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Al-Herz W, Al-Ahmad M, Al-Khabaz A, Husain A, Sadek A, Othman Y. The Kuwait National Primary Immunodeficiency Registry 2004-2018. Front Immunol 2019; 10:1754. [PMID: 31396239 PMCID: PMC6668014 DOI: 10.3389/fimmu.2019.01754] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/11/2019] [Indexed: 12/25/2022] Open
Abstract
Objective: To present the report from the Kuwait National Primary Immunodeficiency Registry between 2004 and 2018. Methods: The patients were followed prospectively between January 2004 and December 2018 and their collected data included sociodemographic, diagnosis, clinical presentation, laboratory tests, and treatment. Results: A total of 314 PID patients (165 males and 149 females) were registered during the study period. Most of the patients (n = 287, 91.4%) were Kuwaiti nationals and the prevalence among Kuwaitis was 20.27/100,000 with a cumulative incidence of 24.96/100,000 Kuwaitis. The distribution of the patients according to PID categories was as follow: immunodeficiencies affecting cellular and humoral immunity, 100 patients (31.8%); combined immunodeficiencies with associated syndromic features, 68 patients (21.7%); predominantly antibody deficiencies, 56 patients (17.8%); diseases of immune dysregulation, 47 patients (15%); congenital defects of phagocyte number or function, 20 patients (6.4%); autoinflammatory disorders, 1 patient (0.3%); and complement deficiencies, 22 patients (7%). The mean age of the patients at onset of symptoms was 26 months while the mean age at diagnosis was 53 months and the mean delay in diagnosis was 27 months. Most of the patients (n = 272, 86%) had onset of symptoms before the age of 5 years. Parental consanguinity rate within the registered patients was 78% and a positive family history of PID was noticed in 50% of the patients. Genetic testing was performed in 69% of the patients with an overall diagnostic yield of 90%. Mutations were identified in 46 different genes and more than 90% of the reported genetic defects were transmitted by an autosomal recessive pattern. Intravenous immunoglobulins and stem cell transplantation were used in 58% and 25% of the patients, respectively. There were 81 deaths (26%) among the registered patients with a mean age of death of 25 months. Conclusions: PID is not infrequent in Kuwait and the reported prevalence is the highest in the literature with increased proportion of more severe forms. Collaborative efforts including introduction of newborn screening should be implemented to diagnose such cases earlier and improve the quality of life and prevent premature deaths.
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Affiliation(s)
- Waleed Al-Herz
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.,Allergy & Clinical Immunology Unit, Pediatric Department, Al-Sabah Hospital, Kuwait City, Kuwait
| | - Mona Al-Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.,Department of Allergy, Al-Rashid Allergy Center, Kuwait University, Kuwait City, Kuwait
| | - Ahmad Al-Khabaz
- Allergy & Clinical Immunology Unit, Pediatric Department, Mubarak Al-Kabeer Hospital, Kuwait University, Jabriya, Kuwait
| | - Ahmed Husain
- Allergy & Clinical Immunology Unit, Pediatric Department, Al-Ameri Hospital, Kuwait City, Kuwait
| | - Ali Sadek
- Kuwait National Center for Health Information, Ministry of Health, Kuwait City, Kuwait
| | - Yasmeen Othman
- Department of Allergy, Al-Rashid Allergy Center, Kuwait University, Kuwait City, Kuwait
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Agarwal MM, Dhatt GS, Othman Y. Gestational diabetes mellitus prevalence: Effect of the laboratory analytical variation. Diabetes Res Clin Pract 2015; 109:493-9. [PMID: 26164090 DOI: 10.1016/j.diabres.2015.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 05/17/2015] [Accepted: 06/19/2015] [Indexed: 11/29/2022]
Abstract
AIMS To highlight the effect of laboratory analytic variation, assessed by glucose (a) total analytic laboratory error (TAEL) present in one index laboratory and (b) total recommended allowable error (TAEa) universally applicable to all laboratories, on the prevalence of gestational diabetes mellitus (GDM). METHODS 2337 pregnant women underwent a 75-g oral glucose tolerance test (OGTT) for universal GDM screening. Since the true value of every laboratory result fluctuates within a range, the glucose TAEL and TAEa were used to define a lower and an upper diagnostic threshold (95% confidence interval, CI) for the three glucose OGTT cut-offs of the criteria of the American Diabetes Association, ADA (2003); the Canadian Diabetes Association, CDA (2013) and the International Association of Diabetes and Pregnancy Study Groups, IADPSG (2010). RESULTS For the ADA, CDA and IADPSG criteria, respectively, the GDM prevalence [95% CI, (glucose TAEL) (glucose TAEa)] was 13.3% [(8.0-21.8) (6.3-25.9)], 30% [(17.3-53.1) (14.3-61.3)] and 45.3% [(27.0-71.0) (22.3-79.2)]. Using the lower and higher assigned OGTT glucose thresholds for TAEL, respectively, among the different criteria, either 200 (8.6%)-601 (25.7%) additional or 122 (5.2%)-426 (18.3%) fewer women would be identified with GDM (p<0.0001). CONCLUSIONS Independent of the diagnostic criteria, any reported GDM prevalence can potentially vary between one half to two times even for laboratories meeting recommended quality specifications. To avoid misclassifying women with GDM substantially, individual laboratories can significantly reduce this disparity by improving analytic performance. All physicians must ensure that their laboratory meets acceptable quality standards for optimal patient care.
