Prognostic impact of chronic lymphocytic leukemia comorbidity index in a young population: a real-world evidence study of a national gulf region cohort.

In chronic lymphocytic leukaemia (CLL), comorbidities assessed by the CLL comorbidity index (CLL-CI) have been associated with outcomes in Western cohorts. We conducted a retrospective analysis of an unselected Middle Eastern cohort of newly diagnosed CLL patients seen at the Kuwait Cancer Control Center (n = 300). Compared to Western studies, these Middle Eastern patients were diagnosed at a younger age (median of 59) and had a higher comorbidity burden (69% non-low risk CLL-CI). A higher CLL-CI score was independently associated with significantly shorter event-free survival and greater risk of death. Our analysis demonstrates that CLL-CI is a valuable tool for comorbidity assessment and prognostic influence in (relatively young) Middle Eastern CLL patients.

Prevalence of and factors associated with multimorbidity among adults in Kuwait.

BACKGROUND: This cross-sectional study aimed to assess the prevalence of morbidity i.e., one morbidity and multimorbidity (≥ 2 morbid conditions) among adults in Kuwait and to examine the sociodemographic and lifestyle factors associated with morbidity as a multinomial outcome in the study population. METHODS: The data were collected from January 26, 2021, to February 3, 2021, using an electronic questionnaire, which was distributed on social media platforms. The consent form was attached with the questionnaire and the participants were requested to sign the consent form before completing the questionnaire. The prevalences (%) of each morbidity and multimorbidity were computed. Multivariable polychotomous logistic regression analysis was used to evaluate the association between the demographic and lifestyle factors with morbidity as a multinomial outcome. RESULTS: Of 3572 respondents included, 89% were Kuwaiti, 78.3% females and 66% were 21- 40 years old. The prevalence of multimorbidity and one morbidity respectively was 27.4% and 29.7%. The prevalence of multimorbidity with two, three, four or five ill-health conditions were 14.3%, 7.4%, 3.5%, and 1.2%, respectively. A higher prevalence of multimorbidity was among respondents over 60 years of age (71%) and Kuwaiti nationals (28.9%). The final multivariable polychotomous logistic regression model revealed that age, sex, nativity, sedentary lifestyle, smoking, and alcohol drinking were significantly (p < 0.05) associated with multimorbidity. However, age and alcohol drinking were significant (p < 0.05) predictors of one morbidity. CONCLUSION: This study provides evidence that multimorbidity is more prevalent among the elderly, females, and Kuwaiti nationals. Sedentary behaviour, smoking and alcohol consumption were significantly and independently associated with multimorbidity. These findings highlight the burden of multimorbidity and should be considered in the development of future prevention programs.

Prevalence and Distribution of Dental Anomalies in Schoolchildren in Kuwait.

OBJECTIVE: Dental anomalies (DA) can affect paediatric patients' aesthetics, function, and psychological well-being. There is a lack of data about the prevalence of DA in children in Kuwait. This study aimed to investigate the prevalence and distribution of DA amongst schoolchildren aged 8 to 12 years. METHODS: A retrospective study was conducted using panoramic digital radiographs of children who attended a single dental center. All radiographs were evaluated by 2 calibrated and trained examiners. RESULTS: DA were present in 110 (20.1%) out of the 546 panoramic radiographs examined: 53.6% in females and 46.4% in males. The mean age of children with DA (9.83 ± 1.29) was similar to that of children with no anomalies (9.96 ± 1.46). The most prevalent anomaly was dental agenesis (9.3%), followed by taurodontism (6.6%) and ectopic eruption (EE, 2%). DA were more common in the maxilla (58.2%) compared to the mandible (41.8%, P = .042). Congenitally missing teeth were significantly more frequent in the mandible (56.9%) than in the maxilla (43.1%, P = .003). EE was significantly more common in the maxilla (90.9%) than in the mandible (9.1%, P = .024). Microdontia and root dilacerations were only present in males, whilst supernumerary teeth, transposition, and impacted teeth were noted in females only. CONCLUSIONS: The prevalence of DA amongst schoolchildren in Kuwait was considered to be relatively high. Certain DA were associated with gender. The significant prevalence of DA highlights the need for early diagnosis using panoramic radiographs, particularly during the ages of 9 and 10, in order to ensure effective patient management.

