Mousa Khoursheed - Academia.edu (original) (raw)

Papers by Mousa Khoursheed

Journal of The Royal College of Surgeons of Edinburgh, Feb 1, 2000

Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendi... more Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high (15-30%) despite several techniques and investigations used to improve the diagnostic accuracy. Many studies investigated the role of raised C-reactive protein in improving the diagnosis of acute appendicitis, but with conflicting results. This study emphasies the impact of a normal (rather than raised) serum C-reactive protein in reducing the rate of negative explorations. In a double blind study, blood for the measurement of serum C-reactive protein (CRP) was collected pre-operatively from 78 patients just before going to the operating room for appendicectomy. The histopathology of the 78 appendices were grouped into positive (acute appendicitis) and negative (normal appendix). White blood count (WBC), CRP and the histopathology findings were correlated. In patients with histopathologically proven acute appendicitis both the WBC count and serum CRP level were significantly raised (P = 0.025 and P &amp;lt; 0.000,1 respectively). Serum CRP level was normal in 13 out of 15 negative explorations (normal appendix on histopathology). The specificity and sensitivity of serum CRP was 86.6% and 93.6%, respectively. A normal pre-operative serum CRP measurement in patients with suspected acute appendicitis is most likely associated with a normal appendix. Deferring surgery in this group of patients would probably reduce the rate of unnecessary appendicectomies.

# The Author(s) 2015. This article is published with open access at Springerlink.com Background W... more # The Author(s) 2015. This article is published with open access at Springerlink.com Background Weight regain due to gastric pouch dilatation af-ter Roux-en-Y gastric bypass (RYGB) is seen more frequently after long-term follow-up. We studied the feasibility and safe-ty of laparoscopic pouch resizing (LPR) for dilated gastric pouch after RYGB associated with inadequate weight loss.

Obesity Surgery, 2021

Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effec... more Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS. A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus. The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient’s situation and surgeon’s experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively. Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.

Obesity surgery, Jun 20, 2016

Bariatric surgery is common in the Middle East region. However, regional accreditation bodies and... more Bariatric surgery is common in the Middle East region. However, regional accreditation bodies and guidelines are lacking. We present the current peri-operative practice of bariatric surgery in the Middle East region. Public and private practice in the Middle East region. A questionnaire was designed to study trends of peri-operative care in bariatric surgery. It was sent to members of the Pan Arab Society for Metabolic and Bariatric Surgery (PASMBS). Ninety-three surgeons (88.6%) responded, 63.4% were in private practice, 68.5% have been in practice for more than 5 years, and 61.1% performed more than 125 cases per year. Laparoscopic sleeve gastrectomy (LSG) was the commonest procedure performed, then laparoscopic Roux-en-Y gastric bypass (LRYGB), one anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), and laparoscopic adjustable gastric banding (LAGB). Pre-operatively as a routine, 65% referred patients for dietitian and (78.3%) for smoking cessation. In contrast as a routin...

Surgery for Obesity and Related Diseases, 2016

Experimental and clinical cardiology, 2004

Although various studies have examined the short-term effects of a ketogenic diet in reducing wei... more Although various studies have examined the short-term effects of a ketogenic diet in reducing weight in obese patients, its long-term effects on various physical and biochemical parameters are not known. To determine the effects of a 24-week ketogenic diet (consisting of 30 g carbohydrate, 1 g/kg body weight protein, 20% saturated fat, and 80% polyunsaturated and monounsaturated fat) in obese patients. In the present study, 83 obese patients (39 men and 44 women) with a body mass index greater than 35 kg/m(2), and high glucose and cholesterol levels were selected. The body weight, body mass index, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the administration of the ketogenic diet. Changes in these parameters were monitored after eight, 16 and 24 weeks of treatment. The weight and body mass index of the patients decreased signi...

Nutrition, 2003

It is generally believed that high-fat diets may lead to the devel opment of obesity and several ... more It is generally believed that high-fat diets may lead to the devel opment of obesity and several other diseases such as coronary heart disease, diabetes, and cancer. This view is based on studies carried out in animals that were given a high-fat diet rich in ...