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Affiliation(s)
- M M Agarwal
- Department of Pathology, College of Medicine, UAE University, Al Ain, United Arab Emirates.
| | - G S Dhatt
- Department of Pathology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Y Othman
- Department of Pathology, Tawam Hospital, Al Ain, United Arab Emirates
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Agarwal MM, Dhatt GS, Othman Y. Gestational diabetes: differences between the current international diagnostic criteria and implications of switching to IADPSG. J Diabetes Complications 2015; 29:544-9. [PMID: 25837380 DOI: 10.1016/j.jdiacomp.2015.03.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/19/2015] [Accepted: 03/09/2015] [Indexed: 12/17/2022]
Abstract
AIMS To highlight the differences between eight international expert panel diagnostic criteria (either current or outdated but in use) for the diagnosis of gestational diabetes mellitus (GDM) and implications of switching to the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criterion. METHODS 2337 pregnant women underwent a 75-g oral glucose tolerance test as part of a universal screening protocol. The GDM prevalence and number of women classified differently were compared between the criteria of the American Diabetes Association (2003); Australasian Diabetes in Pregnancy Society (1998); the Canadian Diabetes Association, CDA (2003 & 2013); the European Association for the Study of Diabetes (1996); IADPSG (2010); the New Zealand Society for the Study of Diabetes (2004) and the World Health Organization (1999). RESULTS The prevalence varied from 9.2% to 45.3% with the different criteria. The IADPSG compared a) best with CDA 2013 [356(15.2%) women classified differently, (kappa, k=68.3%)] and b) worst with CDA 2003 [843 (36.1%) women classified differently, (k=21.8%)]; p<0.001.Switching to IADPSG from the original criteria would increase the prevalence 1.5-4.9 times. CONCLUSIONS In 2015, the various international guidelines for GDM continue to show major discrepancies in the prevalence and the women classified dissimilarly. A consensus on a single global guideline would be a giant leap forward.
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Affiliation(s)
- M M Agarwal
- Department of Pathology, College of Medicine, UAE University, Al Ain, United Arab Emirates.
| | - G S Dhatt
- Department of Pathology, Tawam hospital, Al Ain, United Arab Emirates
| | - Y Othman
- Department of Pathology, Tawam hospital, Al Ain, United Arab Emirates
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Montet D, Al Shobaky A, Barreto Crespo M, Payrastre L, Mansour H, Othman Y, Morshdy A, El Zayat M, Ibrahim H, El-Arabi T, Magid El-Shibiny A, Nagy K, Fadaly H, Sorour M, Hassanien Y, Hassan A, Abdel-Mawgood A, Ahmed A, Abdelghany S, Radwan M, Ismaiel M, Magdy M, Negm M, Mossa A, Heikal T, Abd EL-Hamid A, El Shahaby O, Abdu A, Mowafy A, Sabaa G, Mohamed S. Future topics of common interest for EU and Egypt in food quality, safety and traceability. Quality Assurance and Safety of Crops & Foods 2015. [DOI: 10.3920/qas2014.0428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- D. Montet
- Cirad, UMR 95 Qualisud, TA B-95/16, 73, rue Jean-Fran�ois Breton, 34398 Montpellier Cedex 5, France
| | - A. Al Shobaky
- Mansoura University, 60 El Gohoureya street, El Mansoura, 35516 El Dakahylea, Egypt
| | | | - L. Payrastre
- INRA UMR 1331 Toxalim, 180 chemin de Tournefeuille, BP 93173, 31027 Toulouse Cedex 3, France
| | - H. Mansour
- Ain Shams University, Khalifa El-Maamon st., Abbasiya sq., 11566 Cairo, Egypt
- Ministry of Trade and Industry, Latin America, Garden City, Cairo, Egypt
| | - Y. Othman
- Mansoura University, 60 El Gohoureya street, El Mansoura, 35516 El Dakahylea, Egypt
| | - A. Morshdy
- Zagazig University, Zagazig, 44519 El Sharkaya, Egypt
| | - M. El Zayat
- Mansoura University, 60 El Gohoureya street, El Mansoura, 35516 El Dakahylea, Egypt
| | - H. Ibrahim
- Menoufia University, Shebin-el-Kome st., 32511 Menoufia, Egypt
| | - T. El-Arabi
- Ain Shams University, Khalifa El-Maamon st., Abbasiya sq., 11566 Cairo, Egypt
| | - A.A. Magid El-Shibiny
