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Students of health-related subjects have an important role in national strategies on HIV/AIDS prevention. This study assessed the knowledge, attitudes and beliefs towards HIV/AIDS among students at health institutes in Sana'a city, Yemen. A descriptive cross-sectional questionnaire survey was conducted on 600 students selected by cluster sampling. Students had a moderate level of HIV/AIDS knowledge (an average of 67.6% were correct on all items). Nevertheless, 82.3% knew that HIV could be transmitted by sexual intercourse without a condom, 87.5% from syringes, 71.8% from infected blood and 80.7% from mother to child. Misconceptions about how HIV is transmitted (e.g. hugging and kissing or sharing food, swimming pools and classrooms) were found among 41.5% of the students. Attitudes towards people living with HIV/AIDS showed that 59.8% of students were accepting and positive. There was a common opinion among respondents that HIV-infected persons needed to be punished (65.5%) and isolated (41.0%); however, 86.8% were willing to care for an HIV-infected person. [ABSTRACT FROM AUTHOR]

Thirty-two commonly consumed dishes (fish dishes, sandwiches, soup, pastries, salads, kubas, sweets and dairy dishes) in Kuwait were analysed for total dietary fibre, soluble dietary fibre and insoluble dietary fibre. The total dietary fibres were the highest in salads with an average of 5.39 mg/100 g edible portion. The other dishes contained variable amounts of dietary fibre with ranges of 3.36–4.22, 4.73–4.99, 1.85–4.3, 1.99–3.8, 1.73–2.5 and 0–3.33 mg/100 g for sandwiches, soup, pastries, fish, and sweet dishes respectively. The dairy dishes contained 0% fibre. For the insoluble dietary fibre, the range for all dishes was from 0 to 6.55%, while for the soluble fraction it was from 0 to 2.52%. [Copyright &y& Elsevier]

Attempts to measure the concentration of trace elements in the colon of rats with colitis by acetic acid or trinitrobenzene-sulfonic acid administration. Materials and methods; Information on glutathione peroxidase activity; Cause of oxidative stress conditions.

Aim: Investigate the effectiveness of IDegLira, a fixed-ratio combination of insulin degludec/liraglutide, in a real-world setting in patients with type 2 diabetes mellitus in the United Arab Emirates., Methods: This non-interventional study enrolled adults switching to IDegLira from basal insulin (BI) or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with/without concomitant oral antidiabetic drugs (OADs). Primary endpoint was change in HbA1c from baseline, assessed using a mixed model for repeated measurements., Results: Among 263 patients (BI ± OADs, n = 206; GLP-1 RA ± OADs, n = 57), mean baseline HbA1c was 9.29 % (78 mmol/mol). After 26 weeks, HbA1c was significantly reduced (BI ± OADs, -0.83 % [-9.0 mmol/mol] and GLP-1 RA ± OADs, -1.24 % [-13.5 mmol/mol]; both p < 0.0001). Fasting plasma glucose (FPG) was significantly reduced (-39.48 mg/dL [BI ± OADs] and -82.49 mg/dL [GLP-1 RA ± OADs]; both p < 0.0001). Before treatment initiation, 3/263 patients experienced ≥ 1 severe hypoglycaemic episode and 7/263 patients experienced ≥ 1 non-severe hypoglycaemic episode compared with 1/263 patients who had ≥ 1 severe and 1/263 who had ≥ 1 non-severe episode at end of study. Body weight decreased significantly among patients switching from BI ± OADs (-1.05 kg [p < 0.0001]). Treatment was well tolerated., Conclusions: IDegLira significantly reduced HbA1c and FPG in this real-world setting, along with less frequent episodes of hypoglycaemia. Switching to IDegLira offers effective treatment intensification for type 2 diabetes patients with inadequate glycaemic control., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: A.B. has received honoraria for lectures from many companies, including Novo Nordisk, AZ, MSD, Sanofi, Alhikma, Servier etc. M.K.J. has received research funds as a PI from Sanofi, Novo Nordisk, Johnson & Johnson, and MSD, and has received speaker honoraria as an invited speaker in continuing medical education events from Sanofi, Novo Nordisk, Novartis, and MSD. F.A. has received payment as a PI and co-PI and research coordinator. S.A. has received payment or honoraria for lectures. D.K.D. has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, Novo Nordisk, Lilly, Abbott, MSD, Servier, and Hikma Pharmaceuticals, and has received support for attending meetings and/or travel from AACE Community Dubai., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that mainly affects children and young adults. It is associated with debilitating and long-life complications. Therefore, understanding the factors that lead to the onset and development of these complications is crucial. To our knowledge this is the first study that attempts to identify the common differentially expressed genes (DEGs) in T1DM complications using whole transcriptomic profiling in United Arab Emirates (UAE) patients. The present multicenter study was conducted in different hospitals in UAE including University Hospital Sharjah, Dubai Hospital and Rashid Hospital. A total of fifty-eight Emirati participants aged above 18 years and with a BMI < 25 kg/m 2 were recruited and forty-five of these participants had a confirmed diagnosis of T1DM. Five groups of complications associated with the latter were identified including hyperlipidemia, neuropathy, ketoacidosis, hypothyroidism and polycystic ovary syndrome (PCOS). A comprehensive whole transcriptomic analysis using NGS was conducted. The outcomes of the study revealed the common DEGs between T1DM without complications and T1DM with different complications. The results revealed seven common candidate DEGs, SPINK9, TRDN, PVRL4, MYO3A, PDLIM1, KIAA1614 and GRP were upregulated in T1DM complications with significant increase in expression of SPINK9 (Fold change: 5.28, 3.79, 5.20, 3.79, 5.20) and MYO3A (Fold change: 4.14, 6.11, 2.60, 4.33, 4.49) in hyperlipidemia, neuropathy, ketoacidosis, hypothyroidism and PCOS, respectively. In addition, functional pathways of ion transport, mineral absorption and cytosolic calcium concentration were involved in regulation of candidate upregulated genes related to neuropathy, ketoacidosis and PCOS, respectively. The findings of this study represent a novel reference warranting further studies to shed light on the causative genetic factors that are involved in the onset and development of T1DM complications., (© 2022. The Author(s).)

