Teenagers' Awareness of Peers' Substance and Drug Use in Kuwait.

BACKGROUND: Teenage substance use is a global challenge, and youths residing in Kuwait are not immune from it. Tobacco products are licit; however, alcohol and other mood-altering illicit substance are prohibited with severe penalties including imprisonment. Youths residing in Kuwait are being initiated into the use of mood-altering substances like tobacco at an early age, and it is postulated that, as they grow older, they may progress into using alcohol and other prohibited illicit drugs. AIMS: The aim of this study was to determine licit and illicit substance use by teenagers residing in Kuwait. The study will also explore their awareness of substance use among their peers. DESIGN: A cross-sectional survey using a snowball sampling technique was used to recruit 190 teenagers aged 15-18 years residing in Kuwait. Data were collected using the 130-item questionnaire adapted from 1998 New Jersey Triennial Public High School Survey of Drug and Alcohol Use. Data collection was from September 2012 to June 2013. DATA ANALYSIS: The Statistical Package for Social Sciences Version 22 for Windows was used. Pearson's chi-square, Kruskal-Wallis, and Mann-Whitney U tests were used to test the hypotheses. RESULTS: Tobacco was the most commonly used substance by these teenagers; 8.4% were current smokers, and 50% had experimented. Age of initiation for 21% was before 14 years old. Hashish (marijuana) was the most commonly used illicit drug, with 3.7% current users and 5.3% claiming to have used it. More male than female teenagers in Grade 9 were using tobacco products (χ = 27.428, df = 5, p < .001). CONCLUSION: The use and abuse of mood/mind-altering licit and illicit substances appear to be increasing among older teenagers. Intensifying campaigns about the hazards of substance use and drug testing should start from the primary school level.

Molecular basis for the effects of zinc deficiency on spermatogenesis: An experimental study in the Sprague-dawley rat model.

INTRODUCTION: The objective of this study is to investigate the molecular mechanisms underlying the effects of zinc deficiency on spermatogenesis in the Sprague-Dawley (SD) rat. MATERIALS AND METHODS: Three groups of eight adult male SD rats were maintained for 4 weeks on a normal diet as control, zinc deficient diet and zinc deficient diet with zinc supplementation of 28 mg zinc/kg body weight respectively. Using standard techniques, the following parameters were compared between the three groups of experimental animals at the end of 4 weeks: (a) Serum zinc, magnesium (Mg), copper (Cu), selenium (Se) and cadmium (Cd), (b) serum sex hormones, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GPX), (c) interleukin-4 (IL-4), tumor necrosis factor-alpha (TNF-α), Bcl-2, Bax and caspase-3 expression in the testes, (d) assessment of apoptosis of testicular cells using electron microscopy and (e) testicular volume and histology using the orchidometer and Johnsen score, respectively. RESULTS: The zinc deficient group showed a reduction of testicular volume, serum concentrations of Zn, Cu, Se, Mg, SOD, GPX, IL-4, Bcl-2 and testosterone (P < 0.05), as well as increased levels of serum Cd, MDA and tissue TNF-α, Bax, caspase-3 and apoptosis of the germ cells (P < 0.05) compared with control and zinc supplementation groups. CONCLUSION: Zinc deficiency is associated with impaired spermatogenesis because of reduced testosterone production, increased oxidative stress and apoptosis. These findings suggest that zinc has a role in male reproduction.

Premenstrual dysphoric disorder: prevalence and effects on nursing students' academic performance and clinical training in Kuwait.

AIMS: This study investigated the prevalence of Premenstrual Dysphoric Disorder among non-treatment seeking female students at the College of Nursing Kuwait. It also explored the effects of the disorder on their academic performance as shown by their grade point average and rate of absenteeism at clinical training. BACKGROUND: Many women worldwide are unaware of this distressing menstrual disorder which affects about 3-8% of women of childbearing age. The cyclical mood symptoms often appear during the last week prior to the onset of menstruation. These symptoms interfere with sufferers activities of daily living including occupational, biopsychosocial and sexual activities. DESIGN: A prospective observational study. METHODS: The study used an adapted Arabic version of Daily Record of Severity of Problem for two menstrual cycles to collect data from 110 nursing students. RESULT: Data analysis showed Cronbach's alpha coefficient for the adapted tool was 0·95. The rate of premenstrual dysphoric disorder was 5·6%. Hypotheses tested showed no significant effect on students' academic performance but a significant association with absenteeism at clinical training. CONCLUSION: The rate obtained in this study was similar to those from recent studies. Participants with high luteal scores believe that the condition have lowered their quality of life by making them choose to be in isolation during the period. RELEVANCE TO CLINICAL PRACTICE: Nursing students' absenteeism rate at clinical training is a predictor of their work absence pattern after qualification. Absenteeism due to premenstrual dysphoric disorder, a cyclic monthly disorder will be of monthly occurrences if sufferers do not sought medical treatment. Registered nurses absenteeism will not only result in shortage of trained nursing personnel, but also lowered standard of client care. It also has cost implications as temporary substitute staff may have to be employed during their period of absence or sick leave. This has implications for nursing management.

