Research abstracts
Given below is a sample of abstracts of research undertaken with support from KIMS:
Down
syndrome in Kuwait: Birth prevalence and associated factors
Evaluation of an educational intervention to optimize compliance
among patients with depressive disorders in Kuwait
Phenotypic characterization of type 2 Kuwaiti diabetic
families, including molecular biological research for genes for diabetes,
obesity and related pathophysiologies
Age at death and gender determination of Kuwaiti individual
from dentine by biochemical methods
Risk factors for bronchial asthma in Kuwait (Assesment
of expossure and sensitization to common indoor allergens)
Artificial color levels in food products marketed in the
State of Kuwait and assessment of intake levels by 4-10 years old children
Clinical
Skills Performed by Pre-registration House Officers* (interns) in Kuwait
Principal investigator: Dr. Khaled F. Al-Jarallah
Objectives
Pre-registration House Officers (interns) follow rotations in Medicine,
Surgery, Obstetrics & Gynecology and Pediatrics. This report presents
preliminary data from a study aimed at identifying the clinical skills
performed by PRHOs and the frequency of performance during clinical
rotations in Internal Medicine.
Methods
PRHO’s in the 2002/03, 2003/04 and 2004/05 cohorts who followed
rotations at clinical units in Internal Medicine at Ministry of Health
hospitals (Amiri, Mubarak, Farwaniya and Adan) responded anonymously
at the end of PRHO training to a questionnaire that listed important
clinical skills. Each training unit had an average of 5 to 6 of approximately
equal proportions of males and female trainees assigned to it. Each
respondent indicated whether he or she performed the skill and, if so,
the number times it was done.
Results
265 questionnaires were available for analysis (response rate 72%).
The table below shows the percentages of trainees who performed the
essential skills more than once or did not perform them.
| Clinical Skill | Performed more than once (%) | Did not perform (%) |
| Basic
X-ray interpretation Basic ECG interpretation Arterial puncture for blood gas analysis Inserting intravenous line Blood sampling Inserting urethral catheter Nasogastric feeding Urine examination Administering CPR Pleural tap Securing airway Lumbar puncture Blood film examination Insertion of thoracic drainage Endotracheal intubation Cardiac defibrillation Inserting central venous catheter Treatment of tension pneumothorax Needle aspiration of knee joint |
97.4 95.9 84.9 71.7 77.4 77.7 72.5 64.2 61.1 55.1 50.6 38.1 34.7 32.5 32.8 31.3 30.9 26.4 21.5 |
1.1 2.3 4.2 8.7 10.6 12.1 12.5 25.3 20.0 27.2 27.9 45.3 52.1 55.5 47.6 53.6 58.9 57.0 67.9 |
Discussion
Many essential skills that all trainees should perform had not been
done by some of the trainees during the internship training period.
Among these skills were tasks such as endotracheal intubation, administering
cardiopulmonary resuscitation (CPR), inserting urethral catheter, and
inserting intravenous line. As some of these are life-saving procedures
it could be considered as unacceptable that even a small proportion
of the trainees (at least a fifth of the respon-dents in this study)
did not perform them. Moreover, other skills such as ECG interpretation,
inserting an IV line, or inserting a urethral catheter are basic essentials
that all trainees without any exceptions need to be able perform satisfactorily.
Conclusion
The study demonstrates that the PRHO’s had not performed some
basic or essential clinical skills. Curriculum planners and trainers
supervising the PRHO’s need to ensure that PRHO’s receive
sufficient opportunities during training to have full exposure to the
important clinical skills. It also is necessary to undertake future
prospective studies on the clinical skills acquired by PRHO’s
to ensure that the minimum competency levels are achieved.
* PRHO training (also called internship training) is the 12-month period during which new graduates of medical schools undergo supervised training before they are granted license for independent practice.
Down
syndrome in Kuwait: Birth prevalence and associated factors
Project # 99-07-06, Funded by KFAS, Jan 2000 - Jan 2002,
Principal Investigator: Dr. Sadika A. Al-Awadi.
This is a population-based study to determine the birth prevelance rate of Down syndrome in Kuwait and study the genetic and environmental factors associated with it. It includes all Down syndrome children ascertained clinically and cytogenetically in the Kuwait Medical Genetic Centre since its establishment in 1979. To study the factors associated with Down syndrome, a case- control study will be undertaken including the cases born during the period 1998-99.
Evaluation
of an educational intervention to optimize compliance among patients
with depressive disorders in Kuwait
Project # 99-07-03, Funded by KFAS, Jan 2000 - Mar 2002,
Principal Investigator: Dr. Nabeel Al-Saffar.
