Mousa Khoursheed
Kuwait University
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Featured researches published by Mousa Khoursheed.
Nutrition | 2003
Sami Asfar; Suad Abdeen; H. Dashti; Mousa Khoursheed; Hilal Al-Sayer; T.C. Mathew; A. Al-Bader
OBJECTIVE Epidemiologic studies have suggested that high consumption of green tea protects against the development of chronic active gastritis and decreases the risk of stomach cancer. The effect of green tea on the intestinal mucosa was not studied previously, so we examined the effects of green tea on the intestinal mucosa of fasting rats in a controlled experimental setting. METHODS Two sets of experiments were performed. In the recovery set, rats were fasted for 3 d, after which they were allowed free access to water, black tea, green tea, or vitamin E for 7 d. On day 8, the animals were killed, and small bowels were removed for histologic examination. In the pretreatment set, rats were allowed a normal diet, but the water supply was replaced with green tea, black tea, or vitamin E for 14 d. They were subsequently fasted for 3 d. On day 4, the rats were killed, and small bowels were removed for histologic examination. RESULTS In the recovery set, fasting for 3 d caused shortening of villi, atrophy, and fragmentation of mucosal villous architecture, with a significant (P < 0.0001) reduction in the length and surface area of the villi. Ingestion of green tea and, to a lesser extent, vitamin E for 7 d helped in the recovery of villi to normal. In the pretreatment set, drinking green tea, black tea, or vitamin E for 14 d before fasting protected intestinal mucosa from damage. CONCLUSION The mucosal and villous atrophy induced by fasting was reverted to normal by the ingestion of green tea and, to a lesser extent, vitamin E. Black tea ingestion had no effect. In addition, ingestion of black tea, green tea, and vitamin E before fasting protected the intestinal mucosa against atrophy.
Surgical Endoscopy and Other Interventional Techniques | 2000
Mousa Khoursheed; M. Fuad; H. Safar; H. Dashti; A. Behbehani
BackgroundMedical treatment of peptic ulcer is highly successful, and the eradication of Helicobacter pylori (H. pylori) reduces ulcer recurrence. However, the incidence of perforated duodenal ulcer and its associated mortality have not been reduced by modern methods of therapy. Laparoscopic simple closure and omental plug by suturing, fibrin glue, and stapler have been successful.MethodsOver a 1-year period (1996–97), 21 patients with perforated duodenal ulcer were operated on in our hospital by laparoscopic simple closure and omental patch. The mean age was 36.4±11.8 years (range, 18–61). Twenty patients were male (93.7%). The mean duration of pain was 9.1±11.7 hs (range, 2–48). Three patients had a previous history of duodenal ulcer (14.3%), and another three (14.3%) patients had a history of nonsteroidal antiinflammatory drug (NSAID) intake. Erect chest radiograph showed that 19 patients had air under the diaphragm (90.5%). Sixteen patients (76.2%) had frank pus in the abdomen, and five patients had a minimal peritoneal reaction (23.8%).ResultsThe mean operative time was 71.6±24.6 mins (range, 40–120), and the mean hospital stay was 5.2±1.6 days (range, 3–9). The mean time to resume oral fluids was 3.1±0.8 days (range, 2–4). Only one patient was reoperated due to leakage identified by gastrographin swallow.ConclusionsThis procedure is safe and efficient; however, further study of its long-term effectiveness and comparability to existing therapy is still needed.
Medical Principles and Practice | 2007
Mousa Khoursheed; Ibtisam Al-Bader; Ali I. Mohammad; M.O. Soliman; H. Dashti
Objective: To evaluate laparoscopic adjustable gastric banding and the ‘pars flaccida’ techniques for treating morbidly obese patients. Subjects and Methods: Between May 1999 and July 2002, 64 patients underwent laparoscopic adjustable gastric banding. The ‘perigastric’ technique was performed in the first 31 patients. From September 2000 the band was positioned according to the ‘pars flaccida’ technique in the remaining 33 patients. The patients were divided into three groups: group 1 – ‘perigastric’ technique using Lap-Band size 9.75 and 10 cm (31 patients); group 2 – ‘pars flaccida’ technique using Lap-Band size 10 cm (12 patients), and group 3 – ‘pars flaccida’ technique using the Swedish band (21 patients). There were 58 females and 6 males with a mean age of 36.6 years (range 17–56). The preoperative mean body mass index was 46.2 kg/m2. Results: Band slippage occurred in 10/31 patients (32.2%) of group 1, 3/12 patients (25%) of group 2 and none in group 3 patients (p < 0.01). Conclusion: The ‘pars flaccida’ technique significantly reduces the incidence of postoperative slippage after gastric banding. This complication is further reduced in the Swedish band group. Furthermore, we do not recommend using the 10-cm Lap-Band in the ‘pars flaccida’ technique.
Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland | 2003
Mousa Khoursheed; T.C. Mathew; R. R. Makar; S. Louis; Sami Asfar; Hilal Al-Sayer; H. Dashti; A. Al-Bader
AIM 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. 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. RESULTS 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 Dukes staging, tumour grade, sex, size or site of the tumour. CONCLUSION 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 Dukes staging, tumour grade, sex, size and site of tumour.
Medical Principles and Practice | 2003
R. Gupta; M. Nayak; Mousa Khoursheed; S. Roy; Abdulla Behbehani
Objectives: The aim of this study was to systematically assess the pain experienced by patients undergoing mammography for various clinical presentations. Subjects and Methods: Two hundred and twenty-five patients aged 25–85 years (45.43 ± 8.25 years) presenting for mammography were included in the study. Presenting symptoms and clinical diagnosis were provided by the referring physicians and demographic information was obtained from self-reported questionnaires. Mammography results were recorded by the radiologist. Two different but reliable and valid measures of pain – Visual Analog Scale (VAS) and Pain/Discomfort Rating Scale (DRS) – were used to assess pain during mammography and data were statistically analyzed to examine the possible predictors of pain. Results: Forty-nine percent of the patients reported pain during mammography when cut-off level of VAS score was 40; however, when the cut-off level was raised to 60 (considering the preexisting pain as presenting symptom in some patients) only 23% reported pain. With DRS, 7% reported pain, 27% discomfort and 66% neither pain nor discomfort. Biserial correlation between the VAS and DRS scores suggested strong positive agreement between the two measures of pain (r = 0.56, d.f. = 90, p < 0.01). Patients presenting with coexisting breast lumps and preexisting breast pain and those diagnosed with inflammatory conditions of the breast and fibrocystic changes experienced more pain during mammography. Conclusion: Preexisting breast pathologies and demographic factors such as age and educational level of the patient were important in reporting pain during mammography. This finding indicates that proper assessment of pain using standard measures and its association with breast pathologies and demographic factors is important for planning pain management in women undergoing mammography.
Medical Principles and Practice | 2004
Mousa Khoursheed; F. Al-Sayegh; I. Al-Bader; N. Kanawati; R. Maroof; S. Asfar; H. Dashti
Objectives: The aim of this prospective study was to evaluate the safety and feasibility of laparoscopic splenectomy (LS) in patients with hematological disorders of the spleen. Subjects and Methods: Between 1999 and 2001, 15 patients (11 female and 4 male), with a mean age of 30 years, underwent LS after preoperative evaluation. If difficulties were encountered in LS, one trocar site incision was enlarged to 7–8 cm to engage the left hand for hand-assisted laparoscopic splenectomy (HALS) and the procedure was completed. Various parameters were reported, including spleen size as assessed by ultrasound scan, postoperative mortality and morbidity rates, accessory spleen removal, conversion rate, operative times and length of hospital stay. LS was successfully completed in 9 patients (60%) and HALS was performed in 4 patients (26.6%). Two patients required conversion to open splenectomy. Results: The mean operative time was 209 min and the mean hospital stay was 8.1 days. The hospital stay was significantly longer among HALS patients than LS patients. The mean age of patients and splenic size were associated with a significantly higher conversion rate. No deaths were attributed to the procedure. Complications occurred in 2 of 15 patients. Accessory spleens were identified in 2 patients. Conclusions: LS is both a safe and feasible procedure, but it requires great technical care to avoid serious complications.
Medical Principles and Practice | 2014
Sami Asfar; Mousa Khoursheed; Mervat Al-Saleh; Abdullah A. Alfawaz; Medhat M. Farghaly; Ali Nur
Objectives: The aim of this study was to introduce the concept of non-operative management (NOM) for blunt liver trauma by establishing a protocol and a prospective Liver Trauma Registry in Kuwait. Subjects and Methods: A prospective Liver Trauma Registry was started in 4 hospitals and it included 117 patients who had sustained blunt liver trauma (94 men and 23 women). Unstable patients were taken to surgery while stable patients were managed conservatively regardless of the grade of liver injury. High-grade (III-VI) liver injuries were managed in collaboration with the liver surgery specialist. Results: The mean age of the 117 patients was 29.02 ± 11.18 years (range 7-63). NOM was successful in 94 (96%) patients and failed in 4 (4%) (these 4 then underwent successful surgery). Nineteen (16.2%) were unstable and underwent surgery immediately; 15 (79%) of them survived (they had had grade III-V injuries) and 4 died (2 with grade V injuries and 2 with grade VI injuries). Perihepatic packing was necessary in 8/19 (42%) patients. The overall mortality was 3.4% (4/117). Conclusions: This study showed that NOM was successful in a majority of patients with blunt liver trauma. In addition, it confirmed that the magnitude of liver injury and haemoperitoneum did not preclude NOM as long as the patient was haemodynamically stable.
