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BackgroundCritical pertussis continues to cause significant morbidity and mortality in infants necessitating pediatric intensive care. Despite advances in supportive care, knowledge gaps persist. This study aimed to examine institutional capacity, physician knowledge, and practice variability in managing critical pertussis among pediatric intensive care units (PICUs) across the Gulf Cooperation Council (GCC) countries.MethodsA cross-sectional internet-based survey was distributed to PICU physicians across the six GCC countries between December 1, 2024, and January 31, 2025. Demographic information, clinical experience, diagnostic resources, and therapeutic approaches were collected. A multivariable generalized linear regression (Gamma) model identified factors associated with pertussis knowledge scores.ResultsAmong 185 respondents, almost 70% of participants were male, 62.7% were specialists or consultants, and around half (47%) were certified pediatric intensivists. Access to mechanical ventilation was almost universal (98.4%), yet extracorporeal membrane oxygenation was available in only 24.3% of centers. Polymerase chain reaction-based diagnosis was widely available, but more than one-third (36.2%) of participants reported a test turn-around-time of at least two days. A majority (66%) of physicians used exchange transfusion for hyperleukocytosis, but white blood cell thresholds varied widely. Institutional protocols were lacking in over 40% of centers. The average pertussis knowledge score was 9.52 out of 13 questions (SD ±1.72). Physician's clinical experience showed a strong and graded association with pertussis knowledge.ConclusionsThis study highlights the heterogeneity in pertussis management practices across the GCC PICUs, compounded by variability in resources and different institutional guidelines. Findings highlight the urgent need for standardized protocols to harmonize pertussis care.
Obesity, type 2 diabetes (T2D), cardiovascular disease (CVD), and chronic kidney disease (CKD) are overlapping conditions that drive premature morbidity and mortality worldwide. Care remains siloed and reactive despite shared risk factors and strong evidence for early intervention. To support integrated disease management, the American Heart Association (AHA) recently introduced the concept of cardiovascular–kidney–metabolic (CKM) syndrome, recognizing the bidirectional links between metabolic, kidney, and cardiovascular health. Kuwait faces one of the highest burdens of CKM-related diseases globally. Three-quarters of adults are overweight or have obesity, and 28
BackgroundMental illness stigma undermines help-seeking, treatment engagement, and social inclusion globally. Although the Gulf Cooperation Council (GCC) region has undergone rapid social and health-system modernization, few studies have simultaneously assessed public knowledge, attitudes, and intended behaviour toward people with mental illness using validated instruments.ObjectiveTo examine mental-health knowledge, public stigma, and social acceptance among adults in GCC countries using the Mental Health Knowledge Schedule (MAKS), the Reported and Intended Behaviour Scale (RIBS), and the 40-item Community Attitudes toward the Mentally Ill (CAMI) scale.MethodsAn Arabic-language online survey was completed by 1, 557 adults (84.1% female; mean age = 26.2 years, SD = 10.6; 80.5% from Kuwait). Descriptive statistics, bivariate analyses, and simultaneous-entry multiple linear regression were conducted. Internal consistency was evaluated using Cronbach’s α and McDonald’s ω, supplemented by item-total correlations and confirmatory factor analysis (CFA) of the CAMI.ResultsParticipants reported moderate mental-health knowledge (MAKS M = 41.6, SD = 5.9), moderately positive attitudes (CAMI M = 135.2, SD = 16.2), and moderate behavioural willingness (RIBS M = 13.1, SD = 3.2). Knowledge and attitudes were moderately correlated (r = .341, p <.001), but the association between attitudes and intended behaviour was weaker (r = .209, p <.001). In regression, social restrictiveness was the strongest predictor of behavioural engagement (β = .374, p <.001), followed by male sex (β = .098) and MAKS total (β = −.103). A confirmatory factor analysis indicated poor fit of the original four-factor CAMI structure (CFI = .673, RMSEA = .141), supporting cautious subscale-level interpretation. A supplementary regression using the more reliable CAMI total score confirmed the primary pattern. Sensitivity analyses following removal of implausible age entries and restricting to Kuwait-only participants produced substantively identical findings.ConclusionThese findings, drawn from a predominantly Kuwaiti, female, and university-educated convenience sample, indicate that respondents endorsed sympathetic and recovery-oriented principles yet showed substantial hesitation regarding close social contact. The disconnect between attitudes and behavioural willingness highlights the need for culturally grounded, contact-based anti-stigma interventions that target social distance specifically, while requiring replication in more representative GCC populations.
