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The pattern of drug use among 2183 young Kuwaiti conscripts was studied using the Drug Abuse Screening Test (DAST) and urine analysis. Drug misuse rates were low, compared with similar set-ups elsewhere as independently confirmed by urine test (0.7% amphetamine and 2.8% other street drugs; alcohol was not detected in this sample) and self-report (7.9% on DAST). This may be attributed to the influence of the Islamic traditions on lifestyles. Significant correlations were seen between self-report of multiple drug use and positive urine results for both amphetamine and other street drugs, while positive urine amphetamine was associated with families seeking help for treatment, problems with family and/or work and having or being hospitalized for drug-related medical problems. Amphetamine as the major identified individual misused drug was significantly associated with older age group but negatively correlated with marital status, higher education and employment. The discrepancy between self-report of drug misuse-related problems and objective proof of this may reflect the inappropriateness of some of DAST items to this sample, culturally desired responses or both.

The outpatient follow-up care of 140 substance misusers in Kuwait was evaluated. Treatment has been traditionally based on substitution pharmacotherapy with no set objectives or criteria for outcome evaluation. Patients' structural characteristics, mode of referral, clinical diagnoses, medication prescribed and screening urine samples for drugs were examined for meaningful associations between these variables. Benzodiazepines were by far the most prescribed (94%) medication. Only 40% of the urine test results were positive for drugs containing different combinations of medications and street drugs. Unlike patients who received benzodiazepine, those who received tricyclic antidepressant medication were significantly more likely to associate with predictors of improvement. There is a need for better training of doctors and careful selection of patients in order to implement treatment strategies based on good doctor-patient relationships and well defined objectives for treatment and clear criteria of outcome.

The efficacy of a hypoglycaemic plant extract, in common use by Kuwaiti diabetic individuals, was evaluated using both streptozotocin-induced diabetic and normal rats. A significant decrease in blood glucose concentration was demonstrated on glucose tolerance tests, as compared to untreated animals. The sum of the fasting, 1 and 2 h blood glucose values, decreased from 18.5 +/- 0.72 to 13.6 +/- 0.62 mmol/l (p less than 0.001) and from 58.6 +/- 2.83 to 44.5 +/- 3.12 mmol/l (p less than 0.005) in normal and diabetic animals treated for 1 week, respectively. Treatment with the extract was not found to significantly alter insulin levels or intestinal glucose absorption. The mode of action of the hypoglycaemic preparation remains to be elucidated.

Serum gentamicin levels were assayed in patients receiving the aminoglycoside to determine dosage adjustments. The accuracy and reproducibility of three methods were compared; bioassay, enzyme multiplied immunoassay (Syva EMIT) and fluorescence polarisation immunoassay (Abbott TDx). Each assay method offered acceptable precision. The bioassay method correlated well with both the enzyme multiplied immunoassay and the fluorescence polarisation immunoassay (correlation coefficients 0.854 and 0.937, respectively). The automated methods provide results within 15 min and are not influenced by combinations of antibiotics, hence they are the methods of choice for aminoglycoside determinations.