Pathology & Oncology Research | 2002
Mousa Khoursheed; T.C. Mathew; R. R. Makar; L. Sonia; H. Abul; Sami Asfar; Hilal Al-Sayer; H. Dashti; A. Al-Bader
CD44s is a cell adhesion molecule, which belongs to the family of hyaluronan binding proteins. Anti-body to CD44s is used to establish the association of its expression with the clinicopathological characteristics of colorectal cancer using immunohistochemical methods. The aim of this study is to investigate the expression of the standard form of CD44 (CD44s) in colorectal cancer tissues as compared to adjacent normal colonic tissues. Furthermore, the level of expression of CD44s in colorectal cancer tissues was correlated with the degree of histological differentiation, Duke’s classification, sex, size and site of the tumor. Immunohistochemical analysis for CD44s was carried out in 49 paraffin-fixed sections of neoplastic colorectal tissues and nonneoplastic ones adjacent to the lesion, by the standard peroxidase-antiperoxidase method. Expression of these antigens were compared in normal and malignant epithelium and stromal cells. The results show that the level of CD44s in the epithelial and stromal cells was significantly higher in the colorectal cancer tissues than the normal ones. However, there was no association between the percentages of expressions of CD44s and the degree of histological differentiation, Duke’s classification, sex or size of the tumor. There was however, a significantly higher expression of CD44s in the epithelium of rectal cancer than that of colonic cancer. This study indicates that the expression of CD44s is significantly higher in colorectal cancer tissues. However, further studies are required to understand its role in tumor progression and metastasis of this disease.
Medical Principles and Practice | 2000
Hilal Al-Sayer; A. Al-Bader; Mousa Khoursheed; Sami Asfar; T. Hussain; Abdulla Behbehani; A. Mathew; H. Dashti
Objective: The populations of Kuwait and other Arabian Gulf States are very heterogeneous. Expatriates with different dietary habits constitute approximately 60% of the Kuwaiti population. The aim of this study was to establish a reference range of trace element levels in the serum of the normal population in Kuwait. Method: A total of 379 healthy males (n = 262) and females (n = 117) of various nationalities living in the State of Kuwait were studied. The serum concentrations of zinc (Zn), copper (Cu) and selenium (Se) were measured and the copper/zinc (Cu/Zn) ratio was calculated. Results: The study established the serum Zn, Cu and Se levels in the studied population. The results showed that there was no significant difference in the serum levels of these elements among the different nationalities tested. A significantly higher serum Cu level and Cu/Zn ratio were seen in females. Conclusion: These findings can form the basis and reference for any future studies on trace elements in different pathologic conditions in the Arabian Gulf region.
Surgical Laparoscopy Endoscopy & Percutaneous Techniques | 2013
Mousa Khoursheed; Ibtisam Al-Bader; Fahad Alasfar; Ali Sayed; Abdulaziz Al-Mozaini; Rajaa Marouf; Abe Fingerhut
Background: The aim of our study was to determine the therapeutic effect of low–molecular weight heparin after laparoscopic Roux-en-Y gastric bypass. Methods: We prospectively analyzed data of 39 patients who underwent Roux-en-Y gastric bypass from 1093 consecutive patients who underwent bariatric procedures from May 1999 to May 2012. All patients were given 40 mg enoxaparin subcutaneously once daily preoperatively and continued for 5 days. Results: There were 31 females. Mean age was 32.48 years and mean body mass index was 44.59 kg/m2. Only 46.1% of patients reached the defined therapeutic dose on the second day and 41% on the fifth day. One fatal pulmonary embolism was recorded (1/1093, 0.09%) in the entire series. Conclusions: Anti-Xa surveillance did not correlate strongly with outcome. Further studies are required for proper dose adjustments of low–molecular weight heparin in these obese patients and whether anti-Xa monitoring should be continued.