The project develops methods to optimize compliance beheviour through implementing special drug educational programmes including 'patient information leaflets' and a pharmacist led 'drug counseling protocol' for patients with depressive disorders - Interviews are conducted in the Psychological Medicine Hospital and the Psychiatric Clinic of Adan Hospital. This is carried out by comparing the effect of a single educational intervention with a combined intervention strategy in improving patient medication knowledge and/or compliance.
Phenotypic
characterization of type 2 Kuwaiti diabetic families, including molecular
biological research for genes for diabetes, obesity and related pathophysiologies
Project # 97-07-07, Funded by KFAS, Jan 1999 - Mar 2003,
Principal Investigator: Dr. Abdulla Bin Nakhi.
The aim of the project is to assess the prevalence of type 2 diabetes among Kuwaiti family members; investigate its pathophysiologies; identify genes causing it; in addition to assessing hypertension, abnormal blood lipids, obesity and androgen status. A special site at Sawaber Clinic is used to conduct the study. One hundred Kuwaiti type 2 diabetics, 35 years old and above with at least 2 living siblings, will be randomly selected from the diabetes clinics in Capital and Hawalli health areas. After obtaining subjects' consent, first-degree relatives will be invited for data and blood collection.
Age
at death and gender determination of Kuwaiti individual from dentine
by biochemical methods
Project # 96-07-05, Funded by KFAS, Oct 1997 - Oct 2000,
Pricipal Investigator: Dr: Sahib Al-Qattan.
Ninety six upper first premolar teeth were collected for amino acid analysis, 53 of these teeth were of ages and gender known to the writer and used to establish a base-line for the determination age and gender (control). A total of 453 Kuwaiti teeth was used for trace element analysis, 300 different teeth, 75 (incisor, first premolar and molar, 45 buried first premolar teeth were use for D-and L- aspartic acid analysis for age and gender determination. 14 teeth buried on soil at a depth 0.5m and similarly 17 teeth were buried at 2m. High Performance Liquid Chromotography (HPLC), technique was used to determine the degree of aspartic acid racemization; and atomic absorption spectrophotometer for [Zn,Pb,Fe,Sr,Mn,Mg, and Cu] analysis to determine age and gender. From D-and L-aspartic acid analysis for teeth not buried in the soil we found that the actual age = Estimated age ± SE(±1.2 years). For buried teeth the actual age = Estimated age ± SE(±2.3 years), at depth of 0.5m and Estimated age ± SE(± 3.0 Years) at depth 2m. From trace elements [Zn,Pb,Fe, Mn, Sr,Ng, and Cu] the actual age = Estimated Age ± SE(5.3), and the actual age = Estimated age ± SE(±3.0) at depth 0.5m and actual age ± Estimated age ± SE(±3.3) at depth 2.0m.
Risk
factors for bronchial asthma in Kuwait (Assesment of expossure and sensitization
to common indoor allergens)
Project # 98-07-10, Funded by KFAS, July 1999 - July 2002,
Principal Investigator: Dr. Mahdi Al-Mousawi.
The aim of the project is to identify environmental and individual risk factors for asthma in Kuwait, levels of indoor allergens in samples of dust from houses in Kuwait, and study the relationship between level of indoor allergens with level of sensitization. This is a case-control study of 150 asthmatic subjects matched on 300 non-asthmatic controls. Evaluation of sensitization is done by skin prick testing to a range of allergens, and also by measurement of total and specific serum IgE. Besides, an environmental questionnaire will be completed and dust samples are collected from houses. Patients and controls will be subjected to the procedures: lung function, bronchial responsiveness, medical history and respiratory examination.
Artificial
color levels in food products marketed in the State of Kuwait and assessment
of intake levels by 4-10 years old children
Project # 99-04-02, Funded by KFAS , July 2001 - July 2004,
Principal Investigator: Dr. Wajih N. Sawaya.
The objectives of the project are to identify and determine colorant levels in food products marketed in Kuwait, to conduct a field survey on the levels of colorant consumption by children 4-10 years of age, to assess and compare the intake of food colorants by children 4-10 years of age with the FAO/WHO acceptable daily intake and to train professional staff on food consumption field surveys and colorant analysis. A total of 1920 children will be randomly chosen to represent the total population, including different nationalities (Kuwaiti and non-Kuwaiti), levels of education (kindergarten and elementary schools), sexes (males and females), types of schools (private or public), and educational areas of the five governorates. The daily intakes of artificial colors of 4-10 years old children will be estimated and the actual artificially colored food stuff items to be analyzed will be those identified during the field survey.