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Abstract Background Mitochondrial DNA (mtDNA) copy number is associated with tumor activity and carcinogenesis. This study was undertaken to investigate mtDNA copy number in papillary thyroid cancer (PTC) tissues and to evaluate the risk of PTC development. The clinicopathological features of patients and mtDNA copy number were correlated. The value of mtDNA copy number was evaluated as a biomarker for PTC. Method DNA was extracted from 105 PTC tissues and 67 control thyroid tissues, and mtDNA copy number mtDNA oxidative damage were determined using qPCR techniques. Results Overall, the relative mtDNA copy number was significantly higher in PTC patients (p

Context: Persistent infection with high-risk human papillomavirus (hr-HPV) types is associated with high-grade cervical abnormalities. Aims: The aim of the study was to find most hr-HPV types causing persistent infection in abnormal cytological samples using Aptima HPV testing and discuss the compatibility of the Gardasil 9 vaccine in targeting most types. Settings: The study was conducted in a cytology laboratory in a tertiary hospital. Design: This is a retrospective observational study. Methods and Materials: Cytology and HPV Aptima test reports were obtained for abnormal cervical samples for a 6-year period. Statistical Analysis Used: Pearson Chi-square test. Results: Reports of 2834 abnormal cervical samples were analyzed. Aptima testing was positive in 21% of samples, including 92% of squamous cell carcinoma (SCC), 76.4% of the high-grade squamous intraepithelial lesion (HSIL), 52% of low-grade squamous intraepithelial lesion (LSIL), 40% of adenocarcinoma (ADC), and 21% of atypical squamous cells that cannot exclude HSIL (ASC-H). The Aptima other hr-HPV group was most common (60%), HPV16 was 26%, HPV18/45 was 9.6%, and double HPV infection was 4.3%. HPV16 was the most common infection in HSIL+ cases. HPV infection was most common in age groups (30–39) and (40–49), and a shift to age groups (50–59) and ≥60 was seen in HSIL+ cases. Conclusions: This study is the first of its kind in correlating age with hr-HPV and cytology findings in the Middle East and adds to previous knowledge related to the prevalence and Aptima testing of HPV. The outcome could be used as a baseline for the Gardasil 9 vaccine and for the assessment of its effectiveness after three or five years from initiation.

Ration contamination with cadmium chloride (CdCl2) leads to serious economic loss. The current study aimed to explain the ameliorative effect of grape seed extract (GSE) either alone or in combination with CdCl2. One hundred and fifty chicks were used in the current study. They were equally alienated into 6 groups; group I was kept as control. Group II: given grape seed extract by the first dose (GSE1) of 250 mg/kg; group III: given grape seed extract by the second dose (GSE2) of 500 mg/kg; group IV: given cadmium chloride (CdCl2) to evaluate the undesirable effects of the dose (100 mg/kg diet). Group V: given combination of GSE1+ CdCl2, group VI: given combination of GSE2+ CdCl2. At the end of the 3rd and 5th weeks, the following parameters were measured: Serum oxidants and antioxidants (GSH, SOD, CAT and MDA), brain oxidants and antioxidants (SOD, CAT, MDA, and NO), semi-quantitative RT-PCR detection of brain and liver GST and GPx, as well as serum cytokines (IL-1β, IL-10, and TNF-α), were determined. The results put on display show that GSE extract considerably ameliorated the levels of serum and tissue oxidants and antioxidants, as well as cytokines that ramshackle CdCl2. Histopathological assessment of brain tissue and BAX brain sections was in concurrence with the immunological, oxidant, antioxidant, and RT-PCR results. It is important to take into consideration that the immunostimulant, antioxidative properties of GSE are mechanistically achieved. So, GSE could be used as a protective agent against ration contamination.

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.

