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Kuwaiti territorial waters of the northwest Arabian Gulf represent a unique aquatic ecosystem prone to various environmental and anthropogenic stressors that pose significant constraints on the resident biota which must withstand extreme temperatures, salinity levels, and reducing conditions, among other factors to survive. Such conditions create the ideal environment for investigations into novel functional genetic adaptations of resident organisms. Firstly, however, it is essential to identify said organisms and understand the dynamic nature of their existence. Thus, this study provides the first comprehensive analysis of bacterial and archaeal community structures in the unique waters of Kuwait located in the Northwest Arabian Gulf and analyzes their variations with respect to depth, season, and location, as well as their susceptibility to changes in abundance with respect to various physicochemical parameters. Importantly, this study is the first of its kind to utilize a shotgun metagenomics approach with sequencing performed at an average depth of 15 million paired end reads per sample, which allows for species-level community profiling and sets the framework for future functional genomic investigations. Results showed an approximately even abundance of both archaeal (42.9%) and bacterial (57.1%) communities, but significantly greater diversity among the bacterial population, which predominantly consisted of members of the Proteobacteria, Cyanobacteria, and Bacteroidetes phyla in decreasing order of abundance. Little to no significant variations as assessed by various metrics including alpha and beta diversity analyses were observed in the abundance of archaeal and bacterial populations with respect to depth down the water column. Furthermore, although variations in differential abundance of key genera were detected at each of the three sampling locations, measurements of species richness and evenness revealed negligible variation (ANOVA p<0.05) and only a moderately defined community structure (ANOSIM r2 = 0.243; p>0.001) between the various locations. Interestingly, abundance of archaeal community members showed a significant increase (log2 median ratio of RA = 2.6) while the bacterial population showed a significant decrease (log2 median ratio = -1.29) in the winter season. These findings were supported by alpha and beta diversity analyses as well (ANOSIM r2 = 0.253; p>0.01). Overall, this study provides the first in-depth analysis of both bacterial and archaeal community structures developed using a shotgun metagenomic approach in the waters of the Northwest Arabian Gulf thus providing a framework for future investigations of functional genetic adaptations developed by resident biota attempting to survive in the uniquely extreme conditions to which they are exposed. [ABSTRACT FROM AUTHOR]

Kuwait Bay's southern shore is home to several facilities used for various purposes, impacting the beaches' ecosystems and coastal environment. Furthermore, the presence of numerous stormwater outfalls on Kuwait Bay's southern shores may be one of the sources of pollutants that are discharged from these outfalls. This research aims to evaluate the microbiological quality of seawater near 5 selected stormwater outfalls located on Kuwait Bay's recreational water by measuring the levels of microbial bacteria such as fecal coliform (FC), and Escherichia Coli. (E. Coli), and fecal streptococci (FS), and water quality parameters including temperature, pH, electrical conductivity (EC), and dissolved oxygen (DO). The analytical results were compared with Kuwait Environmental Public Authority (EPA) requirements for water discharge to Kuwait Bay to assess the suitability of the beaches for recreational activities. The field results revealed the presence of mildly alkaline seawater samples, a range of fresh to saline water types, and various DO levels from very low to acceptable levels. noteworthy, the microbial indicators were extremely high and far beyond EPA guidelines, demonstrating extensive microbiological pollution at these locations. The mean FC/FS ratios of C18 had the greatest mean FC/FS ratio (16.75), signifying human contamination. C3 and C5 indicated human waste in mixed pollution with averages of (3.45 and 2.34 respectively), whereas C8 and C10 showed human contamination with average values (of 5.98, and 4.21 respectively). It is suggested that the seawater quality close to wastewater outfalls be frequently evaluated and treated using efficient onsite treatment technologies to decrease the amount of polluted wastewater discharged directly to the beaches. [ABSTRACT FROM AUTHOR]

The wastewater quality alterations due to the use of cleaning agents, sanitisers, and disinfectants, in addition to the accompanying use of water during COVID-19 have potential impacts on wastewater treatment operations. How the characteristics of wastewater could be altered by the COVID-19 pandemic was the concern of this investigation. Daily records of the Ardiya catchment in Kuwait City were examined for the period 2015-2020. Perhaps due to the excessive use of water during 2020 (446 compared to the five-year average of 436 l/c.d) and the corresponding wastewater generation increase (253 compared to the five-year average of 239 l/c.d), the effect of chemical usage on the wastewater quality has dampened. Nonetheless, an increase in the frequency of COD/BOD ratio > 3, TP in the range 6.5 to 8.5, TKN in the range 40 to 50 were observed in 2020, which was not observed during 2015--2019. These COVID-19 related alterations are important to take into consideration in wastewater treatment operations to achieve wastewater treatment targets. [ABSTRACT FROM AUTHOR]