Tumor necrosis factor alpha gene polymorphism affects the pattern of idiopathic nephrotic syndrome in Kuwaiti Arab children.

OBJECTIVES: TNF-α is a pro-inflammatory cytokine that has been implicated in many inflammatory diseases, but its association with idiopathic nephrotic syndrome (INS) is poorly understood. This study looked for an association of TNF-α gene polymorphisms with INS, as well as its effect on steroid responsiveness among Kuwaiti Arab children. METHODS: Genotypes of the TNF-a gene polymorphisms were analyzed using polymerase chain reaction-restriction fragment length polymorphism in 151 INS Kuwaiti Arab patients and 64 age and sex-matched controls. Clinical data of all subjects were reviewed. RESULTS: The heterozygous AG genotype was detected in 8.6% of INS patients compared 23.4% of the controls (p < 0.01). Comparing steroid responsiveness, AA genotype was significantly more common in steroid-sensitive nephrotic syndrome (SSNS) cases than steroid-resistant nephrotic syndrome (SRNS) patients (p = 0.001). However, AG genotype was significantly more common in SRNS patients compared to the SSNS cases (p = 0.001). No difference was found between these two subgroups in the GG genotype frequency. CONCLUSION: AG genotype of TNF-a gene polymorphisms may be considered a suitable marker for INS disease among Kuwaiti children. Both AA and AG genotypes may be useful in predicting steroid responsiveness among these cases of Arab ethnicity. The findings might open the era for the use of genetic markers in the early treatment of NS.

Evaluation of the CLL-IPI and IPS-E Prognostic Indices in a Young Middle Eastern Population with Chronic Lymphocytic Leukemia: A Retrospective Analysis at the Kuwait Cancer Control Center.

INTRODUCTION: The Chronic Lymphocytic Leukemia International Prognostic Index (CLL-IPI) is a powerful prognostic tool validated in multiple Western populations. However, its utility in the young Middle Eastern population is unknown. METHODOLOGY: We conducted a retrospective analysis of 152 unselected patients with chronic lymphocytic leukemia (CLL) diagnosed between 2008 and 2022 at the Kuwait Cancer Control Center, which serves as the sole cancer center in Kuwait. The evaluation of the CLL-IPI was based on the assessment of event-free survival (EFS) across the entire cohort. Subsequently, we compared the CLL-IPI with the International Prognostic Score for Early-stage patients (IPS-E) in order to predict the time to first treatment specifically within the subgroup of patients diagnosed with early-stage disease. RESULTS: The median age of the study cohort was 59.9 years (IQR, 53.1-68.8). The 5-year EFS rates for the low, intermediate, and high/very high-risk categories were approximately 82%, 34%, and 23%, respectively, p < 0.001 (C-statistic = 0.67). On multivariate analysis, advanced stage and unmated IGHV status were independent prognostic factors of EFS. In those with early-stage disease, cumulative 5-year treatment incidence rates for the low, intermediate, and high/very high-risk categories based on the CLL-IPI score were approximately 8%, 55%, and 55%, respectively, p = 0.001 (C-statistic = 0.70). However, based on the IPS-E score, the cumulative 5-year treatment incidence rates for the low, intermediate, and high-risk categories were approximately 0%, 10%, and 60%, respectively, p < 0.001 (C-statistic = 0.73). CONCLUSIONS: The CLL-IPI and the IPS-E are valid stratification tool in our young Middle Eastern population.

Relationship between Symptom Burden and HRQOL among Kuwaiti Women Recently Diagnosed with Breast Cancer: A Cross-Sectional Study.

BACKGROUND: Breast cancer is a life-threatening chronic condition associated with distress and psychological symptoms. Breast cancer also leads to ongoing ambiguity around the symptom burden of the disease and its treatment over the long-term, which impacts health-related quality of life (HRQOL). The factors influenced HRQOL of Kuwaiti women with breast cancer is unclear and not well understood. PURPOSE: The purpose of the study was to explore the relationships between the symptom burden and HRQOL of Kuwaiti women diagnosis with breast cancer within their first year. METHODS: This cross-sectional correlational study surveyed 100 Kuwaiti women diagnosed with breast cancer within the previous year at the Kuwait Cancer Control Center Hospital (KCCC). The study collected data using a combination of five questionnaires: The Memorial Symptom Assessment-Short Form Scale (MSAS-SF), the Medical Outcomes Study Social Support Survey (MOS-SSS), the Functional Assessment of Cancer Therapy-General (FACT-G), and demographic/clinical questionnaire. RESULTS: The 100 Kuwaiti women in the study experienced moderate symptom burden (M = 2.35, SD = 0.28), which is significantly negatively associated with HRQOL. The most prevalent symptoms the women reported were pain, difficulty sleeping, lack of energy, and hair loss. Symptom burden was significantly negatively associated with HRQOL. CONCLUSION: The findings of this study suggest the need for more training for clinicians to diagnose and treat common symptoms. Improved screening tools and psychosocial interventions also need to be developed. Future research should focus on longitudinal data and qualitative methods to gain a more comprehensive understanding of Kuwaiti women's experiences with breast cancer.