Eman Hasan1, Samuel Olusi2, Adel Al-Awadhi3, Khalid Mokaddem1, Prem Sharma4, Sunila George21Rheumatic Disease Unit, Al-Amiri Hospital, Ministry of Health, Kuwait; 2Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait; 3Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait; 4Computer Unit, Health Sciences Center, Kuwait University, KuwaitBackground: Rituximab, a monoclonal antibody that selectively targets CD20-positive B-lymphocytes, is used for the treatment of patients with rheumatoid arthritis (RA) with an inadequate response or tolerance to tumor necrosis factor inhibitors. The objective of this study was to investigate the effects of rituximab treatment on the serum concentrations of vitamin D, interleukin (IL) 2, IL-6, IL-7, and IL-10 in patients with rheumatoid arthritis (RA).Methods: Forty-five patients, aged 25–78 years, were enrolled into a cohort prospective study. All patients were treated with intravenous rituximab. Disease activity score-28 (DAS-28) and serum concentrations of rheumatoid factor (RF), C-reactive protein (CRP), anticyclic citrullinated peptide (anti-CCP), erythrocyte sedimentation rate (ESR), health assessment questionnaire (HAQ), vitamin D, ILs 2, 6, 7, and 10 were estimated in the patients before and after treatment with rituximab.Results: DAS-28, HAQ score, and serum concentrations of CRP, RF, anti-CCP, IL-2, IL-6, IL-7, IL-10, and ESR significantly decreased after treatment. All 45 patients had vitamin D deficiency before treatment and this did not significantly change after treatment. However no significant association was found among serum vitamin D concentration and any of the ILs.Conclusion: We concluded from this study that although rituximab treatment of patients with RA significantly reduced their disease activity and serum concentrations of IL-2, IL-6, IL-7, and IL-10, it did not significantly alter their vitamin D status. Furthermore, no significant association was found among serum vitamin D concentration and any of the ILs.Keywords: vitamin D, rituximab treatment, rheumatoid arthritis, interleukins

Background and Objectives : Radiological and histological evaluations are affected by subjective interpretation. This study determined the level of inter- and intraobserver variation among radiologists for detection of abnormal parenchymal lung changes on high resolution computed tomography (HRCT). Methods : HRCT images of 65 patients known to have systemic lupus erythematosus (with clinical pulmonary involvement) were retrospectively reviewed by four nonthoracic radiologists (two with expertise in magnetic resonance [MR] and two general radiologists). Each radiologist read the scans twice, with an interval between readings of at least 6 months. The interobserver variation among the first and second readings of the four radiologists and the intraobserver variation of each radiologist′s two readings were assessed by the kappa statistic. Results : There was good agreement between the first and second readings of each radiologist. There was moderate agreement between the two readings of one MR radiologist (kappa=0.482); the other three radiologists had kappa values that were good to excellent (0.716, 0.691, and 0.829). There was a clinically acceptable level of interobserver variability between all radiologists. The agreement was fair to moderate between the MR radiologist and the other observers (kappa range: 0.362-0.519) and moderate to good between the other three radiologists (0.508-0.730). Conclusion : The interpretation of imaging findings of abnormal parenchymal lung changes on HRCT is reproducible and the agreement between general radiologists is clinically acceptable. There is reduced agreement when the radiologist is not involved on a regular basis with thoracic imaging. Difficult or indeterminate cases may benefit from review by a chest radiologist.

Background: The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal symptoms/disorders. We estimated the incidence of musculoskeletal pain in the first community-based COPCORD study in Kuwait. Subjects and Methods: The validated Arabic version of the WHOILAR COPCORD Core Questionnaire was used in a survey of 2500 randomly selected Kuwaiti households to assess the frequency of musculoskeletal pain, disability, and health-seeking behavior in adult Kuwaitis. Those subjects reporting no musculoskeletal pain were identified and followed-up for a period of one year by contacting them every 2 weeks. Once a respondent reported pain, an appointment to report to hospital was offered and the subject was examined by a rheumatologist using American College of Rheumatology (ACR) criteria. Results: Of 5159 adults who were non-complainers in an earlier prevalence phase of the study, 3341 responded to phone calls (response rate of 65%). The incidence of musculoskeletal pain was 6.6% (95%CI, 3.4%- 9.7%). Age- and sex-adjusted incidence rates were 7.2% (95%CI, 3.4%- 10.5%) for females and 6.1% (95%CI, 3.1%-9.2%) for males. The incidence rate increased with increasing age, body mass index, and with being married. The common sites of pain were knee, low back and shoulder. Conclusion: The incidence of musculoskeletal pain among Kuwaiti adults is reported for the first time. Further studies adopting the same instrument in other communities are warranted to compare with our findings.