Introduction: To analyse the safety and effectiveness of gliclazide modified release (MR) in adults with type 2 diabetes mellitus participating in Ramadan from three geographically and culturally different regions of the world included in the DIA-RAMADAN study., Methods: DIA-RAMADAN was a real-world, observational, international, non-comparative study. The global study population was divided into three regional subgroups, with data gathered at inclusion 6-8 weeks prior to Ramadan (V0), during Ramadan (4.5 weeks) and 4-6 weeks after Ramadan (V1). Primary endpoint was the proportion of patients reporting ≥ 1 symptomatic hypoglycaemic events (HE), which were collected using a patient diary along with other adverse events., Results: Patient numbers from the three regions were n = 564 (46.5%; Indian sub-continent), n = 354 (29.1%; Middle East) and n = 296 (24.4%; South-East Asia). Patient baseline characteristics, demographics, fasting habits and antidiabetic treatments varied between regions. There were similar proportions of symptomatic HE between regions, with no severe HE. Significant weight reductions were observed in all regions following Ramadan, along with reductions in HbA 1c and fasting plasma glucose., Conclusion: These real-world study data indicate that gliclazide MR is safe and effective for management of type 2 diabetes during Ramadan in all three regions studied as part of DIA-RAMADAN., Trial Registration: Clinicaltrials.gov identifier NCT04132934. INFOGRAPHIC.

