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Two new janiroid isopod species, Heterosignum behbehanii sp. nov. and Uromunna alyamanii sp. nov., are described from the Kuwaiti waters, representing the first record of the genera in the western Indian Ocean. Heterosignum behbehanii sp. nov. is distinguished from its congeners by pereonites 2–7 with a pair of short single lateral spine-like processes; the relatively short length of the anterior part of its pleotelson, which accounts for about 0.1 of the total length of the pleotelson; and the stylet with an elongate, downwardly curved, and distally pointed apex. Uromunna alyamanii sp. nov. is equally unique, with the pleotelson bearing two denticles on each lateral margin, pleopod 2 endopod stylet extending beyond the apex of the protopod, and pleopod 4 exopod distal tip with a long plumose seta. This discovery of unique characteristics of the new species significantly enhances our understanding of marine biodiversity in the western Indian Ocean and underscores the importance of further research in this area. The identification keys are provided to all known species of Heterosignum and Indian Ocean Uromunna species.

Background: Renal replacement therapy (RRT) is advised in end-stage renal disease, the last stage of chronic kidney disease (CKD). RRT includes maintenance hemodialysis (MHD)/peritoneal dialysis/renal transplant. The requirement for MHD is annually escalating in India. It is important to note that over 80% of patients receiving MHD have at least one cardiac disease at the time of dialysis initiation, such as ischemic heart disease, congestive cardiac failure, and arrhythmias. Aims and Objectives: The present study aimed to study high-sensitivity cardiac troponin I (hs-cTnI) serum level as a marker of cardiovascular injury in patients receiving MHD. It was an attempt to envisage a correlation between serum hs-cTnI and hemodialysis (HD) vintage (duration since initiation of dialysis till date). Materials and Methods: We enrolled 40 patients. Group 1 included those who had received MHD for ≤24 months, and Group 2 included those who had received MHD for more than 24 months. Results: We found no significant difference between the two groups’ clinical characteristics and demographic features. The pre-and post-HD serum hs-cTnI values of all patients were recorded. The serum hs-cTnI levels were found to be elevated in 34 out of 40 patients’ post-dialysis, and the result was statistically significant (P=0.0001). Conclusion: The present study has encouraging results, with values of hs-cTnI raised in post-dialysis samples; however, the levels did not correlate with HD vintage. Further studies with larger sample sizes and longer follow-ups would provide more detailed information on hs-cTnI’s role as a marker for HD-induced cardiac damage.

Summary: Background: Individuals with type 1 diabetes (T1D) are traditionally perceived as lean, but recent evidence suggests an increasing trend of obesity. To provide global estimates, this study explored the prevalence of obesity among adults with and without T1D across three distinct global regions. Methods: An observational, cross-sectional study was performed utilizing data from T1D registries and national health surveys to assess the prevalence of obesity (BMI ≥ 30 kg/m2) and the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) across Belgium, Kuwait, and Mexico. Demographic and clinical characteristics of adults with and without T1D were assessed. Prevalence estimates were calculated through a binomial generalized linear mixed-effects model adjusting for age, sex, HbA1c, and survey year. As a sensitivity analysis, propensity score matching was performed for confounder adjustment of age and sex. Findings: The study encompassed 3594 individuals with T1D (from 2003 to 2022) and 9898 without T1D (from 2014 to 2021). After model adjustment for confounders (age, sex, HbA1c% and data-collection year), individual obesity prevalence was lower in individuals with T1D in Kuwait and Mexico than among those without type 1 diabetes (Kuwait: 22% (CI: 18–26%) vs. 44% (CI: 41–48%); Mexico: 5% (CI: 3–7%) vs. 40% (CI: 38–42%)). In contrast, individuals with T1D in Belgium showed a more comparable proportions to those without T1D (12% (CI: 9–16%) vs. 16% (CI:11–22%)). Interpretation: Our data reveal that obesity is prevalent among people with T1D. These findings underscore the need for targeted strategies in T1D care that address the growing concern of obesity. Funding: This manuscript is part of the Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy (SOPHIA) project (www.imisophia.eu). SOPHIA has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No. 875534. This Joint Undertaking support from the European Union’s Horizon 2020 research and innovation program and EFPIA and type 1 diabetes Exchange, Breakthrough T1D, and Obesity Action Coalition.

This study aimed to identify the attitudes of public school teachers in the State of Kuwait at various educational stages towards the experience of distance education during the COVID-19 pandemic. The descriptive approach was applied; a questionnaire consisting of four dimensions was developed to measure teachers' attitudes towards distance education. The study sample consisted of 1028 teachers of various disciplines at all levels of education in public schools in the State of Kuwait. The results indicated that teachers had a higher degree of positive attitudes towards the distance education experience. The results also showed that there were statistically significant differences between the study sample members due to each of the following variables: the educational district and the educational stage. The results did not show statistically significant differences due to the gender variable. Additionally, the results did not show the existence of statistically significant differences due to the variable years of experience on the total degree and dimensions of scale, except for the dimension "student assessment through distance learning using the TEAMS Program" attributed to the experience category (1-5 years).