This study aims to evaluate the performance and effectiveness of six spectral water indices - derived from Multispectral sentinel-2 data - to detect soil moisture and inundated area in arid regions to be used as an indicator of mudflow phenomena to predict high-risk areas. Herein, the validation of the performance of spectral indices was conducted using threshold method, spectral curve performance, and soil-line method. These indirect validation techniques play a key role in saving time, effort, and cost, particularly for large-scale and inaccessible areas. It was observed that the Normalized Difference Water Index (NDWI), Modified Normalized Difference Water Index (mNDWI), and RSWIR indices have the potential to detect soil moisture and inundated areas in arid regions. According to the temporal spectral curve performance, the spectral characteristics of water and soil moisture were distinct in the Near infrared (NIR) and Short-wave Infrared (SWIR1,2) bands. However, the rate and degree differed between these bands, depending on the amount of water in the soil. Furthermore, the soil line method supported the appropriate selection of threshold values to detect soil moisture. However, the threshold values varied with location, time, season, and between indices. We concluded that considering the factors influencing the behavior of water and soil reflectivity could support decision-makers in identifying high-risk mudflow locations.

Background and Aims: Treatments for ulcerative colitis (UC) differ in safety, efficacy, and route of administration; patient preferences for treatment attributes should be considered in treatment decisions. No study to date has explored patient preferences for moderate-to-severe UC treatment in Middle Eastern countries. Methods: A discrete-choice experiment aimed to quantify treatment preferences in patients with moderate-to-severe UC in 5 Middle Eastern countries (Saudi Arabia, Kuwait, Jordan, the United Arab Emirates, and Lebanon). Respondents chose between experimentally designed profiles for hypothetical UC treatments with varying efficacy (time until UC symptoms improve and chance of UC symptom control after 1 year), side effects (annual risk of serious infection, 5-year risk of malignancy), mode and frequency of administration, and need for occasional steroid use. A random-parameters logit model was used to estimate preference weights for these attributes, from which conditional relative importance estimates and maximum acceptable increases in risks of serious infection and malignancy were derived. Results: Among 365 adults with moderate-to-severe UC who completed the survey (mean age, 36 years; 50% female), 5-year risk of malignancy and symptom control after 1 year had the greatest conditional relative importance. Respondents were generally willing to accept statistically significant increases in annual risk of serious infection and 5-year risk of malignancy in exchange for better efficacy, changes in mode of administration and dosing schedule, and avoiding occasional steroid use. Conclusion: Of the attributes evaluated, individuals with UC in Middle Eastern countries most value avoiding 5-year risk of malignancy and a higher probability of symptom control, on average.

Abstract Crohn's disease (CD) is a chronic inflammatory bowel disease. An imbalanced microbiome (dysbiosis) can predispose to many diseases including CD. The role of oral dysbiosis in CD is poorly understood. We aimed to explore microbiome signature and dysbiosis of the salivary microbiome in CD patients, and correlate microbiota changes to the level of inflammation. Saliva samples were collected from healthy controls (HC) and CD patients (n = 40 per group). Salivary microbiome was analyzed by sequencing the entire 16S rRNA gene. Inflammatory biomarkers (C-reactive protein and calprotectin) were measured and correlated with microbiome diversity. Five dominant species were significantly enriched in CD, namely Veillonella dispar, Megasphaera stantonii, Prevotella jejuni, Dolosigranulum pigrum and Lactobacillus backii. Oral health had a significant impact on the microbiome since various significant features were cariogenic as Streptococcus mutans or periopathogenic such as Fusobacterium periodonticum. Furthermore, disease activity, duration and frequency of relapses impacted the oral microbiota. Treatment with monoclonal antibodies led to the emergence of a unique species called Simonsiella muelleri. Combining immunomodulatory agents with monoclonal antibodies significantly increased multiple pathogenic species such as Salmonella enterica, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Loss of diversity in CD was shown by multiple diversity indices. There was a significant negative correlation between gut inflammatory biomarkers (particularly calprotectin) and α-diversity, suggesting more inflammation associated with diversity loss in CD. Salivary dysbiosis was evident in CD patients, with unique microbiota signatures and perturbed species that can serve as disease biomarkers or potential targets for microbiota modulation. The interplay of various factors collectively contributed to dysbiosis, although each factor probably had a unique effect on the microbiome. The emergence of pathogenic bacteria in the oral cavity of CD patients is alarming since they can disturb gut homeostasis and induce inflammation by swallowing, or hematogenous spread of microbiota, their metabolites, or generated inflammatory mediators.