Aims: To explore the real-world safety and effectiveness of gliclazide modified release (MR) in patients with type 2 diabetes mellitus (T2DM) fasting during Ramadan., Methods: DIA-RAMADAN (NCT04132934) was a prospective, international, observational study conducted in nine countries. Patients >18 years of age with T2DM (N = 1244) were examined at an inclusion visit (V0) occurring 6-8 weeks before the start of Ramadan. Patients received a diary to report treatment changes, hypoglycaemic events (HEs), and other adverse events. Gliclazide MR was taken once daily for 14-18 weeks. A second visit (V1) was conducted 4-6 weeks after the end of Ramadan. The primary endpoint was the proportion of patients reporting ≥1 symptomatic HE. Changes in HbA 1c , fasting plasma glucose (FPG), and body weight were secondary endpoints., Results: The proportion of patients reporting ≥1 symptomatic HE during Ramadan was low (2.2%) with no reported severe HEs. There was a significant reduction in HbA 1c (-0.3%), FPG (-9.7 mg/dL), body weight (-0.5 kg) and body mass index (-0.2 kg/m 2 ) between V0 and V1 (p < 0.001)., Conclusions: Patients with T2DM treated with gliclazide MR during Ramadan have a low risk of hypoglycaemia and maintain glycaemic control and weight while fasting., Competing Interests: Declaration of competing interests Achmad Rudijanto has received research grants from Novo Nordisk, Sanofi-Aventis, and Servier; Advisory board fees from Sanofi-Aventis, Astra Zeneca, Novo Nordisk, Ely Lilly, and Novartis. Mohamed Hassanein has attended advisory boards or received speaker honoraria from Servier, MSD, Novartis, Novo Nordisk, Sanofi-Aventis, Astra Zeneca and Eli Lilly. Syed Abbas Raza has participated in advisory boards for Sanofi-Aventis, Novo Nordisk, Servier and Ely Lilly. Thamer Alessa has received research grants from Servier; Advisory Board fees from Sanofi-Aventis, Astra Zeneca, Novo Nordisk, Ely Lilly, and Novartis; Honoraria from Sanofi-Aventis, Astra Zeneca, Servier, Novo Nordisk, Ely Lilly, and Novartis. Wan Mohd Izani Wan Mohamed has received research grants Sanofi Aventis, Novartis, GSK, Novo Nordisk, Lilly, Servier, Astra Zeneca, BI, Takeda, MSD, Bayer, and J&J; Speaker honoraria from Novo Nordisk, Lilly, GSK, Sanofi, Novartis, MSD, Astra Zeneca, Servier, Merck, BioRad and Chemopharm. Shehla Shaikh has received advisory board fees and speaker honoraria from Novo Nordisk, Eli Lilly, Novartis, Sanofi-Aventis, MSD and Servier. Inass Shaltout has been a speaker and advisor to Sanofi, Novartis, MSD, Astra Zeneca, Novo Nordisk, Lilly, Servier, Takeda and Hekma. Agung Pranoto has received research grants from Novo Nordisk and Servier; Advisory Board fees from Sanofi-Aventis, Astra Zeneca, Boehringer Ingelheim, Novo Nordisk, Ely Lilly, and Novartis. Fatheya Al Awadi, Javed Akram, Saud Al Sifri and Md Fariduddin declare no conflicts of interest., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

In 2011, the United Arab Emirates (UAE) had the 10th highest diabetes prevalence globally, but this was based on data that excluded migrants who comprise 80% of the population. This study assessed diabetes prevalence across the UAE population. A random sample of migrants was recruited from the visa renewal centers. Data were collected using interviews, anthropometric measurements and fasting blood for glucose, lipids and genetic analyses. 2724 adults completed the questionnaires and blood tests. Of these, 81% were males, 65% were ≤40 years old and 3% were above 60 years. Diabetes, based on self-report or fasting plasma glucose ≥7.0 mmol/l, showed a crude prevalence of 15.5%, of whom 64.2% were newly diagnosed. Overall age- and sex-adjusted diabetes prevalence, according to the world mid-year population of 2013, was 19.1%. The highest prevalence was in Asians (16.4%) and non-Emirati Arabs (15.2%) and lowest in Africans and Europeans (11.9%). It increased with age: 6.3% in 18-30 years and 39.7% in 51 to 60 years. Lower education, obesity, positive family history, hypertension, dyslipidemia, snoring, and low HDL levels, all showed significant associations with diabetes. The high diabetes prevalence among migrants in the UAE, 64% of which was undiagnosed, necessitates urgent diabetes prevention and control programs for the entire UAE population.

The methionine cycle and its metabolites homocysteine and cysteine serve several important functions in cellular metabolism. Abnormalities in metabolism of the methionine cycle have been associated with cancer. We determined plasma levels of methionine, homocysteine and cysteine in nude mice implanted with human cancer cell lines (MDA-MB-435 breast, PC-3 prostate, HT29 colon, BX-PC3 pancreas) over a prolonged period of tumor growth. The data were compared with correspondins values in nontumor-bearing controls. Nude mice were injected s.c. in the right flank with 10(6) cancer cells. Tumor growth was measured over time. Methionine was measured in plasma by HPLC. Cysteine and homocysteine were measured in plasma by recombinant enzyme assays and spectrophotometry to measure products. The concentrations of cysteine and homocysteine in plasma decreased significantly as a result of progression of breast, prostate and the pancreas tumor types implanted in the nude mice at least over a two-month period. Data for the colon tumors were nonsignificant for both cysteine and homocysteine. In the case of methionine, the decrease was significant only due to progression of the breast tumors, grown over a long time period, as compared to the mice without tumors control. The results suggest that sulphur amino acids may be plasma or serum biomarkers for cancer progression.

