ANURIA SECONDARY TO HOT WEATHER-INDUCED HYPERURICAEMIA: DIAGNOSIS AND MANAGEMENT

There is little information on the management of anuria secondary to severe volume depletion or as a rare manifestation of heat stroke in areas of the world with very hot summers. We present our experience with hot weather-induced hyperuricaemia in Kuwait

ANURIA SECONDARY TO HOT WEATHER-INDUCED HYPERURICAEMIA: DIAGNOSIS AND MANAGEMENT

There is little information on the management of anuria secondary to severe volume depletion or as a rare manifestation of heat stroke in areas of the world with very hot summers. We present our experience with hot weather-induced hyperuricaemia in Kuwait

Varicocelectomy: Modified loupe-assisted versus microscopic technique – A prospective comparative study

Abstract objective: To compare our novel loupe-assisted varicocelectomy (LV) technique to the ‘gold standard’ demanding microscopic varicocelectomy (MV) technique for the management of varicoceles. Patient and methods: Our LV technique, featuring testicular delivery and proximal spermatic cord occlusion using a tourniquet, has not been used before nor to our knowledge has it been reported in the literature. In the LV group, inguinal incision was done prior to testicular delivery and spermatic cord occlusion. Pampiniform and gubernacular veins were identified then tackled. Proximal spermatic cord occlusion helped in identifying those veins, and not confusing them with other cord structures that should be preserved. In all, 95 infertile men were included in this prospective, comparative study; and divided into LV and MV groups. They were followed-up for 1 year, pregnancy achievement, improvements in semen parameters, and complication rates were assessed. Results: Both groups had statistically significant pregnancy rates and negligible complication rates. However, LV cost 33% less than MV and was quicker to perform. We did not find that the MV technique was better than our simple, more cost-effective, less time-consuming LV technique. Conclusion: Our novel LV technique has similar success and complication rates as the ‘gold standard’ MV technique for the management of varicoceles, and is more cost-effective and less time consuming

Giant nonfunctioning adrenocortical carcinoma: a case report and review of the literature

BACKGROUND: Adrenocortical carcinoma is a rare and aggressive malignancy. Patients usually present early with manifestation of abnormal hormone secretion. However, adrenocortical carcinoma can also be nonfunctioning, and such patients present late with a mass effect or distant metastases. CASE PRESENTATION: We herein report a case of a 30-year-old Sri-Lankan woman who presented with a 3-month history of left flank pain associated with nausea, vomiting, and weight loss. Imaging revealed a large left upper quadrant mass with a 1.8-cm left lung nodule. The differential diagnoses included a left adrenal mass, left upper pole renal mass, and retroperitoneal sarcoma. A functional adrenal work-up revealed no abnormal findings. Surgical excision of the mass was uneventful with no postoperative complications. Pathological analysis revealed a nonfunctioning adrenocortical carcinoma measuring 16 × 14 × 10 cm. To our knowledge, a mass of this size is among the largest nonfunctioning adrenocortical carcinomas reported in the published literature. The investigations and approach to treatment were consistent with those in the published literature. CONCLUSION: Large nonfunctioning adrenocortical carcinomas pose a diagnostic and therapeutic challenge, and most are diagnosed at a late stage. Appropriate imaging and functional work-up of the mass are vital before treatment. Surgical excision is safe, even for large adrenocortical carcinomas; excision in patients with advanced disease has been shown to have the best outcomes

Relative contribution of digital rectal examination and transrectal ultrasonography in interpreting serum prostate-specific antigen values for screening prostate cancer in Arab men

Background: This study was conducted to determine the utility of digital rectal examination (DRE), transrec-tal ultrasonography (TRUS) and serum prostate-specific antigen (PSA) in the diagnosis of prostate cancer in men in Arabia, an area of the world with a relatively low incidence of this disease. Patients and Methods: 329 patients suspected of having prostate cancer on account of raised serum PSA level (> 4 ng/ml), DRE or TRUS findings, underwent TRUS-guided prostate biopsy. Raised PSA individually as well as combined, or a lesion suspicious of carcinoma on DRE or TRUS was recorded as PSA (+), DRE (+) or TRUS (+), respectively. The contribution of DRE, TRUS and serum PSA to the diagnosis of prostate cancer was analysed. Results: Of the 329 patients who had prostate biopsies 109 cases (33.1%) had PCa. Of these 109 patients 56 (51 %) had DRE (+), 77 (42%) had TRUS (+) and 49 ( 66%) had both DRE (+) and TRUS (+). Statistical analysis revealed that DRE (+) tripled the probability for cancer. PSA over a range of 10-50 ng/mL demonstrated an in-creasing cancer probability ranging from 2 to 3 fold. TRUS (+) was only significantly associated with cancer risk if PSA was elevated. The presence of all three factors increased the cancer probability by 6 to 7 fold. Conclusion: TRUS findings are dependent on PSA for interpretation while DRE (+) with elevated PSA makes PCa more likely