Abstract It is critical to remove dyes from wastewater as they cause harm to human and aquatic life due to their carcinogenic, toxic, and mutagenic effects. Here, low-cost activated carbons (CPs) were produced from the date (Phoenix dactylifera L.) pits. The prepared CPs were chemically activated utilizing zinc chloride to obtain activated carbons from date pits (ZCPs). The physicochemical properties, chemical composition, and morphology of ZCPs material and the active surface functional groups involved in adsorption were identified using N2 adsorption–desorption isotherm, scanning electron microscopy, point of zero charges (pHPZC), and Fourier transforms spectroscopy. The ZCPs biocomposite was applied for the Brilliant green (BG) removal from aqueous solutions, where the efficiency was assessed as functions of pH value, foreign ions, the initial dye concentration, dose of adsorbent, adsorption time, and temperature. The outcomes showed that the prepared ZCPs biocomposite exhibited high uptake of BG with a qe of 247.752 mg/g. The isotherm and kinetic studies show that the adsorption process of BG dye onto ZCPs biocomposite followed Langmuir, and pseudo-second-order models, respectively. From the estimated thermodynamic functions, it was found that the nature of the BG dye adsorption process onto the prepared ZCPs adsorbent was endothermic and spontaneous. With a relative standard deviation of less than 3%, the prepared ZCPs were successfully applied for the removal of BG from real water samples with a recovery of more than 90%. The plausible mechanism of BG adsorption onto the prepared ZCPs can be assigned to various interactions, such as pore–filling, electrostatic attraction, H-bonding, and π–π stacking.

Mangrove ecotourism is gaining immense popularity in the Gulf Cooperation Council (GCC) countries as a neoliberal conservation tool, and it has contributed significantly to the growth of the tourism sector in the region over the past two decades. However, there is no comprehensive review on the full extent of mangrove ecotourism activities and the contribution to mangrove conservation/restoration and economic growth in the region. A systematic literature review approach was used to examine the evolution of mangrove ecotourism in the GCC countries from 2010 to 2023. A total of 55 articles were retrieved from the Google and Google Scholar search engines, and the Scopus and Web of Science databases were incorporated. We synthesized the results and provided perspectives on the following: (1) the geographical and temporal distribution of studies in relation to mangrove extent, (2) key sites, attractions, and values for mangrove ecotourism activities, (3) the positive and negative impacts of mangrove ecotourism, and (4) existing mangrove conservation and restoration initiatives for the growth of mangrove ecotourism in the GCC countries. The findings underscore the significance of mangrove ecotourism in supporting economic development, protecting coastal ecosystems, and sustaining local livelihoods in the GCC countries. However, this study highlights the crucial need for sustainable coastal environmental management through integrated land use planning and zoning to address the negative impacts of anthropogenic pressures on mangrove ecosystems and ecotourism attractions. The use of remote sensing tools is invaluable in the monitoring of mangrove ecosystems and associated ecotourism impacts for informing evidence-based conservation and restoration management approaches. Thus, harnessing mangrove ecotourism opportunities can help the GCC countries with balancing economic growth, coastal environmental sustainability, and community well-being.