Background: Diabetic neuropathy is a debilitating disorder whose causation is poorly understood. Recent studies have shown significant reduction in the activity of nerve growth factor (NGF) and in the amount of talin cytoskeleton protein immunoreactivity in the perineurium in patients with diabetic neuropathy., Objective: Since talin is involved in transmembrane connections between extracellular matrix and cytoskeleton, this study investigates the subcellular pattern of talin immunoreactivity and the effect of NGF treatment of diabetic rats on the distribution of talin in the sciatic nerve., Materials and Methods: Post-embedding immunogold electron microscopy using monoclonal antibody against talin in combination with quantitative procedures was employed to localize talin-like immunoreactivity in the sciatic nerve of normal, diabetic and NGF treated diabetic rats., Results: We found the highest densities of gold particles in the Schwann cells (139.6+/-5.6 particles/microm2) and in the fibroblasts (127.4+/-4.1 particles/microm2). A moderate amount of immunoreactivity was also present in the endothelial cells of vasa nervosa (32.3+/-9.1 particles/microm2). The myelinated and unmyelinated nerve fibers and the extracellular matrix profiles were not labeled (8.7+/-2.1 particles/microm2, 4.2+/-2.2 particles/microm2, 6.1+/-3.2 particles/microm2, 9.5+/-5.3 particles/microm2, respectively). The immunogold localization of talin in diabetic rats was significantly (p<0.001) reduced in Schwann cells (66.3+/-6.5 particles/microm2) and perineurial and epineurial fibroblasts (56.8+/-3.9 particles/microm2). Diabetic rats treated with NGF for 12 weeks showed significant (p<0.005) increase in talin-like immunogold density in Schwann cells and fibroblasts. Talin immunogold density in Schwann cells and fibroblasts increased approximately 68% and 58%, respectively, after NGF treatment. The endothelial cells of endoneurial and epineurial vessel walls showed no significant change in the talin-like immunogold particle density among control, diabetic and NGF treated diabetic animals., Conclusions: These results have shown that the administration of exogenous NGF may be essential for inducing functionally significant regenerative mechanisms in diabetic neuropathy through maintaining the permeability of the barrier properties of the peripheral nerve.

Objective: To assess the effect of five antioxidants on exocrine function of rabbit testes retained in situ for 24 h and 3 months after experimental torsion., Materials and Methods: The left testes of peripubertal rabbits were clamped for 60 min, after which the clamps were removed and the testes allowed to reperfuse. The right testes served as internal controls. There were eight rabbits in each of the following experimental groups: (a) sham; (b) 60-min ischaemia followed by reperfusion; (c) 60-min ischaemia followed by left orchidectomy. In five further groups, rabbits were exposed to 60-min ischaemia followed by reperfusion, but received one of the following antioxidants before reperfusion: acetyl salicylic acid, ascorbic acid, allopurinol, quercetin or superoxide dismutase. Both testes were excised at 24 h or 3 months. The degree of lipid peroxidation, a measure of free radical damage, was assessed in testicular tissue homogenates by measuring the tissue levels of malondialdehyde (MDA). The Johnsen score was used to assess the morphological damage at 24 h and 3 months for each group., Results: At 3 months twisted viable testes allowed to reperfuse had higher MDA levels than controls; the left testes of rabbits treated with allopurinol had significantly lower MDA levels than untreated rabbits and rabbits given other antioxidants. Rabbits given quercetin, ascorbic acid or superoxide dismutase had lower (but not significantly) left testicular MDA levels than untreated rabbits, while rabbits given acetyl salicylic acid had even higher levels. Allopurinol-treated rabbits had a Johnsen score of > 7.6 and those given other antioxidants had scores of < 7.6 at 3 months., Conclusion: The twisted viable testis treated by orchidopexy contains high free radical levels at 3 months. Of the antioxidants studied, only allopurinol had a beneficial long-term effect, by significantly reducing testicular MDA levels at 3 months.