Background/Objectives: Obstructive sleep apnea (OSA) is a sleep condition characterized by intermittent hypoxia, systemic inflammation, and metabolic dysfunction. Contemporary diagnosis criteria depend on polysomnography (PSG), a procedure that is limited by cost and accessibility. Identifying reliable circulating biomarkers may facilitate disease diagnosis and treatment monitoring. Methods: Insulin-like growth factor binding protein-7 (IGFBP-7) has been implicated in pathways relevant to OSA, although its precise role remains elusive. While we previously identified IGFBP-7 as a candidate of interest, in this report, we assessed circulating IGFBP-7 levels in a single-cohort study of 164 participants (124 with OSA, 40 controls) at the Dasman Diabetes Institute. A Type I PSG test was performed in a level 1 sleep laboratory to diagnose sleep apnea. Among the 124 patients with OSA who underwent multilevel sleep surgery (MLS), 67 completed the 3-month postoperative follow-up and were included in the longitudinal analyses. In these participants, we evaluated the apnea-hypopnea index (AHI) at baseline and 3 months after surgery and examined the associations between circulating IGFBP-7 levels, OSA severity indices, and metabolic parameters. Results: Our data revealed a significant increase in IGFBP-7 levels in people with OSA compared to controls (p < 0.001). Importantly, the increase in IGFBP-7 was positively correlated with AHI (r = 0.272, p < 0.001), indicating a potential link with this condition. IGFBP-7 levels declined significantly following MLS (p < 0.001), paralleling improvements in AHI and suggesting responsiveness to therapeutic intervention and a reduced hypoxic burden. IGFBP-4 levels increased significantly in patients with OSA (p = 0.006) but were not correlated with IGFBP-7. The receiver operating characteristic (ROC) analysis identified IGFBP-7 with a cut-off value of 14,003.21 pg/mL as a potential biomarker for OSA, with moderate performance (AUC = 0.722, 95% CI: 0.636-0.808; sensitivity 73%, specificity 84%). Notably, combining IGFBP-7 with IGFBP-4 resulted in a modest improvement (AUC = 0.755). Conclusions: Our data suggest that IGFBP-7 shows a modest association with OSA severity and may have exploratory value as part of a multi-marker or risk-stratification approach. Further large-scale and longitudinal studies are warranted to extensively explore the potential utility of IGFBP-7 within multi-marker approaches.
BACKGROUND:Spinal needle fracture during spinal anaesthesia is a rare but potentially serious complication, particularly in obstetric practice where neuraxial techniques are frequently used. We report a series of three cases of spinal needle fracture during attempted spinal anaesthesia for caesarean delivery and describe a common technical mechanism and management approach. CASE SERIES:Three patients with obesity had an attempted spinal anaesthetic for caesarean delivery with a fine-gauge pencil-point spinal needle through an introducer. In all cases, fracture occurred during needle redirection while the introducer remained stationary. The neuraxial attempt was abandoned and caesarean delivery proceeded under general anaesthesia in all three cases. Postpartum imaging with computed tomography was used to localise the retained fragments, which were subsequently removed surgically. Neurologic assessment during admission and follow-up at two weeks and one month demonstrated no neurologic deficits in any patient. CONCLUSION:Spinal needle fracture can occur when redirection of a fine spinal needle is attempted through a fixed introducer. Awareness of this mechanism, careful technique, and early imaging are essential to reduce risk and guide management in this rare complication.