The association between academic performance indicators and lifestyle behaviors among Kuwaiti college students.

BACKGROUND: Lifestyle behaviors are developed during young adulthood and carried through life. Accordingly, early detection of unhealthy behaviors can help prevent the increase in non-communicable diseases in the population. College students are an especially vulnerable group who, upon entering a new environment, tend to engage in unhealthy behaviors. OBJECTIVE: The present study aims to evaluate the lifestyle behaviors of Kuwaiti college students and their association with markers of academic achievements. METHODS: One thousand two hundred fifty-nine students participated in the present study and answered an online questionnaire pertaining to their sociodemographic status, academic performance indicators, body weight and height, and lifestyle behaviors. Data were collected from November 2020 to February 2021. RESULTS: Results of the present study showed that obesity was significantly more prevalent among male participants than among females even though males were more physically active. Alternatively, females had a greater grade point average in college, slept more, and had more screen time. Interestingly, we were unable to detect a significant correlation between lifestyle behaviors and academic achievements. CONCLUSION: The observed differences in body mass index between genders may have been attributed to energy intake rather than energy expenditure.

Disparities in oesophageal cancer risk by age, sex, and nativity in Kuwait:1980-2019.

BACKGROUND: This cross-sectional cohort study assessed the inequalities in oesophageal carcinoma risk by age, sex and nativity in Kuwait: 1980-2019. METHODS: Using oesophageal cancer incidence data from the Kuwait National Cancer Registry, relevant Kuwaiti population data and World Standard Population as a reference, age-standardized incidence rates (ASIR) (per 100,000 person-years) overall and by subcohorts were computed. The incident oesophageal cancer cases count was overdispersed with excessive structural zeros, therefore, it was analyzed using multivariable zero-inflated negative binomial (ZINB) model. RESULTS: Overall ASIR of oesophageal cancer was 10.51 (95% CI:  6.62-14.41). The multivariable ZINB model showed that compared with the younger age category (< 30 years), the individuals in higher age groups showed a significant (p < 0.001) increasing tendency to develop the oesophageal cancer.  Furthermore, compared with the non-Kuwaiti residents, the Kuwaiti nationals were significantly (p < 0.001) more likely to develop oesophageal cancer during the study period. Moreover, compared with 1980-84 period, ASIRs steadily and significantly  (p < 0.005) declined in subsequent periods till 2015-19. CONCLUSIONS: A high incidence of oesophageal cancer was recorded in Kuwait, which consistently declined from 1980 to 2019. Older adults (aged ≥ 60 years) and, Kuwaiti nationals were at high risk of oesophageal cancer. Focused educational intervention may minimize oesophageal cancer incidence in high-risk groups in this and other similar settings. Future studies may contemplate to evaluate such an intervention.

Progress Against Cancer in Kuwait: Trends in Incidence, Survival and Mortality.

