Al-Saeed O.,Kuwait University |
Brown M.,Amiri Hospital |
Athyal R.,Amiri Hospital |
Sheikh M.,Kuwait University
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013
Purpose: To determine the relationship between femoral notch morphology, femoral notch width index and anterior cruciate ligament tears using magnetic resonance imaging of the knee. Methods: This retrospective study was conducted on 560 patients who had magnetic resonance imaging (MRI) examinations of the knee between February 2010 and June 2011. Two morphological changes were investigated: the shape of the femoral notch and its width index. The femoral notch shape was classified into one of three types: Type A, which is a narrow (Stenotic) notch that appears narrowed from the base to the midsection as well as at the apex; Type U, in which the midsection does not taper, allowing for a wider contour to the notch than Type A; and Type W, which has the characteristics of Type U but with two apparent apices. The femoral notch width index was calculated as a ratio of central notch width and transcondylar or intercondylar width; values of 0. 270 or more were considered as normal and values of 0. 269 or less were considered as below normal. These measurements were correlated with the presence or absence of anterior cruciate ligament (ACL) tears. Results: Of 560 patients, there were 280 cases of ACL tear. Of the 560 patients, 240 had a Type A femoral notch shape and 320 had a Type U or W femoral notch shape. Of those with Type A, 73 % (176 patients) had ACL tears, and of those with Type U or W, 32 % (104 patients) had ACL tears. Statistical analysis showed that the Type A notch correlated with ACL injury (p value < 0. 0001). The femoral notch width index was low in 37 % (88 subjects) with Type A notch compared with 27. 5 % (88 subjects) with Type U or W notches. Of the 280 subjects with ACL tear, only 17 % (48 patients) had a reduced femoral notch index. Conclusion: This study showed that the Type A femoral notch appears to be a risk factor for ACL injury, whereas a reduced notch index has no significant correlation to ACL injury. Level of evidence: III. © 2012 Springer-Verlag.
Al-Temaimi R.,Kuwait University |
Alroughani R.,Amiri Hospital |
Alroughani R.,Dasman Diabetes Institute |
Jacob S.,Kuwait University |
Al-Mulla F.,Kuwait University
Journal of Neuroimmunology | Year: 2015
Background: Epstein-Barr virus (EBV) infection is implicated with multiple sclerosis (MS) risk, exacerbation, and progression. The HLA-DRB1*1501 haplotype is a strong MS risk factor consistently documented in MS populations. There are no studies of EBV infections and HLA-DRB1*1501 haplotype associating with MS from Kuwait where MS prevalence has increased significantly. Objectives: To determine the association of EBV infection with MS incidence, and to investigate HLA-DRB1*1501 as a potential genetic risk factor for MS in Kuwait. Methods: This is a case-control study involving 141 MS patients and 40 healthy controls. Antibody titers against EBV antigens' viral capsid antigen (VCA) and Epstein-Barr nuclear antigen 1 (EBNA1) were measured using enzyme-linked immunosorbent assays. HLA-DRB1*1501 haplotype assessment was done using rs3135005 TaqMan genotyping assay. Results: Antibody titers against EBV were significantly elevated in MS patients compared to healthy controls (anti-EBNA1, p = 0.008; anti-VCA, p = 0.028). MS males had higher antibody titers to EBNA1 than healthy male controls (p = 0.005) and female MS patients (p = 0.03). HLA-DRB1*1501 haplotype genotypes failed to generate a risk association with MS or EBV antibody titers (p = 0.6). Conclusion: An increased immune response to EBV infection is associated with MS incidence influenced by the type of antigen and sex. HLA-DRB1*1501 haplotype is not associated with MS risk in our Kuwaiti MS cohort. © 2015 Elsevier B.V.