Objective: To build a clinical risk score to aid risk stratification among hospitalised COVID‐19 patients. Methods: The score was built using data of 417 consecutive COVID‐19 in patients from Kuwait. Risk factors for COVID‐19 mortality were identified by multivariate logistic regressions and assigned weighted points proportional to their beta coefficient values. A final score was obtained for each patient and tested against death to calculate an Receiver‐operating characteristic curve. Youden's index was used to determine the cut‐off value for death prediction risk. The score was internally validated using another COVID‐19 Kuwaiti‐patient cohort of 923 patients. External validation was carried out using 178 patients from the Italian CoViDiab cohort. Results: Deceased COVID‐19 patients more likely showed glucose levels of 7.0–11.1 mmol/L (34.4%, p < 0.0001) or >11.1 mmol/L (44.3%, p < 0.0001), and comorbidities such as diabetes and hypertension compared to those who survived (39.3% vs. 20.4% [p = 0.0027] and 45.9% vs. 26.6% [p = 0.0036], respectively). The risk factors for in‐hospital mortality in the final model were gender, nationality, asthma, and glucose categories (<5.0, 5.5–6.9, 7.0–11.1, or 11.1 > mmol/L). A score of ≥5.5 points predicted death with 75% sensitivity and 86.3% specificity (area under the curve (AUC) 0.901). Internal validation resulted in an AUC of 0.826, and external validation showed an AUC of 0.687. Conclusion: This clinical risk score was built with easy‐to‐collect data and had good probability of predicting in‐hospital death among COVID‐19 patients. [ABSTRACT FROM AUTHOR]

A research studies were performed to characterize the wastewater generated from four hospitals located in Kuwait. In general, the wastewater generated from hospitals is discharged directly without any pre-treatment to public sewage treatment plants supervised by Ministry of Public Works (MPW). In this study, wastewater samples were collected on weekly basis from four hospitals (Al-Sabah, Al-Razi, Maternity and Chest diseases). Field wastewater measurements were carried out onsite for all sites including temperature, pH, electrical conductivity and oxidation-reduction potential. The collected samples were analyzed for determination of chemical parameters (total suspended solids and total dissolved solids), organic parameters including total organic carbon, chemical oxygen demand, biochemical oxygen demand and five dominate pharmaceutical compounds (four antibiotics sulfamethoxazole, metronidazole, ranitidine and trimethoprim plus paracetamol) and concentrations of radioactive elements in the wastewater (I-131, K-40, Tc-99m). The laboratory results indicated that all wastewaters from hospitals contained high levels of Tc-99m (0.14-14.151 Bq/L), I-131 (13.56-27.1 Bq/L), and low levels of K-40 (0.45-0.86 Bq/L). In addition, the pharmaceutics' concentration results revealed a high concentration of paracetamol (580 µg/L), where the maximum was detected in wastewater from Al-Razi hospital. The study recommends construction of onsite wastewater pre-treatment units. [ABSTRACT FROM AUTHOR]

A research study was carried out to collect data on the quality and quantity of petroleum and nonpetroleum industrial wastewater from different sources in Kuwait over a period of 1 y as well as developing a database of such characteristics and attributes using geographic information system (GIS) technique. During the field visits, a specially designed field surveys were submitted to the owners of industrial facilities in three industrial areas in Kuwait, namely, Sabhan, Kuwait City, and Shuaiba industrial areas. In this study, wastewater samples were collected and analysed on monthly and biweekly basis from 14 non-petroleum factories of Sabhan industrial areas. This paper was targeting assessment of total petroleum hydrocarbon (TPH) in the raw wastewater for factories of Sabhan industrial area. The field wastewater data indicated presence slightly acid to slightly alkaline (4.9-10.8), reduced to oxidized environment (-410 mv-538 mv) and freshwater to brackish water (120-8,673 µS/cm). The laboratory results revealed that total petroleum hydrocarbon concentrations for wastewater of 14 factories ranged between 0.3 and 19 mg/L. The mean values of total petroleum hydrocarbon concentrations for wastewater of 14 factories were meeting the maximum limit (5 mg/L) set by KEPA for irrigation water purposes except those values of TPH (>5 mg/L) for three factories. The mean value of quantities of wastewater generated from 14 factories was found 55,894 m3/week. The large quantities of raw wastewater generated from these factories can be used safely as irrigation water for landscaping and greenery with respect to total petroleum hydrocarbon concentrations. [ABSTRACT FROM AUTHOR]