INTRODUCTION: To assess progress against cancer, trends in incidence, survival and mortality need to be interpreted simultaneously. METHODS: Data were obtained from the Kuwait Cancer Registry (KCR) for all Kuwaiti children (0-14 years) and adults (15-99 years) diagnosed with one of 18 common cancers during 2000-2013, with follow-up for vital status to 31 December 2015. World-standardised average annual incidence and mortality rates were calculated for 2000-2004, 2005-2009, 2010-2013. Five-year net survival was estimated with the Pohar Perme estimator, corrected for background mortality using life tables of all-cause mortality. Survival estimates were agestandardised using the International Cancer Survival Standard weights. RESULTS: For liver cancer, five-year net survival increased from 11.4% to 13.4% for patients diagnosed between 2000-2004 and 2010-2013, while incidence and mortality rates fell from 5.5 to 3.6 and from 3.9 to 3.0 per 100,000, respectively. Similar patterns were seen for acute lymphoblastic leukaemia (ALL) and lymphoma in children. Survival and mortality remained stable for cancers of the lung, cervix and ovary, but incidence declined from 10.2 to 7.4, 4.9 to 2.4 and 5.8 to 4.3 per 100,000, respectively. For breast cancer, survival increased from 68.3% to 75.2%, while incidence and mortality rose from 45.6 to 58.7 and from 5.8 to 12.8 per 100,000, respectively. For colon cancer, incidence and mortality rates rose from 11.4 to 12.6 and from 2.3 to 5.4 per 100,000, respectively. Five-year survival fell from 64.8% to 50.2% between 2000-2004 and 2005-2009, before rising to 58.5% for 2010-2013. CONCLUSION: Increasing survival, alongside falling incidence and mortality rates, represents progress in cancer control, attributable to effective prevention (e.g. tobacco control and lung cancer) and early diagnostic activity (e.g. mammography for breast cancer), or better treatment (e.g. childhood ALL). The increasing prevalence of obesity, linked to rising incidence for breast and colon cancers, suggests the need for public health prevention campaigns.

Ecological study of breast cancer incidence among nationals and nonnationals in the Gulf Cooperation Council countries.

Background: Breast cancer incidence is increasing in the Gulf Cooperation Council (GCC) countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates. Aims: This study analysed geographical patterns, time trends, and age distribution of female breast cancer incidence among nationals and non-nationals in GCC countries. Methods: Available cancer registry data for 1979-2016 were retrieved for the GCC countries. Age-standardized rates (ASRs) per 100 000 women were calculated using the World standard population. Comparisons were made by calculating comparative incidence figures. Results: From 1998 to 2012, incidence among nationals was highest in Bahrain (ASR 61.85), Kuwait (ASR 52.66), and Qatar (ASR 56.90) and lowest in Saudi Arabia (ASR 19.76), Oman (ASR 22.33), and United Arab Emirates (ASR 31.05). In the most recent period, data were available only in Qatar (2014-2016) and Saudi Arabia (2013-2015). Non-nationals and nationals in Qatar had higher incidence rates than in Saudi Arabia. Incidence among nationals in Qatar was at least twice that in Saudi Arabia (comparative incidence figure 2.32). Incidence among non-nationals in Qatar was 3 times higher than in Saudi Arabia. Among nationals in Kuwait, 10.8% of cases of breast cancer occurred in women aged < 40 years in 2008-2012, compared with 24.2% in non-nationals in Qatar in 2014-2016. Conclusion: Breast cancer incidence has increased over time among women in most GCC countries, likely reflecting the improvements in healthcare access and screening programmes. Nationals and non-nationals developed breast cancer at a younger age than women in other high-income countries. Increased screening uptake is still required in the region. Evidence-based, locally-informed interventions should be implemented to address risk factors specific to the nationals and non-nationals in the GCC countries.

Hypomagnesemia and the Metabolic Syndrome among Apparently Healthy Kuwaiti Adults: A Cross-Sectional Study.

Magnesium plays a key role in metabolic disorder development, and hypomagnesemia may be implicated in the pathogenesis of metabolic syndrome (MetS) and its components. In this cross-sectional study, we investigated the associations between hypomagnesemia, MetS, and MetS components among 231 adults (193 women and 38 men) living in Kuwait who were apparently healthy without chronic diseases. We used the International Diabetes Federation (IDF) and the United States National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria to define participants with MetS. The Ministry of Health cutoff for hypomagnesemia (<0.74 mmol/L) was employed. IDF- and ATP III-defined MetS prevalence was 22.1% and 15.2%, respectively. Hypomagnesemia occurred in 33.3% of all participants and 53.2% of participants with MetS (p < 0.001). Magnesemia correlated negatively with body mass index, waist circumference, systolic blood pressure [SBP], diastolic blood pressure (DBP), fasting blood glucose (FBG), low-density lipoprotein cholesterol level, and triglyceride level; magnesemia correlated positively with high-density lipoprotein cholesterol (HDL-C) levels (p < 0.001). Multivariate logistic regression, adjusting for BMI, age, and sex, showed that hypomagnesemia was associated with a 12- and 5-fold greater odds of getting IDF-defined (adjusted odds ratio [aOR] 11.70; 95% confidence interval [CI] 4.87−28.14) and ATP-defined (aOR 5.44; 95% CI 2.10−14.10) MetS, respectively, in the study population. Hypomagnesemia was significantly associated with a 3.62, 9.29, 7.01, 2.88, 3.64, and 3.27 higher odds of an increased waist circumference (95% CI 1.48−8.85), elevated serum triglyceride level (95% CI 3.97−21.73), elevated FBG (95% CI 3.25−15.11), elevated SBP (95% CI 1.16−7.11), elevated DBP (95% CI: 1.22−10.89), and lowered HDL-C level (95% CI 1.69−6.32), respectively. Hypomagnesemia could be a consequence of the pathophysiology of MetS and its individual components among adults in Kuwait.