Alazmi W.,Kuwait University |
Al-Sabah S.,Amiri Hospital |
Ali D.A.M.,Amiri Hospital |
Almazeedi S.,Amiri Hospital
Surgical Endoscopy and Other Interventional Techniques | Year: 2014
Background: Obesity today is a leading cause of global morbidity and mortality, and bariatric surgeries such as laparoscopic sleeve gastrectomy (LSG) are increasingly playing a key role in its management. Such operations, however, carry many difficult and sometimes fatal complications, including leaks. This study aims at evaluating the effectiveness of endoscopic stenting in treating gastric leaks post-LSG.Methods: A retrospective study was conducted to the patients who were admitted with post-LSG gastric leak at Al-Amiri Hospital Kuwait from October 2008 to December 2012 and were subsequently treated with stenting. The patients were stented endoscopically with self-expandable metal stent (SEMS), and a self-expandable plastic stent (SEPS) was used to facilitate stent removal.Results: A total of 17 patients with post-LSG leaks underwent endoscopic stenting. The median age was 34 years (range 19–56), 53 % of the patients were male, and mean body mass index (BMI) was 43 kg/m2. The median duration of SEMS placement per patient was 42 days (range 28–84). The SEPS-assisted retrieval process took a median duration of 11 days (range 14–35). Successful treatment of gastric leak was evident in 13 (76 %) patients, as evident by gastrografin swallow 1 week after stent removal. In addition, a shorter duration between the LSG and the time of stent placement was associated with a higher success rate of leak seal.Conclusions: The use of SEMS appears to be a safe and effective method in the treatment of post-LSG leaks, with a success rate of 76 %. The time frame of intervention after surgery is critical, as earlier stent placement is associated with favorable outcomes. Finally, SEPS is often required to facilitate SEMS removal, and further modification of stents and its delivery system may improve results. © 2014, Springer Science+Business Media New York.
Vali L.,Kuwait University |
Dashti K.,Kuwait University |
Opazo-Capurro A.F.,University of Concepción |
Dashti A.A.,Kuwait University |
And 2 more authors.
Frontiers in Microbiology | Year: 2015
Acinetobacter baumannii is one of the most important opportunistic pathogens that causes serious health care associated complications in critically ill patients. In the current study we report on the diversity of the clinical multi-drug resistant (MDR) A. baumannii in Kuwait by molecular characterization. One hundred A. baumannii were isolated from one of the largest governmental hospitals in Kuwait. Following the identification of the isolates by molecular methods, the amplified blaOXA-51-like gene product of one isolate (KO-12) recovered from blood showed the insertion of the ISAba19 at position 379 in blaOXA-78. Of the 33 MDR isolates, 28 (85%) contained blaOXA-23, 2 (6%) blaOXA-24 and 6 (18%) blaPER-1 gene. We did not detect blaOXA-58, blaVIM, blaIMP, blaGES, blaVEB, and blaNDM genes in any of the tested isolates. In three blaPER-1 positive isolates the genetic environment of blaPER-1 consisted of two copies of ISPa12 (tnpiA1) surrounding the blaPER-1 gene on a highly stable plasmid of ca. 140-kb. Multilocus-sequence typing (MLST) analysis of the 33 A. baumannii isolates identified 20 different STs, of which six (ST-607, ST-608, ST-609, ST-610, ST-611, and ST-612) were novel. Emerging STs such as ST15 (identified for the first time in the Middle East), ST78 and ST25 were also detected. The predominant clonal complex was CC2. Pulsed-field gel electrophoresis and MLST defined the MDR isolates as multi-clonal with diverse lineages. Our results lead us to believe that A. baumannii is diverse in clonal origins and/or is undergoing clonal expansion continuously while multiple lineages of MDR A. baumannii circulate in hospital ward simultaneously. © 2015 Vali, Dashti, Opazo-Capurro, Dashti, Al Obaid and Evans.
