Infertility is one of the major public health problems, affecting 15% of couples who attempt pregnancy; in 50% of these, the male partner is responsible. Chromosomal abnormalities and Y microdeletions in the azoospermia factor (AZF) region are known to be associated with spermatogenetic failure. In the present study, 289 patients with primary male infertility because of spermatogenetic failure were studied in order to highlight the molecular background of male infertility in Kuwait, and to avoid the possibility of transmission of any microdeletions/chromosomal aberrations to offspring via intracytoplasmic sperm injection (ICSI). Of the 289 infertile men, 23 patients (8%) had chromosomal aberration in the form of Klinefelter syndrome/variant (16/23; 69.6%), XYY syndrome (3/23; 13%), XX male syndrome (2/23; 8.7%), 45,X/46X, i(Yp)(1/23; 4.4%) and 45,XY, t(9;22) (1/23;4.4%). Y-chromosome microdeletion in the AZFb and AZFc regions were detected in 7/266 cases (2.6%). Testicular biopsy was carried out in 31 azoospermic patients, of whom five men had Sertoli-cell only syndrome, while 26 patients had spermatogenic arrest. In conclusion, this study showed that the frequency of both chromosomal anomalies and Y microdeletions were found in 10.4% of the infertile men. The potential risk of transmitting these genetic disorders to offspring provides a rationale for screening infertile men prior to ICSI.
Many Arab women in the Gulf region cover their bodies for cultural and religious reasons, limiting the skin’s exposure to sunlight and therefore its ability to synthesize vitamin D. The aim of this study is to determine whether the clothing style of Kuwaiti premenopausal women affects their vitamin D status, bone marker expression, and bone density. Three groups of healthy unmarried single Kuwaiti females (20-35 years old; n=30 per group) were recruited randomly from the general community: a control group who wear Western-style clothing (unveiled group), a group who wear a hejab that covers the whole body except for the face and hands (hejab group), and a group who wear a black veil with the entire body covered (veiled group). Bone mineral density (BMD), bone markers (procollagen type 1 N-terminal propeptide [P1NP], osteocalcin, and β-CrossLaps), 25-hydroxy vitamin D, intact parathyroid hormone [iPTH], and calcitonin were measured. The bone marker osteocalcin was significantly higher in the hejab group compared to the control group, whereas P1NP and β-CrossLaps were significantly higher in the veiled group compared to the control group. 25-hydroxy vitamin D, iPTH, calcitonin, and BMD were not significantly different across the three groups despite the observed elevation in bone turnover markers. The majority of participants in all three groups exhibited vitamin D deficiency; however, the lowest vitamin D levels were observed among the hejab and veiled participants. These findings suggest that clothing style may contribute to vitamin D deficiency in young Kuwaiti women.
Data obtained may indicate insufficient iodine intake among pregnant women in Kuwait.
After the first fracture, the risk of subsequent fractures increases significantly. Medical treatment can reduce the risk of a second fracture by about 50%, but many older adults do not receive osteoporosis medication following their first fracture. This observational study aimed to understand primary care management patterns of older adults after osteoporotic fractures at the Miami Veterans Affairs (VA) Healthcare System. A retrospective review of 219 fracture cases selected by International Classification of Disease (ICD-9) codes between October 2015 and September 2016 identified 114 individuals age ≥50 years who had a non-traumatic fracture code entered in their medical record for the first time. Among them, 72 (63%) did not undergo a bone mineral density (BMD) test or receive treatment in the 12 months following their fracture. Of the 40 individuals who had a BMD test post-fracture, 17 (100%) received or were considered for anti-osteoporosis treatment if their T-score indicated osteoporosis (T-score ≤−2.5), but only 8/23 (35%) if the T-score was >−2.5. Physicians are more likely to prescribe osteoporosis therapy based on a BMD T-score diagnosis of osteoporosis, rather than a clinical diagnosis of osteoporosis based on a low-trauma fracture. A change in practice patterns is necessary to decrease the incidence of fractures.
This study was performed to investigate the status of iodine intake among the Kuwaiti population and its effect on thyroid function. The study group was comprised of 139 females and 86 males with a mean age of 33 and 35 years, respectively. Urinary iodine excretion (UIE) and serum free T4 (FT4), thyrotropin hormone (TSH), antiperoxidase antibodies (anti- TPOAb), and antithyroglobulin antibodies (anti-TGAb) were determined. Median UIE was 148 μg/L (within the recommended level by the World Health Organization [WHO]). However, UIE levels of <100 and <50 μg/L were detected in both male and female groups, respectively. Serum levels of TSH and FT4 were normal for all except one of the participants who suffered from hyperthyroidism, possibly as a result of elevated iodine intake, which was reflected in an increased UIE of 590 μg/L. Elevated anti-TPOAb >75 IU/mL and anti-TGAb >150 IU/mL were detected in 15% and 34% of subjects; only 10% of them had elevated levels of both anti-TPOAb and anti-TGAb. Thus, based on the WHO recommendations, the iodine intake for the Kuwaiti population is adequate. However, it is recommended that a national study be conducted by the appropriate authority in order to eliminate any artifacts which may have appeared in this study.
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