Background: Experimental studies of the use of free radical scavengers in ischemic/reperfusion (I/R) injury following detorsion of the torted testis have yielded conflicting results due to differences in the period of ischemia used. The authors studied I/R injury in the rabbit model, to define the point beyond which there is reperfusion failure., Methods: Ischemia/reperfusion injury of the testis was created in 3-6-month-old male New Zealand white rabbits by cross-clamping the left spermatic cord for periods of ischemia lasting 0, 15, 30, 60, 90, 120 and 180 min. There were eight animals per experimental group. The right testis served as internal control. Both testes were harvested after 24 h of reperfusion in four animals and after 3 months in the remaining four animals for each group. Testicular malondialdehyde (MDA), a measure of free radical damage, was determined by using the thiobarbituric acid reaction on testicular homogenates. Johnsen score was used to assess morphological damage caused by the ischemia., Results: After 24 h of reperfusion, the mean testicular MDA in the control right testes at 0, 15, 30, 60, 90, 120 and 180 min was 2.1, 2.5, 2.9, 2.4, 2.1 and 1.9 nmol/mg protein, respectively. The mean left testicular MDA at corresponding ischemic periods was 1.6, 2.0, 3.9, 10.0, 4.4, 6.1 and 1.0 nmol/mg protein, respectively. The maximum left testicular MDA was at 60 min (10.0 nmol/mg protein), following which the level dropped significantly to 1.0 nmol/mg protein at 180 min. At 3 months, the mean Johnsen scores for left testes subjected to 0, 60, 120 and 180 min ischemia were 9.4, 8.8, 2.3, 3.5, respectively., Conclusion: The results suggest that following ischemia of up to 60 min in the rabbit testis, adequate reperfusion is possible, but ischemia lasting beyond 60 min results in inadequate reperfusion leading to irreversible damage. Thus, in experiments for assessing the effect of antioxidants on I/R injury of the testis in rabbits, periods up to 60 min of ischemia should be regarded as optimum to observe an effect.

Objectives: To describe a case of Meckel's diverticulum with an unusual complication of iron deficiency anaemia due to chronic intestinal bleeding., Clinical Presentation and Intervention: A 12-year-old boy presented with bloody diarrhoea and abdominal pain in association with a long-standing history of black stools and progressive pallor. Biochemical tests revealed low serum iron (1.2 mmol/l) indicating iron deficiency anaemia and low serum albumin (29 g/l). The other tests were normal. Colonoscopy performed on the 8th day of hospitalization was normal. A technetium-99m pertechnetate scan showed an ectopic gastric mucosa in the Meckel's diverticulum confirmed at surgery in the region of the antimesentric border and on histopathology., Conclusion: Findings indicated that the patient had a bleeding Meckel's diverticulum, complicated by iron deficiency anaemia., (Copyright 2002 S. Karger AG, Basel)

Methylenetetrahydrofolate reductase deficiency (MTHFR) is a rare autosomal recessive disorder. There have been 68 cases reported to date in the literature [Eur J Pediatr 1998;157 (Suppl 2):S77]. It affects intracellular folate metabolism and results in homocystinuria and hypomethionemia. We report a family in which three children (two boys and one girl) died before the age of 3 months with severe MTHFR deficiency. A fourth affected boy was treated with betaine and he improved clinically and biochemically. We demonstrate the unique dermatological and brain imaging features in a kindred from Kuwait., (Copyright 2002 Elsevier Science B.V.)

We measured the activities of erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPX) before therapy in 97 patients with cancer in various sites (gastrointestinal tract (GIT) (n=40), breast (n=30), and others (n=27)), and in 60 matched controls to assess antioxidant enzyme protection. Hemolysate hemoglobin (Hb) was measured spectrophotometrically. The activity of SOD (U/g Hb) was significantly lower in all sites (when all the cancer sites were considered as a group), GIT, breast, and other sites compared to the controls (P<0.0001, P<0.0001, P<0.0001 and P<0.0001, respectively). The activity of GPX (U/g Hb) was significantly decreased in all sites, GIT, and breast cancer sites than in the controls (P=0.024, P=0.033, and P=0.043, respectively). Age showed a weak negative correlation with enzyme activities in controls and patients. There was no significant association between SOD and GPX activities in either the controls or the patients. These results suggest that there may be a greater antioxidant burden for SOD than GPX in cancer, and that a weak association exists between the activities of the two enzymes in antioxidant protection., (Copyright 2002 Wiley-Liss, Inc.)