Abstract Background Associations between psoriasis and allergic diseases (asthma, rhinitis, and eczema) in children have been reported in a limited number of studies, and the association between psoriasis and multimorbidity (co-occurrence) of allergic diseases remains unclear. Hence, this study aimed to assess the association between psoriasis and the co-occurrence of asthma, rhinitis, and eczema in adolescents. Methods This school-based cross-sectional study enrolled adolescents (n = 3,864) aged 11–14 years. Parents completed a questionnaire on doctor-diagnosed psoriasis as well as symptoms and clinical history of asthma, rhinitis, and eczema. Eight nonoverlapping groups comprising single and co-occurring current (past 12 months) asthma, rhinitis, and eczema were identified. A multinomial logistic regression model was used to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results In the analytical sample (n = 3,710; 1,641 male and 2,069 female participants), 3.5% reported doctor-diagnosed psoriasis, and 15.7%, 15.0%, and 10.3% had current asthma, rhinitis, and eczema symptoms, respectively. Doctor-diagnosed psoriasis was associated with “asthma only” (aOR = 2.11, 95% CI: 1.15–3.89), “eczema only” (6.65, 4.11–10.74), “asthma + eczema” (5.25, 2.36–11.65), “rhinitis + eczema” (3.60, 1.07–12.15), and “asthma + rhinitis + eczema” (7.38, 2.93–18.58). Doctor-diagnosed psoriasis was not statistically significantly associated with “rhinitis only” (1.42, 0.71-–2.84) and “asthma + rhinitis” (1.78, 0.69–4.56). Conclusion Our findings indicate that psoriasis is associated with the co-occurrence of allergic diseases among adolescents. However, further studies are required to investigate which biological mechanisms may be shared between psoriasis and allergic diseases.

The agricultural practices carried out by the people of Aunupe Village have been going on for several generations, but the agricultural system used is not optimal because they still use a conventional farming system, namely monoculture. Apart from that, the agricultural input used is chemical fertilizer which of course does not meet the organic aspect and is not sustainable, because high chemical input and long use can damage the texture and nutrients of the soil. For this reason, community empowerment through training in the application of organic farming techniques in the form of agrosilvo conservation in an agroforestry pattern needs to be encouraged so that local communities who use land in forest areas not only obtain agricultural products but can also benefit from environmental and economic services so that they can be sustainable. Thus, the appropriate alternative that can be implemented is to utilize a non-timber farming system combined with maintaining wood trees, known as an agroforestry system, namely agrosilvo conservation. This service aims to provide knowledge and examples to the farming community regarding how to cultivate agriculture using a combination of non-timber plants and woody plants, namely with the conservation agrosilvo system. The method used is descriptive qualitative. The results of the PKMI program activities are the socialization of agro-silvoconservation activities and increased knowledge and capacity of the community in carrying out farming using the agrosilvo-conservation method.

The aim of this case series is to show the management of complex cases by combining different surgical procedures from different dental specialties. Addressing complex cases with an interdisciplinary approach provides the best treatment outcome. This approach helps in reducing the cost, time, and postoperative sequelae. The presented three clinical cases showed a combination of surgical procedures such as aesthetic crown lengthening, lateral ridge augmentation, apical surgery, and implant placement. They also showed that using bone grafting during the apical surgery improved the healing.

BackgroundRheumatoid arthritis (RA) is a common condition treated with biological disease-modifying anti-rheumatic medicines (bDMARDs). However, many patients exhibit resistance, necessitating the use of machine learning models to predict remissions in patients treated with bDMARDs, thereby reducing healthcare costs and minimizing negative effects.ObjectiveThe study aims to develop machine learning models using data from the Kuwait Registry for Rheumatic Diseases (KRRD) to identify clinical characteristics predictive of remission in RA patients treated with biologics.MethodsThe study collected follow-up data from 1,968 patients treated with bDMARDs from four public hospitals in Kuwait from 2013 to 2022. Machine learning techniques like lasso, ridge, support vector machine, random forest, XGBoost, and Shapley additive explanation were used to predict remission at a 1-year follow-up.ResultsThe study used the Shapley plot in explainable Artificial Intelligence (XAI) to analyze the effects of predictors on remission prognosis across different types of bDMARDs. Top clinical features were identified for patients treated with bDMARDs, each associated with specific mean SHAP values. The findings highlight the importance of clinical assessments and specific treatments in shaping treatment outcomes.ConclusionThe proposed machine learning model system effectively identifies clinical features predicting remission in bDMARDs, potentially improving treatment efficacy in rheumatoid arthritis patients.