The Impact of COVID-19 on Dental Treatment in Kuwait-A Retrospective Analysis from the Nation's Largest Hospital.

BACKGROUND: The COVID-19 pandemic has changed the way dentistry has been practiced the world over. This study sought to assess the impact of the COVID-19 pandemic on the patterns of attendance for dental treatment in a large hospital in Kuwait through comparisons with data from the year prior to the pandemic. METHODS: A total of 176,690 appointment records from 34,250 patients presenting to the AlJahra specialist hospital in Kuwait for dental treatment from April 2019 to March 2021 were analyzed. The types of procedures and the departments in which they presented were analyzed, and the patterns of attendance before and during the pandemic were compared. RESULTS: While there was a significant reduction in the number of orthodontic, endodontic, and periodontal procedures, there were no impacts on oral surgery, restorative procedures, or pediatric dentistry. CONCLUSIONS: There has been a return in the number of patients obtaining dental treatment; however, there has been a definite shift in the use of certain dental procedures.

Noncommunicable Diseases and Hospital Utilization in Kuwait: A Generalizable Approach Using the World Health Survey.

BACKGROUND: Kuwait and countries in the Arabian Gulf region face an alarming prevalence of noncommunicable diseases (NCDs) that strain their health systems and threaten their economies. To quantify a key dimension of the burden, we estimated the risk of hospital utilization in Kuwait associated with diagnoses of the most prevalent NCDs, excluding cancer, using a generalizable approach suitable for cross-country disease burden comparisons and assessments of prevention effectiveness. METHODS: The study analyzed responses from a nationally representative sample of 2,165 individuals with self-reported hospital admissions over 12 months and NCD diagnoses from the World Health Survey in Kuwait in 2010. Hospital utilization rates were examined for individuals diagnosed with hypertension, diabetes mellitus, asthma, chronic lung condition, heart disease, and stroke rates and adjusted for demographic and socioeconomic factors. Count regressions were used to estimate the association between individual NCDs while adjusting for other covariates. RESULTS: Using negative binomial regressions, we found that hypertension, the most common NCD in Kuwait, was associated with 75% higher hospital utilization. In addition, heart disease was associated with a 495% increase in hospital utilization rates after adjusting for potential confounders. Many other demographic, socioeconomic, and behavioral characteristics confounded the sizable increase in the risk of hospital admissions associated with NCDs. CONCLUSIONS: We estimated the substantial burden on curative services associated with NCDs in Kuwait through a standardized approach to compare hospital utilization rates associated with various NCDs; this approach is generalizable to more than 70 countries that participated in the World Health Survey.

COVID-19 outcomes among rheumatic disease patients in Kuwait: Data from the COVID-19 Global Rheumatology Alliance (C19-GRA) physician registry.