Background: ABO blood groups have been linked to susceptibility to infection with certain microorganisms, including coronaviruses. We examined the relationship between blood group and clinical outcomes in individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and compared their blood group distribution with the general population.Methods: At the inception of the pandemic, all individuals testing positive for SARS-CoV-2 in Kuwait were admitted to one designated coronavirus disease 2019 (COVID-19) hospital and enrolled in a prospective registry. Patients admitted from February 24 to May 27, 2020, were stratified according to blood group. As a control, blood groups of 3,730,027 anonymized individuals representing almost Kuwait's entire population were obtained from a national database.Results: Of 3305 SARS-CoV-2-positive patients, 37.1%, 25.5%, 28.9%, and 8.5% were groups O, A, B, and AB, respectively. Univariate analysis revealed no significant differences in severe clinical outcomes or death among the blood groups. However, multivariable analysis demonstrated that group A individuals had higher odds of developing pneumonia compared with non-group A (adjusted odds ratio 1.32, 95% confidence interval 1.02-1.72, p < .036). Compared with the general population, the COVID-19 cohort had a lower frequency of group O, equivalent frequency of A, and higher frequency of B and AB. No significant difference in the RhD group was found.Conclusion: This study supports potential involvement of the ABO blood group system in predisposing to infection with SARS-CoV-2 in an unselected population. Examination of the mechanistic link between blood group and COVID-19 and its implications on controlling the current pandemic is warranted. [ABSTRACT FROM AUTHOR]

Background: Subsequent epidemic waves have already emerged in many countries and in the absence of highly effective preventive and curative options, the role of patient characteristics on the development of outcomes needs to be thoroughly examined, especially in middle-east countries where such epidemiological studies are lacking. There is a huge pressure on the hospital services and in particular, on the Intensive Care Units (ICU). Describing the need for critical care as well as the chance of being discharged from hospital according to patient characteristics, is essential for a more efficient hospital management. The objective of this study is to describe the probabilities of admission to the ICU and the probabilities of hospital discharge among positive COVID-19 patients according to demographics and comorbidities recorded at hospital admission.Methods: A prospective cohort study of all patients with COVID-19 found in the Electronic Medical Records of Jaber Al-Ahmad Al-Sabah Hospital in Kuwait was conducted. The study included 3995 individuals (symptomatic and asymptomatic) of all ages who tested positive from February 24th to May 27th, 2020, out of which 315 were treated in the ICU and 3619 were discharged including those who were transferred to a different healthcare unit without having previously entered the ICU. A competing risk analysis considering two events, namely, ICU admission and hospital discharge using flexible hazard models was performed to describe the association between event-specific probabilities and patient characteristics.Results: Results showed that being male, increasing age and comorbidities such as chronic kidney disease (CKD), asthma or chronic obstructive pulmonary disease and weakened immune system increased the risk of ICU admission within 10 days of entering the hospital. CKD and weakened immune system decreased the probabilities of discharge in both females and males however, the age-related pattern differed by gender. Diabetes, which was the most prevalent comorbid condition, had only a moderate impact on both probabilities (18% overall) in contrast to CKD which had the largest effect, but presented only in 7% of those admitted to ICU and in 1% of those who got discharged. For instance, within 5 days a 50-year-old male had 19% (95% C.I.: [15,23]) probability of entering the ICU if he had none of these comorbidities, yet this risk jumped to 31% (95% C.I.: [20,46]) if he had also CKD, and to 27% in the presence of asthma/COPD (95% C.I.: [19,36]) or of weakened immune system (95% C.I.: [16,42]).Conclusions: This study provides useful insight in describing the probabilities of ICU admission and hospital discharge according to age, gender, and comorbidities among confirmed COVID-19 cases in Kuwait. A web-tool is also provided to allow the user to estimate these probabilities for any combination of these covariates. These probabilities enable deeper understanding of the hospital demand according to patient characteristics which is essential to hospital management and useful for developing a vaccination strategy. [ABSTRACT FROM AUTHOR]

Background and Objectives: A global trend in female leadership roles in the medical profession is on the rise, and females have been taking up leadership roles in varying and increasing levels. This study aims to identify changes in trends in the medical field in terms of gender in the last decade in Kuwait.Methods: A case study was conducted, in which data on leadership positions in Kuwait's government hospitals were obtained from hospital registries. Demographic data about female to male physicians were collected from statistics published by the Department of Manpower, Statistics and Planning of Kuwait's Ministry of Health. In addition, statistics on medical graduates were obtained from the Faculty of Medicine (FOM), Kuwait University (KU).Results: In general, every government hospital in Kuwait has experienced an increase in leadership roles among females; in 2008, among all leadership positions in Kuwait's general hospitals, males occupied a majority of positions (60%); whereas in 2016, the male to female ratio was 1:1. The most change in gender trends was witnessed at Mubarak Al-Kabeer Hospital, where female leaders went from 38% in 2008 to 73% in 2016. The specialties that have the highest number of females in leadership positions across all hospitals from 2008 to 2016 were nuclear medicine, radiology, and laboratory medicine. In KU's FOM, female graduates outweighed male graduates, except in 2005-2006, where females reached a minimum of 48%. The number of female physicians has also increased from its lowest of 31% of the total number of physicians in 2004-2006, to 37% in 2015.Conclusion: While women make up more than half of medical graduates in Kuwait at present, significant barriers had restricted their entry into formal medical leadership roles in the past. However, it is now seen that females currently occupy more leadership positions in government hospitals in Kuwait. [ABSTRACT FROM AUTHOR]