IntroductionThis study investigates the digital citizenship behavior (DCB) and behavioral intention (BI) of faculty members at the Public Authority for Applied Education and Training (PAAET) colleges in Kuwait. The research aims to evaluate the effectiveness of technology in teaching and provide a case study of higher educational institutions in Kuwait. The study’s theoretical framework focuses on four key factors: performance expectancy (PE), effort expectancy (EE), social influence (SI), and facilitating conditions (FC), examining their impact on faculty readiness (RED) through the mediation of both BI and DCB. A total of 28 hypotheses were tested, exploring direct and indirect relationships among these variables.MethodsA survey was conducted among 122 faculty members from PAAET colleges in Kuwait. The questionnaire measured the participants’ perceptions of PE, EE, SI, and FC, along with their BI and DCB. The study employed statistical methods to analyze the data and test the 28 hypotheses, aiming to identify significant paths of relationships that contribute to faculty readiness for technology use in education.ResultsThe findings confirmed eight significant paths of relationships, highlighting the importance of inputs such as effort and social influence and their impact on performance as an output in determining faculty readiness. However, the study raised empirical doubts about the remaining 20 hypotheses, providing new evidence that challenges the currently established relationships between technology acceptance and digital citizenship.DiscussionThe study offers valuable insights into the factors influencing the effective use of technology in higher education institutions in Kuwait. It suggests that while some pathways, such as effort and social influence, significantly contribute to faculty readiness, other expected relationships may not hold as previously thought. This new evidence calls for a reevaluation of the existing models of technology acceptance and digital citizenship. The results have important implications for policy and practice, offering guidance on enhancing technology use among faculty members in educational settings. The study contributes to the broader discussion on digital transformation in education, providing a comprehensive understanding of the key factors that affect faculty readiness for adopting new technologies.

Abstract Background The guidelines of the American Diabetes Association and European Association for the Study of Diabetes suggest that patients with obesity type 2 diabetics and chronic kidney disease need either glucagon-like peptide 1 receptor analogues or sodium-glucose cotransporter-2 inhibitors. If neither achieve metabolic control, then the recommendation is to combine both drugs. The evidence base for combining glucagon-like peptide 1 receptor analogues and sodium-glucose cotransporter-2 inhibitors is not well researched, and hence, the impact of the guidelines is limited. The aim of this randomized controlled trial is to test the impact of the combination of glucagon-like peptide 1 receptor analogues/sodium-glucose cotransporter-2 inhibitors on body weight and kidney damage, in patients with type 1 diabetes and chronic kidney disease. In addition, we will explore the associated changes in the metabolic pathways with each of the treatments used in this randomized controlled trial. Methods In this 6-month randomized control trial, 60 participants aged between 21 and 65 years, with a body mass index above 25 kg/m2, and type 1 diabetics with chronic kidney disease will be randomized to receive 1 of 5 possible treatments: (1) standard care (control), (2) glucagon-like peptide 1 receptor analogues alone, (3) sodium-glucose cotransporter-2 inhibitors alone, (4) combination of glucagon-like peptide 1 receptor analogues and sodium-glucose cotransporter-2 inhibitors and (5) combination of glucagonlike peptide 1 receptor analogues and sodium-glucose cotransporter-2 inhibitors with intensive lifestyle advice. The primary objective will be the percentage change in total body weight from baseline at 6 months. The secondary objectives are to compare the change in glycaemia; blood pressure; dyslipidaemia; albuminuria; proportion of participants reaching weight loss of ≥ 5%, ≥ 10% and ≥ 15%; and change in BMI (kg/m2) from baseline and change in waist circumference (cm). All the experiments will be conducted at the Dasman Diabetes Institute after approval from the local research and ethics committee. Discussion The present randomized controlled trial aims to investigate the impact of the combination of glucagon-like peptide 1 receptor analogues and sodium-glucose cotransporter-2 inhibitors on body weight and kidney damage in patients with type 1 diabetes mellitus and chronic kidney disease, as well as exploring the associated changes in the metabolic pathways with each of the treatments used. This study addresses the current gap in the evidence base regarding the combination of these two drugs, which is particularly relevant given the American Diabetes Association and European Association for the Study of Diabetes guidelines recommending their combined use for patients with obesity, type 2 diabetes, and chronic kidney disease who do not achieve metabolic control with either drug alone. Trial registration ClinicalTrials.gov Identifier: NCT05390307 Trial registration date - 25th May 2022

The study aimed to identify the theoretical and intellectual foundations of digital leadership in distance learning, as well as to identify the reality of digital leadership in the distance learning experience of school principals in the primary stage in the State of Kuwait by applying a questionnaire to find out the teachers’ point of view. The researcher used the descriptive analytical approach in analyzing the study. A questionnaire consisting of four axes, namely the Digital Leadership, the Digital Learning Culture, the Digital Leadership Professional Practice and the Digital Learning Development, has been applied to a sample of male and female teachers, in the primary stage in the Ministry of Education in the State of Kuwait, of (179) male and female teachers. Through the application of the study tool, the statistical differences of study variables (sex, scientific qualification, years of experience, specialization and school district) have been identified. The results of the study showed that the reality of digital leadership in the distance learning experience came to a high level, with the strong consent of the sample members, with an average of (3.79), and the (e-learning culture) axis ranked first with an average of (3.88), then the sample members agreed on the (digital leadership and vision) with an average of (3.82), while the (professional practices of digital leadership) ranked with an average of (3.75), and in the last place came the (digital learning development) axis with an average of (3.72). The results of the study showed statistically significant differences in the sex variable in favour of females in the four axes of the study.

