Background: Obstructive sleep apnea (OSA) affects a considerable proportion of adults globally and is associated with elevated morbidity and mortality. Given the lack of epidemiologic data on the burden of OSA in Kuwait, this study sought to estimate its prevalence, associated risk factors, and comorbid conditions among a working population in Kuwait.Methods: This was a cross-sectional study of a sample of working adults (n = 651) from public institutions in Kuwait. High/low risk for OSA was ascertained according to the Berlin Questionnaire criteria. Participants self-reported their coexisting health conditions. Associations were assessed using Poisson regression with robust variance estimation; adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated.Results: Overall, 20.0% (130/651) of participants were classified as being at high risk for OSA, with more male than female subjects being at high risk (24.0% [56/233] vs. 17.7% [74/418], P = 0.053), though this difference did not gain statistical significance. Moreover, a high risk for OSA was more common among older and obese subjects. Factors associated with increased prevalence of a high risk for OSA included current smoking status (aPR = 1.58, 95% CI: 1.02–2.06), longer hours spent watching television (1.76, 1.10–2.81), and lower self-perceived physical health (2.11, 1.15–3.87). However, decreasing trends in the prevalence of high risk for OSA were observed with frequent engagement in vigorous physical activity and longer nightly sleep duration. Compared to those at a low risk for OSA, the subjects at high risk for OSA were more likely to have insomnia disorder (2.83, 1.81–4.41), diabetes (1.94, 1.15–3.27), hypertension (3.00, 1.75–5.16), and depression (4.47, 1.80–11.08).Conclusion: This study estimated that 1/5 of working adults in Kuwait were at high risk for OSA, and the prevalence varied according to personal characteristics and lifestyle factors. Also, a high risk for OSA classification was associated with multiple comorbid health conditions.
Patient: Male, 43-year-old Final Diagnosis: Q-fever endocarditis Symptoms: Lower limb edema • shortness of breath Medication: — Clinical Procedure: — Specialty: General and Internal Medicine Objective: Rare co-existance of disease or pathology Background: There is a close association between Q fever and autoimmune disease, with some case reports in the literature of Q fever presenting as systemic lupus erythematosus (SLE) and others documenting their coexistence. However, making the correct diagnosis remains challenging and Q fever often is overlooked. Therefore, it is essential to review such a rare presentation to help in accurate diagnosis in future cases. This report is of a case of endocarditis due to Coxiella burnetii in a patient with Q fever and a history of SLE. Case Report: We report the case of a 43-year-old man with a history of SLE and rheumatic heart disease, status post-valve replacement. The patient initially presented with an acute kidney injury in the setting of a history of full-house lupus membranous nephropathy, which was diagnosed on kidney biopsy. The patient had been on immunosuppressive therapy for 2 years. Shortly after he was admitted, echocardiography was ordered because the patient had progressive dyspnea, revealing infective endocarditis involving multiple valves. He underwent valve repair surgery and was placed on an extended course of antibiotic therapy. His symptoms gradually resolved, with normalization of his immunological markers. The patient’s immunosuppressive regimen was eventually discontinued. He remains on lifelong antibiotic suppression therapy. Conclusions: This case highlights the importance of awareness of infectious causes of endocarditis in patients with underlying autoimmune diseases such as SLE. This rare case of C burnetii endocarditis may have been associated with underlying valvular SLE.
Background. Air pollution poses a significant threat to human health worldwide. Investigating potential health impacts is essential to the development of regulations and legislation to minimize health risks. Objectives. The aim of the present study was to investigate the potentially hazardous effect of air pollution on the Ali Sabah Al Salem residential area in Kuwait by comparing the pollution level to a control area (Al-Qirawan) by assessing two biomarkers: erythrocyte glutathione S-transferases (e-GST) and total blood antioxidant, and then correlating the activity to pollution-related oxidative stress. Methods. The average concentrations of several airborne gases were measured at Ali Sabah Al Salem and Al-Qirawan, including ozone, carbon monoxide, nitrogen dioxide, nitrogen oxides, particulate matter less than 10 μm (PM10), sulfur dioxide, ammonia, carbon dioxide, hydrogen sulfide, methane, and non-methane hydrocarbon. A total of fifty-eight participants were sampled from two different areas and divided into two groups. The study group was composed of 40 residents exposed to polluted ambient air in the Ali Sabah Al Salem residential area. A reference group composed of 18 residents in the Al-Qairawan area living far from major pollution sources was also tested. Results. All measured gases were higher in concentration at Ali Sabah Al Salem compared to the Al-Qirawan area. Furthermore, PM10 and sulfur dioxide were higher than World Health Organization (WHO) guidelines. The e-GST activity was lower among participants of the Ali Sabah Al Salem residential area compared to participants living in the Al-Qairawan area. The total antioxidant capacity in whole blood of Ali Sabah Al Salem residents was significantly (p<0.0001) higher than in control subjects. Conclusions. Residents in Ali Sabah Al Salem are exposed to a high level of air pollution that has a serious impact on glutathione S-transferases levels. Subsequently, regulations on pollution sources are needed to lower current health risks. Furthermore, the present study provides evidence that finger-prick blood sampling is a quick, non-invasive method suitable for screening e-GST activity and total antioxidants which may be applied for surveillance purposes. Participant Consent. Obtained Ethics Approval. The study was approved by the Scientific Research Committee of the Public Authority for Applied Education and Training, Kuwait. Competing Interests. The authors declare no competing financial interests.
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