In the present study, the effect of enzymatic hydrolysis on the antioxidant activity of three red seaweeds (Chondria cornuta, Chondria dasyphylla, and Murrayella periclados) and two green seaweeds (Cladophora sp. and Ulva lactuca) from the Kuwait coast were evaluated. The seaweeds were hydrolyzed with five carbohydrases and three proteases, and the resulting extracts were tested for antioxidant activity. The total phenolic content and yield of the extracts varied greatly depending upon the species and enzyme used for hydrolysis. Of the 40 enzymatic extracts screened for antioxidant activity, the Viscozyme and Alcalase extracts of M. periclados, Neutrase and Ultraflo extracts of Cladophora sp., and Neutrase extracts of C. cornuta had high antioxidant activity compared to other enzymatic extracts in various in vitro assays. Fractionation of the extracts revealed that the radical scavenging and reducing power of the extracts were mainly due to phenolic fractions. In contrast, the iron‐chelating ability was mainly due to protein fractions. The level of prevention of lipid oxidation in the liposome model system varied for different fractions of extracts and did not correlate with total phenolic content and other antioxidant properties. The results of the study show that, by hydrolyzing seaweeds with specific enzymes, customized seaweed extracts with specific bioactivity could be obtained. [ABSTRACT FROM AUTHOR]

Summary: The coronavirus disease 2019 (COVID‐19) pandemic is straining the healthcare system, particularly for patients with severe outcomes requiring admittance to the intensive care unit (ICU). This study investigated the potential associations of obesity and diabetes with COVID‐19 severe outcomes, assessed as ICU admittance. Medical history, demographic and patient characteristics of a retrospective cohort (1158 patients) hospitalized with COVID‐19 were analysed at a single centre in Kuwait. Univariate and multivariate analyses were performed to explore the associations between different variables and ICU admittance. Of 1158 hospitalized patients, 271 had diabetes, 236 had hypertension and 104 required admittance into the ICU. From patients with available measurements, 157 had body mass index (BMI) ≥25 kg/m2. Univariate analysis showed that overweight, obesity class I and morbid obesity were associated with ICU admittance. Patients with diabetes were more likely to be admitted to the ICU. Two models for multivariate regression analysis assessed either BMI or diabetes on ICU outcomes. In the BMI model, class I and morbid obesities were associated with ICU admittance. In the diabetes model, diabetes was associated with increased ICU admittance, whereas hypertension had a protective effect on ICU admittance. In our cohort, overweight, obesity and diabetes in patients with COVID‐19 were associated with ICU admittance, increasing the risk of poor outcomes. [ABSTRACT FROM AUTHOR]

COVID-19 is a worldwide pandemic that is mild in most patients but can result in a pneumonia like illness with progression to acute respiratory distress syndrome and death. Predicting the disease severity at time of diagnosis can be helpful in prioritizing hospital admission and resources. We prospectively recruited 1096 consecutive patients of whom 643 met the inclusion criterion with COVID-19 from Jaber Hospital, a COVID-19 facility in Kuwait, between 24 February and 20 April 2020. The primary endpoint of interest was disease severity defined algorithmically. Predefined risk variables were collected at the time of PCR based diagnosis of the infection. Prognostic model development used 5-fold cross-validated regularized logit regression. The model was externally validated against data from Wuhan, China. There were 643 patients with clinical course data of whom 94 developed severe COVID-19. In the final model, age, CRP, procalcitonin, lymphocyte percentage, monocyte percentages and serum albumin were independent predictors of a more severe illness course. The final prognostic model demonstrated good discrimination, and both discrimination and calibration were confirmed with an external dataset. We developed and validated a simple score calculated at time of diagnosis that can predict patients with severe COVID-19 disease reliably and that has been validated externally. The KPI score calculator is now available online at covidkscore.com [ABSTRACT FROM AUTHOR]

Background: In light of the COVID-19 pandemic, many have flagged racial and ethnic differences in health outcomes in western countries as an urgent global public health priority. Kuwait has a unique demographic profile with two-thirds of the population consisting of non-nationals, most of which are migrant workers. We aimed to explore whether there is a significant difference in health outcomes between non-Kuwaiti and Kuwaiti patients diagnosed with COVID-19.Methods: We used a prospective COVID-19 registry of all patients (symptomatic and asymptomatic) in Kuwait who tested positive from February 24th to April 20th, 2020, collected from Jaber Al-Ahmad Al-Sabah Hospital, the officially-designated COVID-19 healthcare facility in the country. We ran separate logistic regression models comparing non-Kuwaitis to Kuwaitis for death, intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS) and pneumonia.Results: The first 1123 COVID-19 positive patients in Kuwait were all recruited in the study. About 26% were Kuwaitis and 73% were non-Kuwaiti. With adjustments made to age, gender, smoking and selected co-morbidities, non-Kuwaitis had two-fold increase in the odds of death or being admitted to the intensive care unit compared to Kuwaitis (OR: 2.14, 95% CI 1.12-4.32). Non-Kuwaitis had also higher odds of ARDS (OR:2.44, 95% CI 1.23-5.09) and pneumonia (OR: 2.24, 95% CI 1.27-4.12).Conclusion: This is the first study to report on COVID-19 outcomes between Kuwaiti and non-Kuwaiti patients. The current pandemic may have amplified the differences of health outcomes among marginalized subpopulations. A number of socioeconomic and environmental factors could explain this health disparity. More research is needed to advance the understanding of policymakers in Kuwait in order to make urgent public health interventions. [ABSTRACT FROM AUTHOR]