AbstractThis paper introduces a new modification to an iterative method for solving Cauchy problems (IVPs) based on an inverse polynomial technique. The proposed method is proven to be consistent, stable, and convergent. We also demonstrate the consistency property of the One-stage scheme and the Two-stage scheme, as well as the stability property of the proposed method. To validate the accuracy of our approach, we conduct several numerical experiments and present the results graphically. Our findings show that the proposed method outperforms existing approaches in terms of accuracy and efficiency. Additionally, we discuss the implications of our results for future research in this field. Overall, this paper provides a valuable contribution to the numerical solution of IVPs and lays the groundwork for further exploration in this area.

Dalal Alkhudir,1 Adeeba Al-Herz,1 Khulood Saleh,2 Adel Alawadhi,1,3 Waleed Al-Kandari,2 Eman Hasan,1 Khaled Mokaddem,1 Aqeel Ghanem,4 Youssef Attia Bartella,1 Mohammed Hussain,1 Naser AlHadhood,2 Yaser Ali,4 Ebrahim Nahar,4 Ahmad Alenizi,5 Ali Aldei,1 Fatemah Abutiban,5 Sawsan Hayat,4 Hussain Behbehani,2 Fatemah Baron,5 Hebah Alhajeri,4 Amjad Alkadi,6 Ahmed Alsaber7 1Department of Rheumatology, Amiri Hospital, Kuwait city, Kuwait; 2Department of Rheumatology, Farwania Hospital, Farwaniya, Kuwait; 3Department of Rheumatology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait; 4Department of Rheumatology, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait; 5Department of Rheumatology, Jahra Hospital, Jahra, Kuwait; 6Department of Rheumatology, Sabah Hospital, Sabah, Kuwait; 7College of Business and Economics, The American University of Kuwait, Salmiya, KuwaitCorrespondence: Dalal Alkhudir, Amiri Hospital, Ministry of Health, Kuwait, Email drdalalkh@gmail.comBackground: An association between serum uric acid (UA) and disease activity in rheumatoid arthritis (RA) patients has not been well studied. We describe RA patients with high and normal UA and study its association with RA activity.Methods: Adult RA patients from the Kuwait Registry for Rheumatic Diseases (KRRD) were studied from February 2012 through March 2022. Patients with documented UA levels were included. UA of > 357 μmol/L (6mg/dL) was considered high. Statistical comparison and correlation were made using multivariate logistic regression.Results: Overall, 1054 patients with documented UA. A total of 158 patients (15%) had high UA level with a mean of 409± 44.4μmol/L. The mean age for the high UA group and low UA group were 59.3 ± 10.7 years and 54.5 ± 12.4 years, respectively (p< 0.001). 49.4% were female in high UA group, and 62.2% were female in low UA group, respectively (p< 0.05). Logistic analysis showed an inverse relation between DAS28 and UA, as lower DAS28 score was associated with higher UA level (p=0.032) OR 1.39. There was a direct relation with HAQ, creatinine and UA. A higher HAQ is associated with a higher UA level (p=0.019) OR 0.78. High creatinine level is also associated with high UA level (p< 0.001) OR 0.24. The use of antirheumatic drugs was similar among patients with high and normal UA.Conclusion: RA patients with a higher UA had a lower disease activity despite using similar antirheumatic drugs. The reasons behind this association need to be further studied.Keywords: rheumatoid arthritis, uric acid, disease activity, DAS28, registry, KRRD, Kuwait, Middle East

Building a learning environment for students to meet educational objectives is a major challenge facing education stakeholders, particularly teachers. This study aimed to design and implement an e-task-based approach (eTBA) and examine its impact on 21st-century learning outcomes (21st-CLOCs)--namely, critical thinking and problem solving, collaboration across networks, agility and adaptability, effective communication, initiative and entrepreneurialism, accessing and analyzing information, and curiosity and optimism--in a kindergarten sample (N = 22). A mixed-methods approach was adopted. Observation forms and rubrics were designed and used to collect evidence on 21st-CLOCs, and a repeated-measures analysis of variance was used to measure patterns of progress during a 24-week experiment. Over the course of 12 experience task activities, the 21st-CLOCs developed significantly. Children's overall learning outcomes improved as a result of the e-task-based approach applied in this study. Experiencing three task activities was enough for children to cope with the outcomes, with respect to children's individual variations. Further research is required to apply the e-task based approach to different contexts and grade levels.

The aim of this study to examine the interaction between parents and children in Kuwait. It examines gender, home types, number of wives, and child age order differences in father and mother dialogue scales. The study also examines the association between the father and mother dialogue scale with some social variables. A sample of 725 Kuwaiti aged 17-19 years was selected. Respondents' GPA, some household information, father's and mother's Educational levels were collected were used. Father/Mother Dialogue Scale. Significant differences were found between males and females, types of home, have only one wife and those who have more than one wife, the son/daughter order among siblings in the family, the fathers and mothers' age in both father and mother dialogue scales. Relationship was found between father and mother dialogue and many sociocultural variables. The dialogue between children and their parents is considered to be weak, especially in regard to the father's side.