Inhibition of cyclooxygenase-2 (cox-2) is considered to be anti-inflammatory, whereas inhibition of the constitutive isozyme cox-1 causes renal and gastrointestinal toxicity. Therefore, to achieve an optimal anti-inflammatory effect, an inhibitor should be cox-2 selective without inhibiting cox-1. For this purpose, 10 different cox-2-selective phosphorothioated oligonucleotides (S-oligos) were tested to inhibit the cox-2 enzyme selectively in vivo. An aqueous solution of these S-oligos (3 mg/kg body weight) was injected intraperitoneally (i.p.) into male Sprague-Dawley rats with colitis induced by trinitrobenzene sulfonic acid (TNBS). The colonic levels of cox-2 protein, mRNA, myeloperoxidase (MPO), and prostaglandin E2 (PGE2) were increased significantly on day 1 and remained significantly elevated until day 7 post-TNBS administration, whereas cox-1 remained unaltered. Two S-oligos were found to be effective in reducing the level of cox-2 protein selectively without any effect on the cox-1. The effective S-oligo, but not the mismatched control oligo, reduced the tissue levels of PGE2 and MPO activity significantly. The effective S-oligo reduced the level of cox-2 but not the cox-1 mRNA significantly, whereas a mismatched or a sense control oligo did not affect the levels of these isoforms. M-fold analysis demonstrated extensive secondary structure formation in the cox-2 mRNA. These findings demonstrate that only a few selected sites in the cox-2 target mRNA are accessible in vivo, probably because of the presence of secondary structures. Suppression of cox-2 protein, PGE2, and MPO activity by the S-oligo might prove to be an anti-inflammatory property.

Studies on camels' milk, whether with respect to concentration or bioavailability of trace elements from this milk, are limited and warrant further investigation. The object of this study was to analyse the concentration and distribution of zinc, copper, selenium, manganese and iron in camel milk compared to those in human milk, cows' milk and infant formula under similar experimental conditions. Camels' milk and cows' milk were collected from local farms, human milk samples were obtained from healthy donors in Kuwait and infant formula was purchased locally. Milk fractionation was performed by ultra-centrifugation and gelcolumn chromatography. The concentration of trace elements was analysed by atomic absorption spectrometry and that of protein was determined spectrophotometrically. The concentration of manganese and iron in camels' milk was remarkably higher (7-20-fold and 4-10-fold, respectively) than in human milk, cows' milk and infant formula. The zinc content of camels' milk was higher than that of human milk but slightly lower than in cows' milk and infant formula. The concentration of copper in camels' milk was similar to that of cows' milk but lower than in human milk and infant formula. The selenium content of camels' milk was comparable to those of other types of milk, Approximately 50-80% of zinc, copper and manganese in camels' milk were associated with the casein fraction, similar to that of cows' milk, The majority of selenium and iron in camels' milk was in association with the low molecular weight fraction, It is recommended that camels' milk be considered as a potential source of manganese, selenium and iron, perhaps not only for infants, but also for other groups suspected of mild deficiency of these elements. Further investigations are required to confirm this proposal.

The distribution of breast, colon, gastric, thyroid, oral, rectal, pancreatic and renal cancers were determined in 71 Kuwaitis, 45 other Arabs, and 26 Indians. Plasma levels of micronutrient antioxidants, retinol, alpha-tocopherol, lycopene, and beta-carotene were measured in the groups and in 90 matched controls for comparison. Cholesterol was measured to determine its association with the micronutrient antioxidants. Pancreatic cancer occurred exclusively in Kuwaitis, while breast and colon cancers were disproportionately higher in Kuwaitis than in the other groups. Micronutrient antioxidant levels were similar in the groups, except for higher lycopene levels in Kuwaitis. In most instances, the micronutrient antioxidants, except beta-carotene, decreased significantly in levels in patients than in controls. Low levels of retinol, lycopene, and beta-carotene were strongly associated with pancreatic cancer. Compared to controls, significantly increased levels of beta-carotene occurred in breast, colon, thyroid, and renal cancers; increased lycopene occurred in oral cancer, and increased alpha-tocopherol occurred in pancreatic cancer. Alpha-tocopherol strongly correlated with cholesterol. Generally, changes in alpha-tocopherol/ cholesterol ratios mimicked those of alpha-tocopherol levels. Micronutrient antioxidant levels were significantly lower in male patients than female patients. Age showed a negative but statistically insignificant relationship with micronutrient antioxidants. Lycopene strongly correlated with alpha-carotene and alpha-tocopherol with retinol. Among the patients, all micronutrient antioxidants except retinol decreased significantly in levels in smokers than nonsmokers, suggesting susceptibility to cigarette smoke oxidative stress. We conclude that micronutrient antioxidant depletions and altered associations may imply tumor utilization or antioxidant burden in oxidative stress or both. Furthermore, the incidence of pancreatic, colon and breast cancers among Kuwaitis warrants further study.