A study was carried out to assess the removal efficiency of odorous compounds from the wastewater of hospitals in Kuwait using aeration with activated sludge technique. Samples were collected from the outlet of wastewater from Maternity Hospital. The collected samples were transferred to the laboratory of Sulaibiya Research Plant (SRP) of KISR. Each sample was divided into three parts: the first part of the sample was analyzed to obtain characteristic of hospital wastewater, while the second and third samples were mixed with activated sludge from Kabd wastewater treatment plant and underwent aerobic treatment for 12 and 24 h periods in two bioreactors using a different intensity of aeration. In the first bioreactor, the dissolved oxygen (DO) was kept on the level of 2 mg/L, while in the second 4 mg/L. Wastewater and effluents samples were analyzed for the examination of the following parameters: temperature, pH, electrical conductivity, chemical oxygen demand (COD), ammonium, nitrite, nitrate, organic nitrogen, total nitrogen (TN) and sulfides. Based on obtained results of analyses, the removal efficiency of wastewater parameters were calculated mainly for COD, NH4 –N, sulfides and TN. The laboratory results indicated that after a hydraulic retention time (HRT) of 24 h, the mean values of sulfide removal efficiency increased from 82.54% to 93.85%, when DO increased from 2 to 4 mg/L, respectively. Under the same previous operating conditions, the mean value of ammonium removal efficiency was increased from 85.96% to 97.44%. To obtain the best effluents the biological process should be extended aeration type with HRT 24 h at DO 4 mg/L. The obtained results will be recommended as the base for treating wastewater from hospitals in package units before discharging to sewage network. [ABSTRACT FROM AUTHOR]

A research study was conducted to determine the addition of garden soil to natural soil for removal of coliphage viruses from treated wastewater. Treated wastewater containing viruses was passed through soil columns filled with soil collected from Sulaibiya area, Kuwait. The four soil column experiments were under operation for eight months. The first and second soil columns filled with natural soil, while the third and fourth soil columns filled with modified soil consist of Sulaibiya soil mixed with 1% garden soil. All soil columns had soil depth of 0.1 m and with constant hydraulic head of 0.1 m above soil surface. For each experimental condition, two identical columns were set up, so that the reproducibility of the results can be evaluated, producing four columns. For all columns, the tests were conducted under alternating 1 d flooding and 1 d drying conditions. Influent and effluent water samples were collected and analysed following cycles of flooding periods. The coliphage virus counts in the treated wastewater ranged between 0 and 62,800 pfu/100 ml. The laboratory results revealed that coliphage removal for Sulaibiya soil ranged between 58% and 100% with average value of 88.4%, while their removal efficiency for modified columns was between 60% and 100% with average value of 92.3%. The presence of garden soil mixed with the soil relatively increased the coliphage removal from treated wastewater. [ABSTRACT FROM AUTHOR]

Parts of the fresh groundwater of Raudhatain and Umm Al-Aish freshwater fields have been contaminated with petroleum hydrocarbons leached from petroleum lakes and petroleum-contaminated soil resulting from the 1991 Gulf War. Pump and treat methodology has been suggested for treatment of contaminated groundwater. Selection and design of methodologies for the treatment of contaminants require knowledge related to types and physiochemical properties of contaminants. Therefore, as a preliminary step toward treatment of contaminated water, a study was conducted in order to identify and quantify contaminants in terms of polar and nonpolar material of contaminated water. Groundwater samples were collected from 10 monitoring wells (nine contaminated and one uncontaminated) of water fields. Collected samples were analyzed for total petroleum hydrocarbon (TPH), total organic carbon (TOC), phenol, tannin and lignin, volatile acids and Ultraviolet (UV)-induced fluorescence before and after activated silica gel. The silica gel splits aggregated polar and nonpolar material by retaining polar material on its activated surfaces. The results of the study indicated that both polar and nonpolar materials are present in the contaminated groundwater. TPH, UV-induced fluorescence, phenol, and volatile acid contents were dominantly composed of polar material at 86%, 84%, 73%, and 90%, respectively; whereas TOC, tannin and lignin contents were dominantly composed of nonpolar material at 58% and 60%, respectively. The results suggest that treatment techniques specific for polar and nonpolar contents will be required for the treatment of petroleum hydrocarbon-contaminated groundwater. [ABSTRACT FROM AUTHOR]