The World Health Organization (WHO) announced on March 11, 2020, that COVID-19 could be considered a pandemic. This epidemic has become a huge issue for academics, doctors, healthcare providers, epidemiologists, and decision-makers alike. Motivated by studying natural phenomena, we concentrated on making a statistical model capable of fitting natural pandemics into the whole world. In this manuscript, we introduced a new novel distribution called the Inverse Power Haq (IPH) distribution. We created this distribution due to its formidable merits. We introduced its statistical properties and plotted its probability density function (PDF), cumulative distribution function (CDF), and hazard rate function (HRF). We utilized classical estimation techniques to determine the parameters for the suggested distribution. In the paper's conclusion, we performed a data analysis, applying the distribution to COVID-19 infection in Kuwait for practical purposes. Our analysis demonstrated the superior performance of the proposed distribution compared to its competitors, establishing it as the most suitable choice for modeling COVID-19 data in patients of different ages. Lastly, the conclusion section includes a summary of our overall findings and conclusions.

Krukenberg tumours are a rare form of metastatic tumours of the ovary. They primary site is usually the gastro-intestinal system with the most common being gastric cancer. We present the case of a 35-year-old female coming in with a large pelvi-abdominal mass for investigation. This pelvic mass showed mild to moderate metabolic activity. 18F-FDG PET-CT was able to identify the primary gastric carcinoma. Subsequent histopathology confirmed this to be gastric adenocarcinoma with metastases to the ovary. Keywords: 18F-FDG PET-CT, metastatic gastric carcinoma, Krukenburg tumour.

The prevalence of bacterial persisters is related to their phenotypic diversity and is responsible for the relapse of chronic infections. Tolerance to antibiotic therapy is the hallmark of bacterial persistence. In this study, we have screened a transposon library of Mycobacterium smegmatis mc2155 strain using antibiotic tolerance, survival in mouse macrophages, and biofilm-forming ability of the mutants. Out of 10 thousand clones screened, we selected ten mutants defective in all the three phenotypes. Six mutants showed significantly lower persister abundance under different stress conditions. Insertions in three genes belonging to the pathways of oxidative phosphorylation msmeg_3233 (cydA), biotin metabolism msmeg_3194 (bioB), and oxidative metabolism msmeg_0719, a flavoprotein monooxygenase, significantly reduced the number of live cells, suggesting their role in pathways promoting long-term survival. Another group that displayed a moderate reduction in CFU included a glycosyltransferase, msmeg_0392, a hydrogenase subunit, msmeg_2263 (hybC), and a DNA binding protein, msmeg_2211. The study has revealed potential candidates likely to facilitate the long-term survival of M. smegmatis. The findings offer new targets to develop antibiotics against persisters. Further, investigating the corresponding genes in M. tuberculosis may provide valuable leads in improving the treatment of chronic and persistent tuberculosis infections.

The objectives of this study are to investigate brand identification, brand symbolism, and brand evangelism, examining their interplay among the consumers of two frozen yogurt brands in Kuwait (PICK and Pinkberry) [...]

Adopting the Tools of Liberalism and Clash of Civilizations theories of international relations, and the vertical-horizontal media typology, this study examines the perceptions of 25,800 Arabs as expressed in a survey exploring their perceptions of violence against the United States, American citizens as “good,” President Donald Trump’s foreign policy in the Middle East, increasing economic relations with the United States, welcoming American foreign aid, and finally favoring diplomatic relationships with Israel. This study also looks at religiosity, the effectiveness of U.S. foreign aid, and the media sources influencing those perceptions. The findings suggest that religious activities and duties relating to Allah positively influence those perceptions while religion as ideology and politics negatively influence them. If the U.S. intentions in providing aid to Arabs are perceived to be benevolent and charitable, civic organizations and ordinary people are beneficiaries of aid, the United States is more likely to be seen in a positive light than if aid is perceived to benefit Arab governments. Of vertical media, newspapers have the strongest effects while TV and radio have little or none. Horizontal media have a mid-range effects. The study discusses the results in relation to implications for policy makers.

Introduction: Pain is the most frequent complaint following laparoscopic cholecystectomy and the main reason for staying overnight at hospital. The retrieval of gall bladder (GB), an important terminal event of laparoscopic cholecystectomy, has been reported as one of the factors affecting postoperative port-site pain due to tissue trauma at port site. This extraction of GB is usually done either from the epigastric or umbilical port as per the surgeon's preference. We tried to compare the postoperative pain and ease of retrieval among epigastric and umbilical port retrieval. Materials and Methods: It was a randomized controlled trial at a tertiary care hospital over 2 years. A total of 70 participants were finally analyzed in the study. The participants were divided into 2 groups based on the port of retrieval. The postoperative pain and ease of retrieval were analyzed among the groups. Results: Mean postoperative port-site pain and ease of retrieval were significantly better with retrieval through umbilical port as compared with the epigastric port with P values of. 0013 and. 0023, respectively. However, time taken for retrieval was significantly less when done through epigastric port. Conclusion: This study thus recommends umbilical port to be used for retrieval of GB due to significantly lesser port-site pain and better ease of retrieval.