PURPOSE: We aimed to assess the characteristics of inflammatory rheumatic disease (IRD) patients in Kuwait diagnosed with COVID-19 and the factors linked with hospitalization, complications, and mortality. METHODS: Data of IRD patients from Kuwait diagnosed with COVID-19 between March 2020 and March 2021, submitted to the COVID-19 Global Rheumatology Alliance physician-reported registry, were included in our analysis. Data on patients' age, gender, smoking, diagnosis, IRD activity, and other comorbidities were collected. Statistical Package for the Social Sciences (SPSS), version 25, was used for statistical analysis. RESULTS: A total of 52 patients were included, with a mean age of 55 years (±14). The majority of patients were ≤65 years (77%), female (77%), non-smokers (80.8%), and diagnosed with rheumatoid arthritis (67.0%). Of the included patients, 19.2%, 9.6%, and 7.7% reported having methotrexate monotherapy, antimalarials monotherapy, and interleukin-6 inhibitors monotherapy immediately before COVID-19, respectively. Most of the included patients (92.3%) were either in remission or had minimal/low disease activity, while others (7.7%) had moderate disease activity. Forty-three patients (82.7%) were hospitalized, while 11 patients (25.6%) required ventilation (invasive or non-invasive). Ten of the ventilated patients (90.9%) received glucocorticoids as part of the local protocol to treat severe COVID symptoms, and 4 patients (7.69%) died. The duration till symptom-free ranged between 0 to 30 days, with a mean value of 10 days (±6.5). CONCLUSION: The current study provides timely real-world evidence regarding characteristics and potential risk factors linked to poor COVID-19-related outcomes in the IRD population in Kuwait.

Risk Factors for Wound Infections after Vascular Surgery: Kuwait Experience.

INTRODUCTION: Wound infections represent a serious complication after vascular surgery particularly after vascular reconstructive procedures. We aimed to identify risk factors predisposing patients to these complications. METHODS: This was a retrospective review of open vascular surgical procedures performed between April 2014 and March 2019 in Kuwait. Patient demographics, procedures performed and their indications, and post-operative outcomes were collected and analyzed. Patients with pre-operative active infections were excluded from the analysis. Statistical analysis was performed, and odds ratios (ORs) and relative risks were calculated for the outcomes of interest. Fisher's exact test and two-tailed t test were used where appropriate. RESULTS: 391 patients were identified. The majority (54%) presented with chronic limb threatening ischemia. The mean age was 58 (±10) years, with a male predominance (76%). Wound infection occurred in 53 (14%) patients. The most commonly isolated organism was Staphylococcus aureus (47%). Diabetes (OR 8.03, 95% CI: 1.9142-33.7439, p = 0.0044), hypertension (OR 2.38, 95% CI: 1.2960-4.3684, p = 0.0052), ischemic heart disease (OR 2.30, 95% CI: 1.4349-4.6987, p = 0.0016), hyperlipidemia (OR 2.12, 95% CI: 1.0305-4.3620, p = 0.0412), and chronic renal failure (OR 2.55, 95% CI: 1.0181-6.4115, p = 0.0457) were all found to be significantly associated with the development of post-operative wound infections in vascular surgery patients. CONCLUSION: Diabetes, hypertension, ischemic heart disease, hyperlipidemia, and chronic renal failure were associated with post-operative wound infections. Anticipation of wound complications in patients with these risk factors may aid early diagnosis and treatment.

Epidemiology of de novo Acute Myeloid Leukemia in Kuwait per the 2016 WHO Classification.

OBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that arises from the clonal proliferation of immature myeloid cells. Although the number of AML cases has dramatically increased worldwide, information on its prevalence and incidence in Kuwait is lacking. This study reports the incidence of AML and patient demographics in the country from 2014 to 2020, based on the 2016 WHO classification of AML. SUBJECTS AND METHODS: Data on patients with AML, including acute promyelocytic leukemia (APL), were collected from a clinical cohort with 281 cases analyzed in this study. RESULTS: The overall median age of the population was 47 years with a 1.1:1 male-to-female ratio. Over the study period, the incidence of AML demonstrated a general increasing trend, with the highest and lowest overall incidence occurring in 2018 and 2015, respectively. The frequency of APL in our cohort was 8.9%. Regarding the 2017 European LeukemiaNet (ELN) risk stratification of patients with AML, 37%, 46%, and 17% of patients had a favorable, intermediate, and adverse risk, respectively. A total of 57% of cases achieved complete remission post-induction, and the median overall survival was 37 months. CONCLUSION: Our study may help predict the future trends of AML in Kuwait to help improve clinical management and patient outcomes.

Cystinosis in Pediatric Renal Transplant Recipients: A Case-Control Study From Kuwait.