Screening mammography is considered to be the most effective means for the early detection of breast cancer. However, epidemiological studies suggest that longitudinal exposure to screening mammography may raise breast cancer radiation-induced risk, which begs the need for optimization and internal auditing. The present work aims to establish a comprehensive well-structured Diagnostic Reference Level (DRL) system that can be confidently used to highlight healthcare centers in need of urgent action, as well as cases exceeding the dose notification level. Screening mammographies from a total of 2048 women who underwent screening mammography at seven different healthcare centers were collected and retrospectively analyzed. The typical DRL for each healthcare center was established and defined as per (A) bilateral image view (left craniocaudal (LCC), right craniocaudal (RCC), left mediolateral oblique (LMLO), and right mediolateral oblique (RMLO)) and (B) structured compressed breast thickness (CBT) criteria. Following this, the local DRL value was established per the bilateral image views for each CBT group. Screening mammography data from a total of 8877 images were used to build this comprehensive DRL system (LCC: 2163, RCC: 2206, LMLO: 2288, and RMLO: 2220). CBTs were classified into eight groups of

Background: The non-vitamin K antagonist oral anticoagulants (NOACs) have become the mainstay anticoagulation therapy for patients requiring oral anticoagulants (OACs) in the Gulf Council Cooperation (GCC) countries. The frequency of NOAC-associated major bleeding is expected to increase in the Emergency Department (ED). Nonetheless, we still lack local guidelines and recommendations for bleeding management in the region. The present Delphi-based consensus aims to establish a standardized and evidence-based clinical care pathway for managing NOAC-associated major bleeding in the Kingdom of Saudi Arabia (KSA) and the United Arab Emirates (UAE). Methods: We adopted a three-step modified Delphi method to develop evidence-based recommendations through two voting rounds and an advisory meeting between the two rounds. A panel of 11 experts from the KSA and UAE participated in the consensus development. Results: Twenty-eight statements reached the consensus level. These statements addressed key aspects of managing major bleeding events associated with NOACs, including the increased use of NOAC in clinical practice, clinical care pathways, and treatment options. Conclusion: The present Delphi consensus provides evidence-based recommendations and protocols for the management of NOAC-associated bleeding in the region. Patients with major NOAC-induced bleeding should be referred to a well-equipped ED with standardized management protocols. A multidisciplinary approach is recommended for establishing the association between NOAC use and major bleeding. Treating physicians should have prompt access to specific reversal agents to optimize patient outcomes. Real-world evidence and national guidelines are needed to aid all stakeholders involved in NOAC-induced bleeding management.

In the last few decades, revegetation strategies for ecosystem restoration have received great attention in dryland studies, especially those related to the restoration and revegetation of native desert plants to combat land degradation. Long-term monitoring and assessment are critical for the restoration programs to track the progress of the restoration program goals. The effectiveness and success of monitoring depend on the selected methods with respect to spatial and temporal scales. Traditional methods for vegetation monitoring are time-consuming, expensive, and require considerable labor efforts (manpower) in terms of field measurements, collecting samples, lab analysis, and the difficulty of accessing some study areas. Thus, satellite remote sensing images have been widely used to monitor land degradation and restoration programs using multispectral and hyperspectral sensors and indices such as NDVI, which is the most popular index for vegetation monitoring. However, such techniques showed many limitations when used in arid ecosystems, especially for seasonal vegetation assessments, which could mislead the monitoring and assessment of the restoration projects. This paper discusses lessons learned from previous research work, including the limitations of using satellite remote sensing in arid ecosystems and the use of UAV methods to overcome these issues and challenges to provide more accurate outcomes for seasonal assessment of vegetation in arid landscapes.

Background: A growing body of evidence underscores the beneficial impact of therapeutic drug monitoring (TDM) on the efficacy and cost-effectiveness of anti-tumour necrosis factor (TNF) therapy in patients with inflammatory bowel disease (IBD). Objectives: We surveyed clinician attitudes, perceptions and barriers related to TDM in IBD in the Middle East. Design: A 15-question survey was distributed through national gastroenterological societies in five Middle Eastern countries (UAE, Saudi Arabia, Kuwait, Lebanon and Egypt). Methods: Data on clinician characteristics, demographics, utilization patterns and obstacles related to the adoption of TDM with anti-TNFs were gathered. Logistic regression analysis was used to predict factors influencing the utilization of TDM. Results: Among 211 respondents (82% male), 82% were consultants, 8% were physicians with an interest in gastroenterology (GI), and 6% were GI trainees. Of these, 152 met inclusion criteria, treating >5 IBD patients per month and ⩾1 with an anti-TNF per month. TDM was used in clinical practice by 78% (95% CI: 71–85) of respondents. TDM was utilized following the loss of response (LOR) in 93%, for primary non-response (PNR) in 40% and before restarting anti-TNF therapy after a drug holiday in 33% of respondents, while 34% used TDM proactively. No specific factors were associated with the use of TDM. Barriers to TDM use included cost (85%), time lag to results (71%) and lack of insurance reimbursement (65%). Overall knowledge of TDM (70%), interpretation and actioning of results (76%) or awareness of clinical guidelines (57%) were not perceived as barriers. If barriers were removed, 95% would use TDM more frequently; 93% for LOR, 60% for PNR, 50% when restarting after a drug holiday, and 54% would use TDM proactively. Conclusion: Most gastroenterologists use TDM for LOR, with cost, time lag and insurance reimbursement being significant barriers. Addressing these barriers would increase the judicious use of reactive and proactive TDM to optimize anti-TNF therapy in IBD.