Background: Chronic kidney disease (CKD) is a global health problem, with a worldwide prevalence of around 9.1 per cent (as of 2017). In India, its prevalence was found to be around 17.2%. There are several risk factors of CKD, out of which the presence of underlying longstanding uncontrolled diabetes mellitus (DM) and hypertension are common. Certain previous studies have tried to assess the level of knowledge, attitudes and practices of such a 'high risk' group for developing CKD but there is a paucity of literature on it. Hence, this study was undertaken to assess these domains in individuals at risk for developing CKD. Patients and Methods: It is an observational cross-sectional study conducted from October 2020 to December 2021 at a tertiary care teaching and referral hospital in India. A total of 215 patients who were at risk of developing CKD, were enrolled and were given a CKD Screening Index questionnaire to fill and scoring was done for all three components-knowledge, attitudes and practices. Results: The mean age was found to be 49.21 ± 13.49 years with a male: female ratio of 1.4:1. Nearly three-a fourth of the patients were having DM while one-fourth of the participants had a previous history of hypertension. The mean scores on the knowledge, attitude and practices scales were found to be 11.80 ± 5.31, 50.18 ± 8.23 and 30.83 ± 7.53 respectively. The study results revealed that the majority of patients had 'low' levels of knowledge scores but 'average' levels of attitude and practice scores. A significant correlation was found amongst knowledge and attitude scores (r = 0.226, P = 0.001), knowledge and practice scores (r = 0.153, P = 0.025) and practice and attitude scores (r = 0.295, P = 0.000) of our patients. Conclusion: There is a need of improving awareness at least amongst the population at risk of getting CKD. Improving knowledge would help in inculcating positive attitudes and healthier practices amongst these, thus delaying the onset of this disease.

Here we provide a Code-compliant description of Ostrea oleomargarita Oliver, Salvi, and Al-Kandari, sp. nov as reported in Salvi et al. (2022) and complemented with the ZooBank registration numbers of the publication and of the new species name. Results of phylogenetic, species delimitation, and morphological analyses on which the systematic assessment of this new species is based can be found in Salvi et al. (2022).

Background: Lockdown was a unique experience that affected many aspects of life, particularly during the challenge of Ramadan fasting (RF). Studying this can increase understanding of the effects of lifestyle changes on quality of life (QoL) for children with type 1 diabetes (T1D) during RF. Methods: A cross-sectional study that assessed the effect of lockdown on lifestyle and QoL on fasting children living with T1D during Ramadan in the Middle East and North Africa region (2020-2021). We compared the child (self) and parent (proxy) reports using PEDQoL v3.0 disease specific questionnaire during lockdown and non-lockdown periods, and assessed correlations with lifestyle changes using regression and gap analyses. Results: A total of 998 reports from 499 children with T1D aged 8 to 18 years (study = 276, control = 223), and their parents during RF in lockdown and non-lockdown periods. Fathers were more involved in their children’s care during lockdown ( P = .019). Patients had better compliance with treatment ( P = .002), a reversed sleep pattern ( P = .033), increased food intake ( P ⩽ .001), and less exercise ( P

Type 1 diabetes (T1D) is a complex autoimmune disorder that is highly prevalent globally. The interactions between genetic and environmental factors may trigger T1D in susceptible individuals. HLA genes play a significant role in T1D pathogenesis, and specific haplotypes are associated with an increased risk of developing the disease. Identifying risk haplotypes can greatly improve the genetic scoring for early diagnosis of T1D in difficult to rank subgroups. This study employed next-generation sequencing to evaluate the association between HLA class II alleles, haplotypes, and amino acids and T1D, by recruiting 95 children with T1D and 150 controls in the Kuwaiti population. Significant associations were identified for alleles at the HLA-DRB1, HLA-DQA1, and HLA-DQB1 loci, including DRB1*03:01:01, DQA1*05:01:01, and DQB1*02:01:01, which conferred high risk, and DRB1*11:04:01, DQA1*05:05:01, and DQB1*03:01:01, which were protective. The DRB1*03:01:01~DQA1*05:01:01~DQB1*02:01:01 haplotype was most strongly associated with the risk of developing T1D, while DRB1*11:04-DQA1*05:05-DQB1*03:01 was the only haplotype that rendered protection against T1D. We also identified 66 amino acid positions across the HLA-DRB1, HLA-DQA1, and HLA-DQB1 genes that were significantly associated with T1D, including novel associations. These results validate and extend our knowledge on the associations between HLA genes and T1D in Kuwaiti children. The identified risk alleles, haplotypes, and amino acid variations may influence disease development through effects on HLA structure and function and may allow early intervention via population-based screening efforts.

Background: Previous registries have shown a younger average age at presentation with cardiovascular diseases in the Middle East (ME), but no study has examined atrioventricular block (AVB). Moreover, these comparisons are confounded by younger populations in the ME. We sought to describe the average age at presentation with AVB in ME and quantify the effect of being from ME, adjusted for the overall younger population. Methodology: This was a retrospective analysis of PANORAMA registries, which collected data on patients who underwent cardiac rhythm device placement worldwide. Countries with a median population age of ≤30 were considered ‘young countries’. Multivariate linear regression was performed to assess the effect of being from ME, adjusted for being from a ‘young country’, on age at presentation with AVB. Results: The study included 5,259 AVB patients, with 640 (8.2%) from the ME. Mean age at presentation was seven years younger in ME than in other regions (62.9 ± 17.8 vs. 70 ± 14.1, P < 0.001). Being from a ‘young country’ was associated with 5.6 years younger age at presentation (95%CI –6.5––4.6), whereas being from ME was associated with 3.1 years younger age at presentation (95%CI –4.5––1.8), (P < 0.001 for both). Conclusion: The average age at presentation with AVB in the ME is seven years younger than in other regions. While this is mostly driven by the overall younger population, being from the ME appears to be independently associated with younger age. Determinants of the earlier presentation in ME need to be assessed, and care should be taken when applying international recommendations.