- Zewail City for Science & Technology, 1 Ibrahimi Street, Medan El-Sheikh Youssef, Garden City, 11461 Cairo, Egypt
| | - K. Nagy
- Agriculture Research Center, 9 Gamma Elqahera st.,12619 Giza, Egypt
| | - H. Fadaly
- Damietta University, New Damietta, 34511 Damietta, Egypt
| | - M.A. Sorour
- Sohag University, Nasser City, 82524 Sohag, Egypt
| | - Y.A. Hassanien
- Menoufia University, Shebin-el-Kome st., 32511 Menoufia, Egypt
| | - A.R. Hassan
- Menia University, Menia, PO Box 61519, Egypt
| | | | - A. Ahmed
- Ain Shams University, Khalifa El-Maamon st., Abbasiya sq., 11566 Cairo, Egypt
| | - S. Abdelghany
- Cairo University, Orman, Gamaa Street, 12613 Giza, Egypt
| | - M. Radwan
- Cairo University, Orman, Gamaa Street, 12613 Giza, Egypt
| | - M. Ismaiel
- Farm Frites Company, 18th Joseph prostito St. Sindbad Road Nozha - Heliopolis, Cairo, Egypt
| | - M. Magdy
- Katilo Co. Company, Salah Salem Street,Katilo Building, 34511 Damietta, Egypt
| | - M. Negm
- Agriculture Research Center, 9 Gamma Elqahera st.,12619 Giza, Egypt
| | - A.T. Mossa
- National Research Center, El Buhouth St., Dokki, 12311 Cairo, Egypt
| | - T. Heikal
- National Research Center, El Buhouth St., Dokki, 12311 Cairo, Egypt
| | | | - O. El Shahaby
- Mansoura University, 60 El Gohoureya street, El Mansoura, 35516 El Dakahylea, Egypt
| | - A. Abdu
- Mansoura University, 60 El Gohoureya street, El Mansoura, 35516 El Dakahylea, Egypt
| | - A. Mowafy
- Mansoura University, 60 El Gohoureya street, El Mansoura, 35516 El Dakahylea, Egypt
| | - G. Sabaa
- Zagazig University, Zagazig, 44519 El Sharkaya, Egypt
| | - S. Mohamed
- Zagazig University, Zagazig, 44519 El Sharkaya, Egypt
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Abstract
AIMS In populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM. METHODS FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g OGTT for universal screening of GDM. RESULTS One hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80-0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately half of the women would not need to continue with the cumbersome OGTT. CONCLUSIONS Screening using a FCG significantly reduces the number of OGTTs needed for the diagnosis of GDM. Wider assessment, particularly in low-risk populations, would confirm the potential value of the FCG as a screening test for GDM.
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Affiliation(s)
- M M Agarwal
- Department of Pathology, Faculty of Medicine, UAE University, Al Ain, UAE.
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Abstract
In this study, the bacteriostatic effect of Piper betle and Psidium guajava extracts on selected early dental plaque bacteria was investigated based on changes in the doubling time (g) and specific growth rates (micro). Streptococcus sanguinis, Streptococcus mitis and Actinomyces sp. were cultured in Brain Heart Infusion (BHI) in the presence and absence of the extracts. The growth of bacteria was monitored periodically every 15 min over a period of 9 h to allow for a complete growth cycle. Growth profiles of the bacteria in the presence of the extracts were compared to those in the absence and deviation in the g and micro were determined and analyzed. It was found that the g and mu were affected by both extracts. At 4 mg mL(-1) of P. betle the g-values for S. sanguinis and S. mitis were increased by 12.0- and 10.4-fold, respectively (p < 0.05). At similar concentration P. guajava increased the g-value by 1.8- and 2.6 -fold, respectively (p < 0.05). The effect on Actinomyces sp. was observed at a much lower magnitude. It appears that P. betle and P. guajava extracts have bacteriostatic effect on the plaque bacteria by creating a stressed environment that had suppressed the growth and propagation of the cells. Within the context of the dental plaque, this would ensure the attainment of thin and healthy plaque. Thus, decoctions of these plants would be suitable if used in the control of dental plaque.
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Affiliation(s)
- A R Fathilah
- Department of Oral Biology, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
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