News Article | February 21, 2017
This Jan. 25, 2017 photo taken with a super wide-angle lens, shows the new 304 million dinar ($997 million) Jaber Hospital, about a 20-minute drive from downtown Kuwait City, Kuwait. In the coming months Kuwait’s first new government hospital in more than three decades will open its doors -- but to Kuwaiti citizens only. It’s the latest in a series of steps that some see as discrimination against the large numbers of non-native residents who build the high-rises, sweep the roads and clean toilets in the oil-rich emirate. Even elsewhere in the Persian Gulf -- a coveted destination for migrant workers -- there are growing voices who want the foreigners out. (AP Photo/Jaber Abdulkhaleg) KUWAIT CITY (AP) — Kuwait's first new government hospital in more than three decades will soon open its doors — but only to Kuwaiti citizens. It's the latest in a series of steps targeting foreigners, including laborers who build high-rise towers, sweep the roads and clean toilets in this tiny oil-rich emirate: a group that far outnumbers the native population. The 304 million dinar ($997 million) Jaber Hospital, about a 20-minute drive from downtown Kuwait City, is expected to open in the coming months. It will be the first government hospital built in Kuwait since 1984, taking some pressure off an overburdened public health system. U.S. ally Kuwait, like other oil-rich Persian Gulf states, has for decades offered a free cradle-to-grave health care for its citizens, along with plenty of generous perks such as subsidized utility prices and housing grants. But services have been fraying in recent years — despite the cushion of several hundred billion dollars that Kuwait has been building since the 1970s, mostly in a fund for future generations. That money, which stays out of the state budget, is meant to provide for Kuwaitis when the oil runs out. It carried Kuwait through the expenses of the seven-month Iraqi occupation and the 1991 U.S.-led Gulf War that liberated it. Expatriates with residency and work visas in Kuwait get subsidized health care. A foreign laborer — usually from another Arab country or an Asian migrant — would pay 1 Kuwaiti dinar ($3.2) to see a doctor at a public hospital. His employer would typically pay for him an annual health insurance to the government of 50 dinars, or about $160. Western expats who live and work in Kuwait tend to go to private hospitals as part of lucrative health care packages provided by their employers. Many see the new, citizens-only hospital as a step too far. "They were granted their workers' visa. They deserve to be treated with dignity," Dr. Yousef al-Muhanna, a 34-year old general surgeon, said of the migrant workers. The discrimination goes against the Hippocratic Oath, he says. "We are not supposed to look at their passports - we are supposed to deal with their medical conditions." The shift started sometime last year, when hospitals and clinics in Jahra, west of the capital, and the Amiri Hospital in Kuwait City began barring expatriates from morning visits for non-emergency services. Recently, lawmaker Safaa al-Hashem told the media in Kuwait's parliament that "expats are crowding our hospitals and competing with us for the air we breathe in hospital waiting rooms." She complained that many foreigners bring families on visitor visas to enjoy Kuwait's health care benefits, including deliveries, gastric bypass surgeries, cancer treatment, and other procedures. "Isn't time for us to put an end to this? We must reform the current system; we must impose taxes on expatriates, not on Kuwaitis," she said. It's not just the health care. Kuwait's government and politicians have grown more wary of foreigners in other sectors as well in recent years, adopting or promoting a series of policies that target the roughly 3 million expats living and working here. Legislation last April increased the price of electricity and water in all residential buildings, but exempted Kuwaiti nationals. Social media posts and tweets by Kuwaitis and even statements from officials blaming expats for everything — from traffic congestion to the raiding of open buffets by wedding crashers — are becoming all too common. Earlier this month, when Egypt beat Burkina Faso in the first semifinals match of the soccer African Cup of Nations, Kuwait's ministry of interior warned Egyptian expats — one of the largest Arab communities here — against celebrating their team's win with car parades. The traditional parades are a raucous event, with soccer fans driving around honking their cars, music blasting and flags waving from car windows. The ministry said it would immediately deport anyone who takes part in "illegal parades" — so the Egyptians kept their partying off the streets. "As an Arab expat, when you go to the West, they call you a terrorist or refugee," said Egyptian architect Waleed Shalaan, who has been living in Kuwait since 1999 and considers it his home. "You go to the Gulf states, they call you a leech or a parasite." Recent law changes require foreigners to have a minimum monthly salary of 400 Kuwaiti dinars ($1,309), and spend two years in Kuwait before applying for a local driving license — with the exception of some professions such as doctors, journalists, university professors, and engineers. Housewives and students may not drive, and anyone caught driving without a license can be deported. Only tourists and others on a visitor's visa can drive with an international license. After al-Hashem's "air we breathe" comment, fellow lawmaker Abdulkareem al-Kandari called for a special session of parliament to discuss what he called the "alarming increase in the number of expats versus Kuwaiti nationals." "We refuse to be a minority in our own country," he said — though Kuwaiti nationals already are, with foreigners making up about 70 percent of the population of 4.2 million. Several lawmakers demanded the government deport 100,000 expats annually to balance the country's demographics. Without offering details, Hind al-Sabeeh, the minister of social affairs, promised a plan to "balance the demographics of the country over the next five years, without disrupting the balance of work." Hind Francis, an analyst at the Rai Institute think tank, said xenophobic sentiments have been on the rise in Kuwait as a way to deflect blame from the authorities. "Many big problems that concern the public are blamed on the expatriates: congested roads, overcrowded hospitals, many areas in which public policy has failed," she said. Sarah al-Qabandi, a 35-year old corporate social responsibility manager in the private Ooredoo Telecom says that blaming Kuwait's problems on the expats is a shame. "We expect people abroad to treat us like royalty ... we want to be treated well, and yet we don't welcome anyone in our own country," she said.