Introduction Rheumatoid arthritis (RA) is a chronic autoimmune disease affecting females. In RA, the treat to target strategy necessitates an early and intensive approach to achieve disease control. (1, 2) However, the therapeutic options can adversely affect reproductive health and pregnancy. Hence, the age of female patients at presentation might be a factor in decision making; although, there is a scarcity of evidence to support this hypothesis. We analyzed prescribing trends in Kuwait to examine the effect of female age on initial treatment decision. Methods Retrospective analysis of patients enrolled in the Kuwait RA Registry from 2012 to 2024. Baseline characteristics and medication prescribed at the initial visit were analyzed based on age group. Results 1101 female patients were included and stratified into two age groups [Formula: see text]49 years and >49 years. 30.8% were [Formula: see text]49 years and had a higher proportion of rheumatoid factor (RF) n Anti-CCP positivity (82.4% vs 75.5%, p=0.087). There was no significant difference in the mean DAS-28 at baseline (3.2 vs 3.1, p=0.32). A numerically higher proportion of patients started methotrexate (MTX) in the >49 years group (59.4% vs 54%, p=0.090). No statistically significant difference was found between the groups in sulfasalazine (SSZ), hydroxychloroquine (HCQ), or leflunomide (Lef) use. Rituximab was the most prescribed biologic with no statistical difference between the groups in prescription rate (p=0.822); TNF inhibitors (TNFi) were prescribed more often in the >49 years group (16.5% vs 11%, p=0.022); adalimumab, highest TNFi, prescription was not statistically different between the groups; Etanercept was prescribed more often the >49 years group (7.7% vs 4.7% and 5% vs 1.2%) respectively. There was no statistical difference between the groups in monotherapy vs. combination therapy treatment strategy. Discussion & Conclusion This study showed that age at presentation does not significantly influence the initial choice of Disease-Modifying Anti-Rheumatic Drugs in female RA patients in Kuwait. Other factors, such as completion of family and patient preferences, likely play a more critical role in treatment decisions. Further research is needed to explore these influences and optimize management strategies for RA in women, particularly concerning reproductive health.

Introduction Rheumatoid Arthritis (RA) is a chronic autoimmune disease that causes joint inflammation and potential disability. (1). The relationship between comorbidities and RA is well-known and is associated with poor outcomes. (3,4, 5) Furthermore, patients with RA are at an increased risk of cardiovascular disease (CVD). (6) This study investigates the epidemiology of RA in Kuwait, focusing on the prevalence of comorbidities such as hypertension, type 2 diabetes, hyperlipidemia and obesity using the Kuwait Rheumatoid Arthritis registry. Methods This retrospective study analyzes data from 2239 RA patients in Kuwait, enrolled from February 2012 to May 2024 Results As shown in Table 1, (71.0%) are females with a mean age of 55.6 years and a mean disease duration of 11.1 years. The average body mass index (BMI) is 29.2, with 39.2%% having a BMIˆ3 of 30 and 11.3% are active smokers. Analysis of comorbidities in RA patients shows that hypertension (23%) and diabetes Type 2 (20%) are the most prevalent conditions, followed by thyroid disease and hyperlipidemia (13%), as demonstrated in Figure 1. Conclusion This study reveals a high prevalence of hypertension, diabetes, dyslipidemia and obesity, all of which are modifiable risk factors for CVD. This finding emphasizes the importance of pre-emptive screening for these comorbid conditions, establishing a comprehensive care plan, and optimizing treatment protocol to improve patient outcome.

Background and Aims: Positive rheotaxis extended drop (PRED) has been described by Martin et al, 2017 showing sperm with

ABSTRACT Aim To assess the level of glycemic, blood pressure, and cholesterol control (the ‘ABCs’) nationally amongst adults with diabetes living in Kuwait. Materials and Methods Using data from two national cross‐sectional surveys, the levels of risk factor control were assessed in 1,801 adults with diabetes, aged 18–82 years. Glycemic control was defined as HbA1c

Abstract Aims/Introduction This study determined the prevalence and risk factors for diabetic peripheral neuropathy (DPN), painful DPN and diabetic foot ulceration (DFU) in patients with type 2 diabetes in secondary healthcare in Qatar, Kuwait and the Kingdom of Saudi Arabia. Materials and Methods Adults aged 18–85 years with type 2 diabetes were randomly enrolled from secondary healthcare, and underwent clinical and metabolic assessment. DPN was evaluated using vibration perception threshold and neuropathic symptoms and painful Diabetic Peripheral Neuropathy was evaluated using the Douleur Neuropathique 4 questionnaire. Results A total of 3,021 individuals were recruited between June 2017 and May 2019. The prevalence of DPN was 33.3%, of whom 52.2% were at risk of DFU and 53.6% were undiagnosed. The prevalence of painful DPN was 43.3%, of whom 54.3% were undiagnosed. DFU was present in 2.9%. The adjusted odds ratios for DPN and painful DPN were higher with increasing diabetes duration, obesity, poor glycemic control and hyperlipidemia, and lower with greater physical activity. The adjusted odds ratio for DFU was higher with the presence of DPN, severe loss of vibration perception, hypertension and vitamin D deficiency. Conclusions This is the largest study to date from the Middle East showing a high prevalence of undiagnosed DPN, painful DPN and those at risk of DFU in patients with type 2 diabetes, and identifies their respective risk factors.