Public interest in radioactivity and radionuclides distribution in the environment has increased significantly due to their toxicity, health effects, and related environmental impacts. One of the concerns for wastewater treatment and reclamation is the presence and distribution of contaminants that are not removed by the wastewater treatment plant in case its effluent is reused, particularly, for irrigation or direct potable reclamation. Radionuclides are contaminants that are not effectively removed by wastewater treatment plants. To address radionuclides in wastewater treatment plants of Kuwait, a survey was planned and conducted in five wastewater treatment plants to investigate the presence and distribution of radioactivity in wastewater. The results of gamma, alpha, and beta surveys indicated that the wastewater treatment plants investigated showed normal level of radioactivity concentrations that were below the International Atomic Energy Agency (IAEA) recommended limits for unrestricted use of the treated wastewater. It was found that radionuclides had different fates in treatment plants. Radionuclides like 40K, total 210Pb, 137Cs, 226Ra, 228Ra, 238U, and 235U would likely partition onto sludge and biosolids than be discharged in the liquid effluents. In contrast, 131I would more likely remain in the liquid effluent than partition onto the sludge. Its short half-life of 8 days would, however, mean that it would have limited effects even if the treated wastewater is widely used. Storage to segregate these radionuclides may not be feasible because it will require long periods due to the long half-lives of some of them (e.g., half-life of 137Cs is 30.7 years). [ABSTRACT FROM AUTHOR]

The knowledge of the characteristics of seawater is important for designers and engineers to design and construct a desalination plant with low operational problems. Therefore, establishing a database for Kuwait’s seawater characteristics is considered a crucial tool for researchers seeking to develop and improve desalination technologies for future applications. Because of this fact, this project was proposed to analyze the physical, chemical, and biological characteristics of Kuwait’s seawater at Subiya, Doha, Shuwaikh, Shuaiba, and Az-Zour, and other two locations that belong to the Kuwait Institute for Scientific Research (KISR) as Doha Research Plants (DRP) used as the intake for desalination/distillation research activities. A database on Kuwait’s seawater characteristics at the proposed locations was established. Then, the suitability of the proposed locations for future desalination activities was investigated depending on four fouling indices. The results obtained from the investigation of fouling indices were compared to the result obtained from experimental testing. This paper will summarize the results of the analysis and the experimental work and explore the best location for desalination activity in Kuwait and KISR. [ABSTRACT FROM AUTHOR]

A study was carried out to determine the optimum soil depth for the removal of coliphage viruses from treated wastewater. Treated wastewater containing viruses was passed through soil columns filled with soil collected from Sulaibiya area, Kuwait. The soil column experiments were under operation for eight months during the period from August 2004 to March 2005. Three soil depths were used in these experiments. These are 0.1, 0.2, 0.4, and 0.8m of natural Sulaibiya soil. For each experimental condition, two identical columns were set up, so that the changes of the results can be evaluated, producing total of eight columns. For all columns, the coliphage tests were studied only under alternating 1 d flooding and 1 d drying conditions. Influent and effluent coliphage samples were collected and analyzed following cycles of flooding periods. The coliphage virus count in the treated wastewater ranged between 0 and 62,800 pfu/100 ml. The laboratory results revealed that coliphage removal for Sulaibiya soil ranged between 58 and 100% for soil depth of 10 cm, and the viruses were completely removed after passing 20 cm thickness of soil. Also, the results indicated that no virus breakthrough occurred at soil depths of 40 and 80 cm. [ABSTRACT FROM AUTHOR]

Laboratory and field experiments have been carried out to find an optimum method for the treatment of hydrogen sulfide-rich groundwater that often occurs at comparatively shallow depths (15-40m from the surface) in the urban areas of Kuwait City and is pumped to the surface during dewatering of the construction sites. The treatment would be necessary to remove the gas from the pumped groundwater before its disposal, either on the surface or to the stormwater network, to avoid health and environmental hazards created by the release of the hydrogen sulfide gas, which is toxic, to the atmosphere or to the sea. Based on these experiments, it has been recommended that an economic and reliable hydrogen sulfide treatment facility for groundwater pumped at the study area should consist of sand filters, followed by aeration units for the removal of major part (60-70%) of hydrogen sulfide. Chlorination or activated carbon adsorption can be utilized as a polishing process to remove the residual hydrogen sulfide, depending on its concentration in the water after the aeration treatment and the rate of groundwater pumping. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional study aimed to assess the knowledge and practice of universal precautions among Faculty of Medicine, Kuwait University, medical students in their clinical years. Subjects and Methods: A self-administered questionnaire including 9 knowledge and 9 practice questions of universal precautions was used. A score was calculated for both knowledge and practice. These scores were dichotomized into less than median score (poor) and more than median score (good). 244 students were invited to participate. Results: Of the 244 students, 220 (90.2%) accepted to participate. Of the 9 knowledge questions about universal precautions, 7 were answered correctly by more than 60% (range 64.8-90.4) of the students. All questions regarding the practice of universal precautions were answered correctly by over 60% (range 61.8-96.4) of the students. The prevalence of poor knowledge was 38.2% (84/220) and poor practice was 27.7% (61/220). Grade point average was significantly (p = 0.008) associated with the knowledge status of the respondents; however, it was not significantly associated (p = 0.397) with practice of universal precautions. Furthermore, neither the knowledge status nor any of the sociodemographic variables were significantly associated with the practice of universal precautions. Conclusions: A substantial number of students of the Faculty of Medicine, Kuwait University, in their clinical years appeared to have poor level of both knowledge and practice of universal precautions. Efforts are needed to optimize the level of knowledge and practice among students to minimize the risk of preventable infections. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A study, aimed at characterizing the nature of anthropogenic and biogenic hydrocarbon contamination in the groundwater of Kuwait, was carried out using fluorescence spectroscopy and other analytical techniques. The results of these analyses have demonstrated that the groundwater in certain areas of northern Kuwait has been significantly impacted by contamination originating from the oil-contaminated surface soils. The study revealed that a water-soluble fraction (WSF) of the crude oil surface contamination appeared to be slowly leaching into the freshwater lenses located in the area. The study also showed that hydrocarbon pollutants were practically absent in the brackish water areas of central and southern Kuwait, except for a few isolated sites. However, nonpetroleum hydrocarbons, with ultraviolet-visible absorption characteristics and fluorescence characteristics typically associated with humic substances, were observed at a few sites in the brackish water fields. [ABSTRACT FROM AUTHOR]