Alroughani R.,Amiri Hospital |
Alroughani R.,Dasman Diabetes Institute
Multiple Sclerosis Journal | Year: 2014
Amenorrhea has not been reported as an adverse event in fingolimod phase III clinical trials in patients with multiple sclerosis (MS) with either 0.5 mg or 1.25 mg dosages. Here we report three cases of young women with MS who developed amenorrhea within 6 months of initiation of fingolimod. They experienced irregularities in their menstrual cycles in the first 3 months, which progressed to amenorrhea by 5th or 6th month. Gynecology evaluations showed no other etiologies. Menses returned to baseline after discontinuation of fingolimod for 2-3 months. Amenorrhea could be associated with fingolimod in the first year. Future surveillance is advised to determine the incidence rate of this adverse event. © The Author(s) 2014.
Almazeedi S.,Amiri Hospital |
Al-Sabah S.,Amiri Hospital |
Alshammari D.,Farwaniya Hospital |
Alqinai S.,Amiri Hospital |
And 4 more authors.
Obesity Surgery | Year: 2014
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. © Springer Science+Business Media New York 2013.
Almazeedi S.,Amiri Hospital |
Al-Sabah S.,Amiri Hospital |
Al-Mulla A.,Amiri Hospital |
Al-Murad A.,Amiri Hospital |
And 4 more authors.
Obesity Surgery | Year: 2013
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. © 2012 Springer Science+Business Media New York.
Al-Jafar H.A.,Amiri Hospital
BMJ case reports | Year: 2013
Lenalidomide is an immunomodulatory agent that was approved for the treatment of a monoclonal bone marrow disorders, myelodysplastic syndrome del(5q)(MDS del(5q)), in 2005; the drug was subsequently also approved for the treatment of refractory multiple myeloma, a bone marrow malignancy of the B-lymphocyte lineage. The purpose of this study is to report a case of MDS del(5q) in a female patient, which was most likely secondary to the immunosuppressive drugs that the patient was taking for scleritis. After lenalidomide treatment, the patient's haematological symptoms rapidly resolved and she became transfusion independent, with normal haemoglobin levels. This medication also helped control her dependence on high doses of oral prednisolone. The patient continued to receive treatment with low-dose lenalidomide, and her scleritis has been in long-term remission for 3 years. A larger prospective study can further define the role of lenalidomide in the management of scleritis.
Al-Sabah S.K.,Amiri Hospital |
Almazeedi S.M.,Amiri Hospital |
Dashti S.A.,Amiri Hospital |
Al-Mulla A.Y.,Amiri Hospital |
And 2 more authors.
Obesity Surgery | Year: 2015
Background: Laparoscopic sleeve gastrectomy (SG) is becoming a popular and preferred primary bariatric intervention; however, its applicability in the adolescent age group remains controversial. The aim of this study is to evaluate the efficacy of SG in treating obesity and its co-morbidities among adolescents. Methods: A retrospective study was conducted of patients aged 12–21 who underwent SG from 2008 to 2012 at Amiri Hospital, Kuwait. The major outcome measures were percent excess weight loss (%EWL) over a 2-year follow-up period, resolution of co-morbidities, and occurrence of complications. Results: A total of 135 adolescent patients underwent the procedure, of which, 97 (71.9 %) were females. The patients had a median age of 19 years (range 12–21), mean body mass index of 48.5 kg/m2, and mean follow-up period of 20 ± 11.4 months. The %EWL at 2 years for males and females was 84 and 77 %, respectively. All of the patients with type 2 diabetes mellitus and 75 % of those with hypertension showed complete resolution of the disease at 2 years. Conclusion: SG seems to be an effective and safe bariatric procedure in obese adolescents, as it can significantly decrease excess body weight and reduce co-morbidities in a relatively short period of time. © 2014, Springer Science+Business Media New York.