OBJECTIVES: Cystinosis is the most frequent cause of the inherited renal Fanconi syndrome and is also potentially treatable. In this study, we have reported our single-center experience of the longterm outcomes of kidney transplant in patients with cystinosis. MATERIALS AND METHODS: Pediatric patients with cystinosis (n = 17) were compared with a matched control group without cystinosis (n = 126). The 2 groups were compared with regard to demographic data, posttransplant complications, and graft and patient outcomes. RESULTS: Most patients with cystinosis were male teenagers (52.9%) with comparable mean age (12.4 ± 4.1 vs 14 ± 3.1 years) versus the group without cystinosis. The 2 study groups were comparable with regard to type of dialysis, type of donor, blood group, and pretransplant comorbidities (P > .05). Patients with cystinosis received significantly more potent induction therapy (P < 0.05), but both groups were maintained on comparable immunosuppressive regimens (mostly tacrolimus based) (P > .05). Most grafts in both groups displayed immediate graft function. The percentage of patients with cystinosis with primary graft function was significantly higher than the percentage of those patients without cystinosis who had primary graft function (P = .024); this was associated with a relatively lower baseline creatinine level, although this was not significant (P > .05). Posttransplant complications, especially posttransplant diabetes, cytomegalovirus viremia, or BK nephropathy, were comparable (P > .05). Moreover, patient and graft survival rates were similar in the 2 groups (P > .05). CONCLUSIONS: Under standard immunosuppression, renal transplant and cysteamine therapy were safe with good long-term outcomes in patients with cystinosis. Studies that can include more patients and that have longer follow-up are needed to better understand the nature of this genetic disease and to discover the best treatment options.

Diabetes Mellitus and Its Risk Factors among Migrant Workers in Kuwait.

The prevalence of diabetes mellitus (DM) is growing enormously worldwide, and actions need to be taken in order to minimize the burden of diabetes mellitus and reduce its complications. Since two-thirds of Kuwait's population are expatriates, the prevalence of and factors associated with diabetes among migrant workers was assessed as it has a significant impact on migrant workers' quality of life, health, and productivity. The data used in this study was for all migrant workers who attended Shuaiba Industrial Medical Center (SIMC) for physical examination in the year 2018. Univariate and multivariate regression were used to assess the relationship between diabetes mellitus and the other independent factors where odds ratios with confidence intervals were delineated. Information for a total of 3477 participants was recorded in the dataset for 2018. Of the total participants, 10.1% had diabetes mellitus. About 49% of the participants were overweight. The largest age group of participants was between 31 and 40 years of age. A small percentage of the participants were diagnosed with hypertension at 11.8%. Additionally, 76.1% of the participants reported themselves as non-smokers. Diabetes was positively associated with age, hypertension, and nationalities. However, no association was found between BMI and smoking tobacco. This is the first study in SIMC to assess DM and its associated risk factor among migrants, since migrant workers are neglected subpopulations that need our focus and attention to achieve justice and fairness. The findings revealed that the prevalence of DM among our study population was considerably lower. However, a healthy lifestyle, including a healthy diet and being physically active, need to be introduced to prevent any further damage.

The Prevalence of Burnout and Its Associated Factors Among Surgical Specialists in Kuwait Ministry of Health Hospitals.

BACKGROUND: Workplace burnout is a state of emotional exhaustion (EE), depersonalization of others (DP), and low personal accomplishment (PA) owing to workplace stressors. This study aimed to assess the prevalence of burnout and its associated factors among surgical specialists in Kuwait. METHODS: This cross-sectional study assessed the prevalence of burnout among 489 surgeons in practice at Kuwait Ministry of Health (MOH). Data were collected using a self-administered questionnaire. Burnout was assessed using the Maslach Burnout Inventory, which defines burnout as having a high score of EE or DP, or a low score of PA; with severe burnout involving all. The associations between burnout or severe burnout with sociodemographic and occupational characteristics were assessed using multivariate binary logistic regression to adjust for potential confounders. RESULTS: Prevalence estimates for burnout and severe burnout were 76.9% (95% Confidence Interval = 72.9-80.7%) and 14.0% (11.0-17.5%), respectively. The prevalence estimates for high EE, high DP, and low PA scores were 44.7, 43.1, and 47.2%, respectively. The prevalence of burnout and severe burnout was highest among neurosurgeons. Burnout was lowest among otolaryngology surgeons and severe burnout was lowest among cardiothoracic surgeons. After adjustment, burnout was associated with younger age, lower income, and more on-calls per month. The four most common sources of stress included less family time, verbal assault, case overload, and highly complicated cases. CONCLUSION: The prevalence of burnout among surgeons in Kuwait MOH hospitals is high. Occupational health programs should use these findings to design and implement interventions that can treat and prevent burnout in this population.