Obesity surgery, Jan 21, 2015

Weight regain due to gastric pouch dilatation after Roux-en-Y gastric bypass (RYGB) is seen more ... more Weight regain due to gastric pouch dilatation after Roux-en-Y gastric bypass (RYGB) is seen more frequently after long-term follow-up. We studied the feasibility and safety of laparoscopic pouch resizing (LPR) for dilated gastric pouch after RYGB associated with inadequate weight loss. From 1st June 2011 to 1st September 2013, patients who underwent LPR after failed RYGB were retrospectively compared and analyzed. Data included patient demographics, comorbidity, indication for revision, preoperative weight and BMI, operative time, hospital stay, conversion rate, mean follow-up, body mass index (BMI) loss, percentage excess weight loss (%EWL), reoperation rate, morbidity, and mortality. Out of 170 revisional bariatric procedures, 32 LPR (27/5, F/M) were performed for dilated gastric pouch after RYGB. The mean age, preoperative weight, and BMI were 38.3 ± 9.3 years, 101.7 ± 22.8 kg, 38.8 ± 6.4 kg/m(2), respectively. The median operative time and hospital stay were 100 min and 2 days, ...

Obesity Surgery, 2011

The aim of this study was to compare serum levels of trace elements in morbidly obese female pati... more The aim of this study was to compare serum levels of trace elements in morbidly obese female patients seeking bariatric surgery with those of age-matched females with body mass index (BMI) less than or equal to 30. Blood samples were collected from 66 morbidly obese female patients seeking bariatric surgery prior to undergoing surgery. Blood was collected also from 44 female patients (with BMI less than or equal to 30) prospectively from April 2009 till February 2010. Exclusion criteria in both groups were the presence of any co-morbidities on medication, patients receiving any vitamin supplement or any herbal product intake, smoking, and alcohol consumption. Serum zinc, magnesium, copper, and selenium were measured and compared between the two groups. The mean age and BMI for morbidly obese female patients was 28.5 years (21.5-35.5) and 45.26 kg/m(2) (40.3-50.22). The control group had a mean age and BMI of 30.75 years (21.35-40.15) and 25.88 kg/m(2) (22.73-29.03). For morbidly obese patients, the serum level of copper, zinc, selenium, and magnesium was 1,623.84, 698.34, 86.08, and 17,830 μg/l, respectively, compared to 1,633.36, 734.82, 101.14, and 18,260 μg/l for the control group. The serum levels of the trace elements were not statistically significantly different between the two groups except for selenium, which was significantly reduced among morbidly obese female patients (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001). Serum selenium level is significantly reduced among morbidly obese female patients seeking bariatric surgery.

Obesity Surgery, 2010

Bariatric surgery for morbid obesity has been established as an effective treatment method and ha... more Bariatric surgery for morbid obesity has been established as an effective treatment method and has been shown to be associated with resolution of co-morbidities. Despite its success, some patients may require revision because of weight regain or mechanical complications. From September 2005 to December 2009, 42 patients underwent revisional Roux-en-Y gastric bypass (RYGB). All procedures were performed by one surgeon. Demographics, indications for revision, complications, and weight loss were reviewed. Thirty-seven patients were treated with laparoscopic (n = 36) or open (n = 1) RYGB after failed laparoscopic adjustable gastric banding. Four patient were treated with laparoscopic (n = 3) or open (n-1) RYGB after failed vertical banded gastroplasty, and one patient underwent open redo RYGB due to large gastric pouch. Conversion rate from laparoscopy to open surgery was 2.5% (one patient). Mean operative time was 145.83 ± 35.19 min, and hospital stay was 3.36 ± 1.20 days. There was no mortality. Early and late complications occurred in six patients (14.2%). The mean follow-up was 15.83 ± 13.43 months. Mean preoperative body mass index was 45.15 ± 7.95 that decreased to 35.23 ± 6.7, and mean percentage excess weight loss was 41.19 ± 20.22 after RYGB within our follow-up period. RYGB as a revisional bariatric procedure is effective to treat complications of restrictive procedures and to further reduce weight in morbidly obese patients.

