Prevalence of childhood obesity in the state of Kuwait.

BACKGROUND: Overweight and obesity have reached an epidemic in Kuwait, with the highest rate of adult obesity in the region. National estimates of childhood obesity in Kuwait are scarce. The purpose of this study is to evaluate the prevalence of overweight and obesity among school children in Kuwait. METHODS: This is a cross-sectional study of a representative sample of 6-18 years old school children, randomly selected from 244 schools in Kuwait. Anthropometric data was measured from 6574 students in September 2012-June 2013. Overweight and obesity have been defined in accordance with the Centres for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF) and World Health Organization (WHO) 2007 criteria. RESULTS: The prevalence estimate overweight was based on the three different systems (CDC = 17.7%, IOTF = 23.3%, WHO = 21.6%). The prevalence of obesity was (CDC = 33.9%, IOTF = 28.2%, WHO = 30.5%). Boys had a higher percentage of obesity regardless of the classification system used. CONCLUSIONS: The prevalence of childhood obesity is alarmingly high in the State of Kuwait and exceeds the prevalence rates reported from neighbouring countries and from North America.

Prevalence of thyroid autoantibodies in children, adolescents and young adults with type 1 diabetes in Kuwait.

OBJECTIVE: To investigate the prevalence of thyroid autoimmunity among children and adolescents with type 1 diabetes in Kuwait. SUBJECTS AND METHODS: In a mixed cross-sectional and longitudinal study, anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) were measured in 232 subjects (118 males and 114 females) with type 1 diabetes. RESULTS: The mean age of the total study population was 10.9 ± 3.6 years (range 1-21), and the median diabetes duration was 3.9 years (range 0-16). At the initial screening, 57 out of 232 (24.6%) patients had positive antibodies, and of the remaining 175 patients, who were antibody negative,131 (74.3%) were followed up for 4-9 years. 23 out of these 131 (17.7%) patients became antibody positive, with a cumulative prevalence of elevated antibodies of 34.5%. Anti-TPO was present in 34 (14.7%), anti-TG in 23 (9.9%) and both antibodies in 23 (9.9%) patients. Thyroid antibodies presented early within the first 5 years of the onset of diabetes (63.2 vs. 36.8%, p < 0.05). The prevalence of elevated thyroid antibodies increased after the onset of puberty in both females and males (p < 0.0001). A total of 58.7% of the patients with positive antibodies were females compared to 41% males (p < 0.0001). The basal thyroid-stimulating hormone was higher in subjects with positive antibodies (5.1 ± 10.7 mIU/l) compared to those who were antibody negative (1.79 ± 0.87 mIU/l, p < 0.001). Furthermore, 30 out of 232 (12.9%) patients developed thyroid dysfunction. CONCLUSION: In this study, a high prevalence of thyroid autoimmune antibodies was found in patients either at the onset of type 1 diabetes or within the 4-9 years of follow-up.

Cardiovascular disease risk factors in the South Asian population living in Kuwait: a cross-sectional study.

BACKGROUND: High rates of diabetes and cardiovascular disease have been reported in South Asian immigrants in many countries. However, the prevalence and characteristics of cardiovascular disease risk factors among a South Asian population living in Kuwait have not yet been investigated. This study was therefore designed to estimate the prevalence of cardiovascular disease risk factors and determine whether they are independently associated with diabetes in such a population. METHODS: A population-based cross-sectional study was conducted on 1094 South Asians (781 men and 313 women), mainly Indian and Pakistani (≥ 18 years of age), of whom 75.1% were Indians. Interviews were carried out, during which socio-demographic and anthropometric data were collected, followed by a physical examination and collection of fasting blood samples for laboratory investigations. Diabetes was defined by fasting plasma glucose ≥ 7 mmol/l, or being on treatment, and/or self-reported previously diagnosed Type 2 diabetes. RESULTS: The prevalence of diabetes was 21.1%, with 3.4% of that percentage of people being newly diagnosed. Using BMI measurements, 24.0% of those who participated in the study were obese and 46.1% were overweight. Dyslipidaemia was found in 77.6% and hypertension in 44.8%. Advancing age (≥ 40 years), male gender, high LDL, high total cholesterol, hypertension and positive family history of diabetes were significantly associated with increased risk of diabetes. CONCLUSION: Our study shows that the prevalence of cardiovascular disease risk factors in South Asian expatriates in Kuwait exceeds prevalence rates reported in their homeland and other countries. This may suggest the added stress of environmental factors on the development of cardiovascular disease risk factors in such populations. Specialized prevention programmes targeting such high-risk ethnic populations are paramount and need to be implemented.

Diabetes and associated cardiovascular risk factors in the State of Kuwait: the first national survey.

BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of mortality worldwide as well as in Kuwait. People with diabetes have two to five times greater risk of developing CVD as compared with non-diabetic individuals. To date, little information exists on the prevalence and characteristics of cardiovascular risk factors in Kuwait. The objective of this survey was to address the growing burden of diabetes and related cardiovascular risk factors, and to estimate, for the first time, the prevalence of cardiovascular risk factors in the State of Kuwait. METHODS: The study was carried out using the World Health Organization (WHO) STEPwise approach for surveillance of non-communicable disease risk factors. This study represents a national survey for Kuwaiti nationals aged between 20 and 65 years. All participants were involved in an interview for gathering sociodemographic information, underwent focused physical examination and donated a blood sample for the study-specific laboratory investigations. RESULTS: A total of 1970 subjects, with a mean age of 48.9 ± 10.5, were screened. The prevalence of cardiovascular risk factors was as follows: diabetes 17.9%, dyslipidaemia 70.3%, hypertension 25.3% and obesity 48.2%. Over 62% had a sedentary lifestyle, and 17.8% were smokers. The prevalence of diabetes and dyslipidaemia increased with age and body mass index. Diabetes was also significantly associated with age above 40 years (OR = 10.5), family history of diabetes (OR = 2.79), hypertension (OR = 2.22), obesity (OR = 2.87) and lower literacy (OR = 4.23). CONCLUSIONS: This study found that advancing age (≥ 40 years), diabetes mellitus, obesity, positive family history of diabetes, hypertension and dyslipidaemia are significant risk factors for developing CVD in Kuwait as in other parts of the world. Understanding these factors allows for preventive measures to be taken for Kuwaiti population.

Which patients wait longer to be seen and when? A waiting time study in the emergency department.

We investigated the waiting time for patients before seeing a physician in the emergency department of a tertiary care hospital in Riyadh, Saudi Arabia. Bi- and multivariate analyses of routine data for 2187 patients determined the association between selected patient characteristics and waiting time. The median waiting time between triage and being seen by a physician was 35.0 min (range 1.0-325.0 min). Age, day of arrival, time of arrival and triage category were significantly associated with waiting time. Older patients and those arriving on Sundays and Wednesdays waited longer. Variability in waiting times could be addressed by more standardized triage policies, but may also be influenced by other clinical or non-clinical factors that required further investigation.

Which patients wait longer to be seen and when? A waiting time study in the emergency department

We investigated the waiting time for patients before seeing a physician in the emergency department of a tertiary care hospital in Riyadh, Saudi Arabia. Bi- and multivariate analyses of routine data for 2187 patients determined the association between selected patient characteristics and waiting time. The median waiting time between triage and being seen by a physician was 35.0 min [range 1.0-325.0 min]. Age, day of arrival, time of arrival and triage category were significantly associated with waiting time. Older patients and those arriving on Sundays and Wednesdays waited longer. Variability in waiting times could be addressed by more standardized triage policies, but may also be influenced by other clinical or non-clinical factors that require further investigation

Matched-related allogeneic stem cell transplantation in Saudi patients with Fanconi anemia: 10 year's experience.

Allogeneic SCT is curative for bone marrow failure in Fanconi anemia (FA) patients but the optimal conditioning regimen is undetermined. We report here our experience with 56 FA patients who underwent allogeneic matched related SCT. The conditioning regimen varied according to time of SCT and disease status at SCT; 22 patients (group A) received Cy 20 mg/kg, thoraco-abdominal radiation and antithymocyte globulins (ATG); and 34 patients (group B) received Cy 60 mg/kg and ATG. Median time to engraftment was similar (14 days) in both groups. Hemorrhagic cystitis was significantly more common in group B. Overall survival and event-free survival of all patients were 85 and 78.3% respectively. For groups A and B respectively, overall survival was 72.5 and 96.9% (P=0.013); and event-free survival was 72.5 and 82.3% (P=0.3). The use of the nonradiation Cy/ATG regimen in matched related SCT for FA patients offers better overall and event-free survival.

Cytogenetics, molecular and ultrastructural characteristics of biphenotypic acute leukemia identified by the EGIL scoring system.

Biphenotypic acute leukemia (BAL) is a rare, difficult to diagnose entity. Its identification is important for risk stratification in acute leukemia (AL). The scoring proposal of the European Group for the Classification of Acute Leukemia (EGIL) is useful for this purpose, but its performance against objective benchmarks is unclear. Using the EGIL system, we identified 23 (3.4%) BAL from among 676 newly diagnosed AL patients. Mixed, small and large blast cells predominated, with FAB M2 and L1 constituting the majority. All patients were positive for myeloid (M) markers and either B cell (B) (17 or 74%) or T cell (T) (8 or 34%) markers with two exceptional patients demonstrating trilineage phenotype. Six (50%) of studied M-B cases were positive for both IGH and TCR. In six (26%) patients myeloid lineage commitment was also demonstrable by electron cytochemistry. Abnormal findings were present in 19 (83%) patients by cytogenetics/FISH/molecular analysis as follows: t(9;22) (17%); MLL gene rearrangement (26%); deletion(6q) (13%); 12p11.2 (9%); numerical abnormalities (13%), and three (13%) new, previously unreported translocations t(X;6)(p22.3;q21); t(2;6)(q37;p21.3); and t(8;14)(p21;q32). In conclusion, the EGIL criteria for BAL appear robust when compared against molecular techniques that, if applied routinely, could aid in detecting BAL and help in risk stratification.