Lithium protects against toxic effects of cadmium in the rat testes.

PURPOSE: To investigate the protective effect of Lithium against the toxic effect of Cadmium in the rat testes. METHODS: Twenty four adult male Sprague-Dawley rats were treated with four different regimens: Cadmium only, Cadmium and lithium, lithium only and controls. Rats were sacrificed after 6 weeks and testicular levels of pro-inflammatory cytokine (IL-4), anti-inflammatory cytokine (TNF-α), Pro-apoptotic protein (Bax) and anti-apoptotic protein (Bcl-2) were measured by ELISA while serum levels of FSH, LH, Prolactin and Testosterone were measured using the Vidas parametric system. Antioxidant status (MDA, SOD) was also assessed in serum. Histopathological changes of testes were examined using light and electron microscopy. Immunohistochemical staining for Bax, Bcl-2 and Caspase 3 were performed. RESULTS: Treatment with lithium was associated with significant reduction in the toxic effects of Cadmium as shown by reduced testicular levels of TNF-α, serum levels of Malondialdehyde and testicular level of Bax, and increased levels of IL-4, Zn-Cu SOD, Bcl-2 and Testosterone. Testicular histopathology showed that Cadmium produced an extensive germ cells apoptosis and the addition of lithium in Cadmium-treated rats significantly reduced cadmium-induced testicular damage. CONCLUSION(S): Lithium has a protective effect against cadmium-induced testicular apoptosis in the rat.

Emotional reaction to diagnosis of infertility in Kuwait and successful clients' perception of nurses' role during treatment.

BACKGROUND: The unfulfilled desire of millions of infertile couples worldwide to have their own biological children results in emotional distress. This study evaluated the emotional reactions of couples attending a combined infertility clinic in Kuwait and successful clients' perception of nurses. METHODS: Quantitative and qualitative methods were used. The first phase was by structured interview using two standardized psychological scales: the 25-item Hopkins Symptom Checklist and Modified Fertility Adjustment Scale. Data were collected from 268 couples attending the combined infertility clinic, between October 2002 and September 2007. The second phase was a semi-structured interview of 10 clients who got pregnant following treatment. The interview explored their feelings and perception of the nurses' role. Interviews were transcribed verbatim and analyzed. RESULTS: The average duration of infertility was 4 years; 65.7% of the women and 76.1% of men suffered from primary infertility. Emotional reactions experienced were: anxiety in women (12.7%) and men (6%), depression in women (5.2%) and men (14.9%) and reduced libido in women (6.7%) and men (29.9%). Also in men, 14.9% experienced premature ejaculation, 5.2% weak ejaculation and 7.9% had impotence although 4.9% were transient. In the semi-structured interviews, the emotions expressed were similar and in addition to anger, feelings of devastation, powerlessness, sense of failure and frustration. In the survey, 12.7% of the men were found to show more anxiety than women (6%). Although all the 10 women interviewed confirmed they were anxious; only 4 of their partners were reported to be sad or anxious. Successful clients' perception of nurses' roles included nurses carrying out basic nursing procedures, communicating, educating about investigative and treatment procedures, providing emotional support by listening, encouraging, reassuring and being empathetic. CONCLUSIONS: This study illuminates the emotional reactions of infertile clients. Fertility nurses in Kuwait can provide emotional support through communication. The need for additional and continuous training for nurses employed in fertility settings in Kuwait is paramount.

The effect of obesity on the outcome of infertility management in women with polycystic ovary syndrome.

INTRODUCTION: Obesity has become a worldwide epidemic with ever increasing incidence and public health problems in both developing and developed countries. OBJECTIVE: The objective of the study is to investigate the incidence of obesity among patients with polycystic ovarian syndrome attending infertility clinic and the effect on treatment outcome. METHODOLOGY: Two hundred and seventy women with polycystic ovarian syndrome attending the infertility clinic were evaluated clinically, biochemically, and laparoscopically. They were stratified according to their body mass index (BMI) as follows: normal weight: 18-24; overweight: 25-29, obese:30-34, and grossly obese: > or = 35. Therapy included induction of ovulation with clomiphene citrate and gonadotrophins. The patients were followed up through during induction of ovulation and pregnancy. RESULTS: There were ethnic differences in mean BMI. Significantly more obese women had oligomenorrhoea (p<0.01) and anovulation (p<0.01) than women with normal weight. Obesity adversely affected the outcome of ovulation induction with clomiphene citrate and gonadotrophins; 79% of women with BMI 18-24 ovulated at 6 months compared to 15.3% in those with BMI 30-34 (p<0.001) and 11.8% in women with BMI > or = 35 (p<0.001). The pregnancy rate and outcome were also adversely affected by obesity. CONCLUSION: Obesity has a negative impact on the outcome of treatment of infertility. Weight reduction programme should be an essential component of infertility management.