Clinical Microbiology and Infection, 1999

Anatomia, Histologia, Embryologia: Journal of Veterinary Medicine Series C, 2000

Exposure to thioacetamide is associated with the development of liver cirrhosis in experimental a... more Exposure to thioacetamide is associated with the development of liver cirrhosis in experimental animals[ In addition to liver\ thioacetamide toxicity has been observed in other organs[ In this study\ the toxic e}ect of thioacetamide on the spleen was investigated at 9\ 3\ 7 and 01 weeks post!treatment durations[ The level of tissue copper and selenium increased until the eighth week when a signi_cant drop was observed[ The zinc level was also increased but returned back to normal by week 7\ thereafter it showed further increase[ Calculation of the copper:zinc ratio showed an increase\ but\ recovered and returned to normal value by week 01[ The level of manganesẽ uctuated until the eighth week[ It then increased rapidly[ His! tological studies of the spleen tissue showed a signi_cant increase in extramedullary haematopoiesis in the red pulp region and marked hyperplasia in the marginal zone and follicles[ The results of this study\ demonstrate an intimate association between trace element levels and spleen pathology\ as observed in studies of other organs[

The Surgeon, 2003

To investigate the expression of E-cadherin, a calcium-dependent cell-cell adhesion molecule in c... more To investigate the expression of E-cadherin, a calcium-dependent cell-cell adhesion molecule in colorectal carcinoma. Antibodies to E-Cadherin were used to establish the association of their expression with the clinicopathological characteristics of this disease using immunohistochemical methods. Immunohistochemical analysis for E-cadherin was carried out in formalin-fixed, paraffin-embedded sections of neoplastic colorectal tissues and non-neoplastic ones adjacent to the lesion from 49 patients who underwent surgery, by the standard peroxidase-antiperoxidase method. Expression of this antigen in normal and malignant epithelium and stromal cells was compared. Both neoplastic and normal tissues showed expression of E-cadherin. There was, however, higher expression of E-cadherin in epithelial cells in both tumour and normal tissues than stromal cells. The percentage of expression in epithelial cells of well-differentiated tumours was significantly higher than moderately differentiated tumours. Loss of normal membranous expression and the presence of cytoplasmic and mixed staining were found frequently in tumour tissues (p = 0.004). This loss of membranous expression, however, did not correlate with Duke&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s staging, tumour grade, sex, size or site of the tumour. This study suggests that the lower expression of E-cadherin in less differentiated tumours may explain their aggressive nature, although loss of membranous expression was not significantly correlated to Duke&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s staging, tumour grade, sex, size and site of tumour.

Obesity Surgery, 2017

Background Despite its technical simplicity, laparoscopic sleeve gastrectomy (LSG) complications ... more Background Despite its technical simplicity, laparoscopic sleeve gastrectomy (LSG) complications are increasingly reported. Intra-thoracic sleeve migration (ITSM) is a rare complication after LSG which has been inconsistently addressed in the literature. Aims The purpose of this study was to emphasize ITSM occurrence after LSG and evaluate the perioperative factors associated with its development. Methods Between January and July 2016, LSG patients diagnosed with ITSM at two bariatric surgery departments were identified. Perioperative factors were assessed for all the patients and compared between two groups, LSG alone and LSG with concomitant hiatal hernia (HH) repair (HHR). Results A total of 19 patients (6 males and 13 females) were included. Central obesity was present in 18 patients (94.7%). Nine patients (47.4%) had concomitant hiatal hernia repair during their original LSG. Post-LSG GERD (94.7%) (38.9% de novo and 61.1% recurrent) and post-LSG constipation (57.9%) were commonly associated with ITSM. Severe refractory GERD was the most common presentation for ITSM (94.7%), followed by epigastric pain (47.4%), persistent nausea/vomiting (36.8%), and dysphagia (21.1%). Time interval between primary LSG and ITSM diagnosis ranged from 1 day to 3 years. Patients with LSG and concomitant HHR presented with higher post-LSG BMI compared to the LSG patients (37 ± 6.4 kg/m 2 vs. 30.1 ± 6.3 kg/m 2 , p = 0.03). All the patients underwent successful reduction of ITSM and subsequent HHR. Conclusion Central obesity, chronic constipation, post-LSG GERD, and concomitant HHR are commonly seen in postlaparoscopic sleeve gastrectomy intra-thoracic sleeve migration.

Medical Principles …, 2000

Obesity surgery, 2006

Postoperative complications resulting from bariatric sur-gery can lead to severe vitamin-deficien... more Postoperative complications resulting from bariatric sur-gery can lead to severe vitamin-deficiency states, such as Wernicke's encephalopathy (WE). We present a 29-year-old woman with BMI 41.7 with no history of alcoholism who developed acute WE after a gastric bypass for mor- ...

European Journal of Surgery, 2003

Pathology & Oncology …, 2002