrophy. RESULTS: Eighteen patients (42.8%) had serologic markers for CD; ten of them with a systemic form, five with a polyarticular form and three with a pauciarticular form of JRA. Levels of AGA -IgG were high in 14 patients (77.8%), four patients (22.2%) had high levels of AGA-IgA and seven patients (38.9%) had anti-endomysium antibodies (AEA). One patient had anti-reticulin antibodies (ARA) 5.5%. Sixteen patients underwent intestinal biopsy; in only one patient with AEA antibodies (2.38%), biopsy revealed typical finding of CD. The patient with CD showed improvement in both growth parameter as well as articular symptoms after starting gluten-free diet CONCLUSION: Our study shows that the screening for silent CD among children with JRA may be useful. Those patients with AEA need further follow up since these antibodies are quite sensitive and specific for CD.