Hydrogen sulfide occurs in high concentration (10–200 mg/l) in different parts of Kuwait City and its suburbs at relatively shallow depths (15–40 m from the surface). This was revealed by drilling through the aquifer system underlying the city and sampling and analyzing the ground water at the drilled locations. The near-absence of coliform bacteria in the sulfide-rich zones, the presence of sulfur-reducing bacteria in the deep (>80 m) Dammam Formation aquifer and a linear positive relation between the concentration of hydrogen sulfide and the total dissolved solids content suggested non-anthropogenic origin of the sulfide in the ground water of Kuwait. The upward movement of sulfide-rich water from depth and its differential flushing by surface recharge through outcrops of the aquifers appear to have given rise to the present distribution of hydrogen sulfide in the aquifers underlying the Kuwait City. [ABSTRACT FROM AUTHOR]

Reports on the possibility of ground water contamination in Kuwait following the Gulf War in 1990. Destruction of oil wells, septic tanks and drainage systems; Study on underground water in Kuwait from June to December 1993 with regard to irrigation; Analysis of water from four different aquifers for organic and inorganic material.

One of the major concerns after the Iraqi invasion was the possibility of air pollution due to the presence of many volatile contaminants emmitted from sewage tanks and pipeline. Hydrogen sulfide (H[SUB2]S) was one of the major contaminants and was a common cause of complaint from the residents in the Ardiya district in Kuwait. In this study an effort was made to develop an apparatus for the estimation of Henry's constant (H) for H[SUB2]S. The accuracy of this instrument was counter checked with respect to published data. The experiments could be reproduced with a maximum error of 10%. The experiments were performed between 20-40[SUP0]C. Henry's constants for the sewage water were found to be 600,720 and 905 atm/mole at 20, 30 and 40[SUP0]. The values were compared to the literature values and were found to be on the higher side, indicating a need for remedial measures. [ABSTRACT FROM AUTHOR]