Health Promotion Programs to Reduce Noncommunicable Diseases: A Call for Action in Kuwait

Most public health issues in Kuwait are related to unhealthy behaviours. Research shows that behaviours are the result not only exclusively of personal choices but also of myriads of other social and environmental factors. Kuwait is one of the leading countries in obesity and tobacco use in the world. Cardiovascular diseases stemming from complications related to these and other risk factors are important health issues based on their morbidity and mortality implications. These risks are spread across society and affect the old as well as young boys. The serious gaps between Kuwait’s health-related needs and the existing policies to reduce public health risks in Kuwait create a significant obstacle to healthy behaviour change. Kuwait requires adequate laws, policies, regulations, activities, and programs to promote people’s health. The Socio-Ecological Model (SEM) has been used successfully in health promotion in various behavioural settings, including obesity, physical inactivity, and smoking. We propose the use of SEM as a planning framework in building sustainable health promotion programs in Kuwait while paying attention to other concepts such as systems thinking, authentic community participation, community capacity, policy development, public health infrastructure enhancement, health coaching, and equity.</jats:p

Enhancing Research and Development in the Health Sciences as a Strategy to Establish a Knowledge-Based Economy in the State of Kuwait: A Call for Action

Kuwait Vision 2035 is an initiative that was launched in 2017 by His Highness the Emir of the State of Kuwait Sheikh Sabah Al-Ahmad Al-Jaber Al-Sabah. This initiative includes the implementation of a detailed development plan aimed at transforming the state of Kuwait into a regional leader in science, technology, and innovation. Health research will arguably prove to be one of the most impactful research arenas when it comes to accomplishing the goals set forth by the Kuwait Vision 2035 Development Plan. The high impact of health research is derived from its capacity to aid in the establishment of a knowledge-based health industry. The state of Kuwait lacks a system for promoting and managing national R&amp;D efforts. At present, the research and development (R&amp;D) expenditure in the state of Kuwait is far below the international standards that have been shown to lead to innovation and the subsequent development of a knowledge-based economy. Improvement of the weak and unstructured existing R&amp;D apparatus in the State of Kuwait is among the most urgent challenges facing the nation as it strives toward innovation and development of a knowledge-based economy. Developing health research capacities in the State of Kuwait can significantly contribute toward improving public health, health promotion, disease prevention and treatment, and overall human welfare. Importantly, the positive impacts of such extensive benefits will not be restricted to the state of Kuwait and its citizens, but may in fact reap benefits for the global society as a whole. This article first analyzes the current status of healthcare services and health science research in the State of Kuwait, and then summarizes some essential R&amp;D design principles that Kuwait needs to implement in order to achieve the milestones set forth in the Kuwait Vision 2035 Development Plan.</jats:p

Enhancing Research and Development in the Health Sciences as a Strategy to Establish a Knowledge-Based Economy in the State of Kuwait: A Call for Action

Kuwait Vision 2035 is an initiative that was launched in 2017 by His Highness the Emir of the State of Kuwait Sheikh Sabah Al-Ahmad Al-Jaber Al-Sabah. This initiative includes the implementation of a detailed development plan aimed at transforming the state of Kuwait into a regional leader in science, technology, and innovation. Health research will arguably prove to be one of the most impactful research arenas when it comes to accomplishing the goals set forth by the Kuwait Vision 2035 Development Plan. The high impact of health research is derived from its capacity to aid in the establishment of a knowledge-based health industry. The state of Kuwait lacks a system for promoting and managing national R&amp;D efforts. At present, the research and development (R&amp;D) expenditure in the state of Kuwait is far below the international standards that have been shown to lead to innovation and the subsequent development of a knowledge-based economy. Improvement of the weak and unstructured existing R&amp;D apparatus in the State of Kuwait is among the most urgent challenges facing the nation as it strives toward innovation and development of a knowledge-based economy. Developing health research capacities in the State of Kuwait can significantly contribute toward improving public health, health promotion, disease prevention and treatment, and overall human welfare. Importantly, the positive impacts of such extensive benefits will not be restricted to the state of Kuwait and its citizens, but may in fact reap benefits for the global society as a whole. This article first analyzes the current status of healthcare services and health science research in the State of Kuwait, and then summarizes some essential R&amp;D design principles that Kuwait needs to implement in order to achieve the milestones set forth in the Kuwait Vision 2035 Development Plan