The liver is the site of first pass metabolism, detoxifying and metabolizing blood arriving from the hepatic portal vein and hepatic artery. It is made up of multiple cell types, including macrophages. These are either bona fide tissue-resident Kupffer cells (KC) of embryonic origin, or differentiated from circulating monocytes. KCs are the primary immune cells populating the liver under steady state. Liver macrophages interact with hepatocytes, hepatic stellate cells, and liver sinusoidal endothelial cells to maintain homeostasis, however they are also key contributors to disease progression. Generally tolerogenic, they physiologically phagocytose foreign particles and debris from portal circulation and participate in red blood cell clearance. However as immune cells, they retain the capacity to raise an alarm to recruit other immune cells. Their aberrant function leads to the development of non-alcoholic fatty liver disease (NAFLD). NAFLD refers to a spectrum of conditions ranging from benign steatosis of the liver to steatohepatitis and cirrhosis. In NAFLD, the multiple hit hypothesis proposes that simultaneous influences from the gut and adipose tissue (AT) generate hepatic fat deposition and that inflammation plays a key role in disease progression. KCs initiate the inflammatory response as resident immune effectors, they signal to neighbouring cells and recruit monocytes that differentiated into recruited macrophages in situ. Recruited macrophages are central to amplifying the inflammatory response and causing progression of NAFLD to its fibro-inflammatory stages. Given their phagocytic capacity and their being instrumental in maintaining tissue homeostasis, KCs and recruited macrophages are fast-becoming target cell types for therapeutic intervention. We review the literature in the field on the roles of these cells in the development and progression of NAFLD, the characteristics of patients with NAFLD, animal models used in research, as well as the emerging questions. These include the gut-liver-brain axis, which when disrupted can contribute to decline in function, and a discussion on therapeutic strategies that act on the macrophage-inflammatory axis.

Two species of the genus Ophelina Örsted, 1843 (Annelida, Opheliidae) are reported from the coast of Kuwait (Arabian Gulf) after specimens collected in the intertidal and shallow subtidal, namely Ophelina arabica sp. nov. and Ophelina grandis (Pillai, 1961). The new species is mainly characterised by features of the anal tube, which is provided with about 25 annulations at each side; the ventral margins are fully fused while dorsal margins are fused at most of their length but are free at the distal end in the shape of a conspicuous incision; the posterior end is opened with free margins; the anal tube also lacks marginal papillae but bears a pair of basal papillae and an unpaired anal cirrus attached to ventral margin at mid-length. Ophelina grandis is reported for the first time in the Arabian Gulf; specimens are fully described and compared with similar species. A key for species of Ophelina in the Indo-Pacific, Southern Asia, Indo-Malay Archipelago and Australia, is also provided.

The aim of this study to examine the interaction between parents and children in Kuwait. It examines gender, home types, number of wives, and child age order differences in father and mother dialogue scales. The study also examines the association between the father and mother dialogue scale with some social variables. A sample of 725 Kuwaiti aged 17‒19 years was selected. Respondents’ GPA, some household information, father’s and mother’s Educational levels were collected were used. Father/Mother Dialogue Scale. Significant differences were found between males and females, types of home, have only one wife and those who have more than one wife, the son/daughter order among siblings in the family, the fathers and mothers’ age in both father and mother dialogue scales. Relationship was found between father and mother dialogue and many sociocultural variables. The dialogue between children and their parents is considered to be weak, especially in regard to the father’s side.

Abstract There has recently been a growing interest in examining the role of epigenetic modifications, such as DNA methylation, in the etiology of type 1 diabetes (T1D). This study aimed to delineate differences in methylation patterns between T1D-affected and healthy individuals by examining the genome-wide methylation of individuals from three Arab families from Kuwait with T1D-affected mono-/dizygotic twins and non-twinned siblings. Bisulfite sequencing of DNA from the peripheral blood of the affected and healthy individuals from each of the three families was performed. Methylation profiles of the affected individuals were compared to those of the healthy individuals Principal component analysis on the observed methylation profiling based on base-pair resolution clustered the T1D-affected twins together family-wide. The sites/regions that were differentially methylated between the T1D and healthy samples harbored 84 genes, of which 18 were known to be differentially methylated in T1D individuals compared to healthy individuals in publicly available gene expression data resources. We further validated two of the 18 genes—namely ICA1 and DRAM1 that were hypermethylated in T1D samples compared to healthy samples—for upregulation in T1D samples from an extended study cohort of familial T1D. The study confirmed that the ICA1 and DRAM1 genes are differentially expressed in T1D samples compared to healthy samples.