Abstract In the present study, the 1-Nicotinoyl-4-phenyl thiosemicarbazide (H2NPT) multidentate nitrogen, oxygen and sulfur containing ligand is being synthesized in a simple single step reaction by condensing 1:1 molar ratio of ethanolic solutions of both phenyl isothiocyanate and nicotinoyl hydrazine. The prepared H2NPT and its complexes with Co2+, Ni2+ and Zn2+ and Cu2+ were characterized by pH-metric titrations, elemental analysis, FTIR, electronic spectra and thermogravimetric (TGA) analyses. The association constant of the ligand and the stability constants of its complexes were calculated by pH-metric measurements in 50% ethanol–water mixture. Also, DFT method was used to draw the geometry of all compounds and the parameters such as bond lengths, bond angles, dipole moment, Frontier orbitals (HOMO, LUMO), MEP and other energetic parameters (optical energy gap, softness, hardness, electronegativity) were evaluated. The prepared H2NPT reacted with Co2+, Ni2+ and Zn2+ and Cu2+ metal ions to form colored precipitates that were readily floated to the surface solution using oleic acid (HOL) surfactant with vigorous shaking of the flotation cell. The heavy metals' concentrations in the dissolved precipitates are determined by flame atomic absorption spectrometry (FAAS). The different parameters affecting the flotation process were thoroughly investigated, viz. pH of sample solution, concentration of ligand, metal ions and HOL, temperature and interfering ions. Nano-gram quantities of Cu2+, Co2+, Ni2+ and Zn2+in 1500-ml samples are quantitatively determined with 1-Nicotinoyl-4-phenyl thiosemicarbazide (H2NPT) at pH 3.0–6.5 for Cu2+ and at 7.0–7.5 for Co2+, Ni2+ and Zn2+. The concentrations of these heavy metals are increased 300-fold. Interferences, on the flotation process, from various foreign ions were avoided by adding excess H2NPT. The mode of chelation between H2NPT and the investigated metal ions is proposed to be through the S, N and/or O atoms of the ligand. The mechanism of flotation is proposed to be due to an electrostatic interaction between the HOL surfactant and the formed metal–ligand complexes through H-bond formation. The proposed multi-element flotation methodology has been utilized for the determination of the analytes in certified reference materials, alloys, synthetic mixtures and in water samples with a recovery % more than 90% and a relative standard deviation (RSD), as a precision

Abstract Background Understanding the factors that influence adolescent’s perception of fast food and their fluid consumption is crucial for designing effective nutrition education programs tailored to this population. This study aimed to evaluate the associations of sex and the use of media and the internet with adolescents' perception of fast foods and the amount of fluid consumption. Methods A cross-sectional survey was conducted on school adolescents between the ages of 15 and 18 years in Kuwait, using a multistage stratified random sampling method (N = 706 adolescents; 343 boys and 363 girls). A pre-tested and specifically designed self-report questionnaire covering several measures such as: (a) types of foods that are considered fast foods; and (b) participant’s fluid consumption. Body weight and height were measured using calibrated medical scales. Body mass index (BMI) was computed. The adolescents were stratified by sex into two groups: boys and girls, for the purpose of analysis. Results Seven out of 14 food choices showed significant sex differences (p values ranged from 0.016 to