Background: Currently, more than 30% of the population in the gulf demonstrate a body mass index (BMI) exceeding 30. This burden of obesity has proven to take a toll on the population; therefore, we created the first Kuwait National Bariatric Surgery Database to report on bariatric surgeries performed in Kuwait.Methods: Data was collected from the six public hospitals in Kuwait. This data was then submitted to a merged National Registry. Data web portal were used to upload, merge, and analyze the data.Results: The average age for participants was 32.6 years. The average preoperative BMI was 45.9 kg/m2 for males and 43.3 kg/m2 for females. 16.4% of males and 12.3% of females presented with type 2 diabetes, while the most prevalent obesity related disease was a poor functional status in both males and females (90.8% and 90.5%, respectively). Most procedures performed in Kuwait are sleeve gastrectomy. The most encountered in-hospital complication after primary bariatric surgery was bleeding (1.5%), with Roux-en-Y gastric bypass (RYGB) having the highest recorded rate of post-operative complications (3.6% bleeding). The overall rate of operative complications was 2.6%, which was most prevalent post-RYGB (10.3%) and lowest post-sleeve gastrectomy (2.5%).Conclusion: The importance of tracking and documenting the journey and change in the rates of obesity and effectiveness of bariatric procedures in individual countries with significantly high obesity rates is imperative to be able to create a plan of action to tackle this worldwide epidemic. This report will be able to provide the population with an accurate accounting that demonstrates further the safety of bariatric/metabolic surgery. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Leprosy is an ancient, chronic, communicable disease. It is claimed that it has been ‘eliminated’ as a public health problem at the global level. However, sporadic new cases are increasingly being encountered, even in non-endemic countries such as ours. A more disturbing fact is the increase in the number of cases in the indigenous population. Objectives: The aim of this study was to analyze the magnitude of the leprosy problem in the region of Farwaniya, in which most of the immigrants in Kuwait live, based on detection and prevalence rates over the last 6 years, in addition to a clinico-pathological analysis of the collected data. Patients and methods: All clinically diagnosed cases of leprosy seen over a period of 6 years, from January 2003 to December 2008, were included in the study. Socio-demographic details and clinical features were recorded on a proforma. The results were compared to similar previous data from Kuwait, and to that from other countries in the region. Results: Forty-six patients (38 male and eight female) aged 22–48 years (average 33.6 years), clinically diagnosed with leprosy, were enrolled. Of the enrolled patients, 89.1% were expatriates, while 10.9% were Kuwaiti citizens. The majority of patients (n =24) were from India, followed by Bangladesh (n =6), Egypt (n =5), Pakistan (n =3), and Indonesia, Philippines and Sri Lanka (n =1 each). The duration of signs and symptoms ranged from 1 to 24 months (average 4.7 months). A total of 58.5% of expatriate patients developed their symptoms 2–5 years after entry into Kuwait. Delayed diagnosis (after 12 weeks) was observed in 70.8%. Thirty-one patients (67.4%) had multibacillary leprosy (borderline lepromatous n =15, borderline type n =7, borderline tuberculoid n =5, and lepromatous leprosy n =4), while 15 patients (32.6%) had the paucibacillary form of leprosy (tuberculoid type n =8, borderline tuberculoid n =7). The detection of lepra bacilli in tissue sections was the most common diagnostic tool (67.4%), while nasal smears showed positive results in 28.3% of cases and the slit skin smear in 17.4%. Conclusions: This study shows that leprosy in the region of Farwaniya, Kuwait, which has predominantly been a disease of immigrants, has started to infect the Kuwaiti population; such cases may just represent the tip of the iceberg. Careful examination of immigrants on arrival and subsequent periodic regular check-ups are required to prevent the spread of the disease. Furthermore, early referral of suspected cases and screening of contacts, with initiation of treatment as early as possible, are essential to control the spread of leprosy in Kuwait. [Copyright &y& Elsevier]

The prevalence of Salmonella isolated from a poultry farm and from the poultry processing plant environment were evaluated from August 2004 to July 2005 along with microbial antibiotic resistance. In total, 3242 samples were collected from the farm and processing plant. Samples collected from the farm included hatching eggs, paper liners, litter, feed, water, drinkers, air, bird rinse, and ceca. While samples collected from the processing plant included carcass rinse and ceca. Out of 2882 samples collected from the farm, the overall percentage prevalence of Salmonella was 5.4% with prevalence rates of 10%, 1.5%, 0.7%, 0.2%, 13.5%, and 12.6% for hatching eggs, litter, feed, drinkers, bird rinse and ceca, respectively. No Salmonella were detected in any of the paper liner, water, or air samples. Out of 360 samples collected from the processing plant, the overall percentage prevalence of Salmonella was 4.7% with prevalence rates of 6.1% and 3.3% for carcass rinse and ceca samples, respectively. Salmonella Enteritidis was the most prevalent serotype. All of the isolates were resistant to at least one antibiotic and 10 different resistance profiles were found among 173 isolates of Salmonella Enteritidis. Resistance to ampicillin, nalidixic acid, and tetracycline were the most common. The widespread occurrence of multiple resistant Salmonella Enteritidis is a cause for concern, and local regulatory enforcement agencies should ensure prudent use of antibiotics.

A total of 128 MRSA isolates from a burns unit in 1992 and 1997 was studied by resistotyping, plasmid analysis and pulsed-field gel electrophoresis (PFGE) of SmaI-digested chromosomal DNA to ascertain whether a clone of MRSA had persisted in the unit or whether different clones had been introduced at different times. All the MRSA isolates produced beta-lactamase and had high MICs to methicillin (>256 mg/L). All were resistant to tetracycline, kanamycin, cadmium acetate and mercuric chloride. Most were resistant to gentamicin, neomycin, erythromycin, chloramphenicol, trimethoprim, ciprofloxacin, propamidine isethionate and ethidium bromide, and were susceptible to minocycline, vancomycin and teicoplanin. None of the 1992 isolates was resistant to mupirocin, but 56% and 19% of the 1997 isolates expressed high- and low-level mupirocin resistance, respectively. Many of the 1997 isolates had acquired a 38-kb plasmid encoding high-level mupirocin resistance. The 1992 isolates had two main PFGE patterns; 82% of them belonged to PFGE pattern 1. The 1997 isolates had PFGE pattern 1, the same as the majority of the 1992 isolates. All MRSA isolates from both years carried the mecA gene in the same SmaI fragment. These findings demonstrated that a clone of MRSA that was prevalentin the burns unit in 1992 had persisted and became the predominant clone in 1997.