Al Amiri Hospital

Berkshire, United Kingdom

Al Amiri Hospital

Berkshire, United Kingdom
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AlMarri F.,Al Amiri Hospital | Al Sabah S.,Al Amiri Hospital | Al Haddad E.,Al Amiri Hospital | Vaz J.D.,Al Amiri Hospital
Obesity Surgery | Year: 2017

Introduction: Obesity has become an epidemic in the Arabian Gulf, with the prevalence of obesity according to the latest report from the World Health Organization (WHO) showing the gulf region to be countries with the highest incidence of obesity in the 30% plus group. This study aims to examine publications on bariatric surgery and compare them with the other countries with a high incidence of obesity in the world. Methods: A literature review on bariatric surgery published from the earliest detected year of publication up until March 2016 using SCOPUS, PubMed, Ovid, and Google Scholar was conducted. Individual papers were assessed for types of surgery, preoperative measures, names of journals, authors, and outcomes. The data was analyzed using Endnote library and SPSS. Key words used in the search included “Bariatric Surgery,” “Arabian Gulf,” “Kuwait,” “Qatar,” “Saudi Arabia,” “United Arab Emirates,” “Oman,” “USA,” “Australia,” “weight loss surgery,” “sleeve gastrectomy,” “gastric bypass,” “gastric band,” “mini-gastric bypass,” “biliropancreatic diversion,” “duodenal switch,” and “intragastric balloon.” Original papers, systematic reviews and case reports were included. Results: From our review, the gastric sleeve proved to be the most popular published on procedure in the Arabian Gulf, whereas the USA had the highest percentage of gastric bypass surgeries and Australia had equivalent numbers when it came to gastric bypass and band. The numbers of studies from Saudi Arabia, Kuwait, UAE, Bahrain, Qatar, and Oman were 70, 44, 20, 7, 6, and 0, respectively. The mean impact factor of the published articles was 2.53 +/− 1.76 SD. Most of the publications were published in Obesity Surgery (29%), Surgery for Obesity and Related Diseases (5%), and Surgical Endoscopy (5%). Conclusion: The Arabian Gulf has both the highest percentage of bariatric procedures performed as well as the highest prevalence of obesity. However, they have the lowest number of publications and research when compared to their western counterparts; therefore, more research and publications are needed in the Arabian Gulf region, as well as the possibility of producing a regional registry to be able to have a good overview of bariatric surgery in the region. © 2017 Springer Science+Business Media New York

Al Sabah S.,Al Amiri Hospital | Al Haddad E.,Al Amiri Hospital | Muzaffar T.H.,Al Amiri Hospital | Almulla A.,Al Amiri Hospital
Obesity Surgery | Year: 2017

Background: The prevalence of obesity is on a continuous rise worldwide, with major studies clearly correlating obesity with the development of chronic metabolic disorders including type 2 diabetes. Bariatric surgery has proven to be beneficial in the management of this condition; however, a limited number of studies exist on its effect on type 1 diabetes. Objective: The objective of this study is to evaluate the outcome of laparoscopic sleeve gastrectomy for the management of patients with type 1 diabetes (DM1). Setting: This is a retrospective cohort study conducted in a university hospital and private practice in Kuwait. Research Design and Methods: Analysis was conducted on 10 patients diagnosed with type 1 diabetes that underwent bariatric surgery from October 2008 until December 2016 at Amiri Hospital and Royale Hayat Hospital, Kuwait. Primary parameters included body mass index (BMI), % excess weight (%EWL) loss at follow-up, glycosylated hemoglobin (A1C), and basal insulin requirements. Total cholesterol readings and fasting blood glucose (FBS) levels were considered secondary outcomes. Statistical analysis of the data was carried out using Statistical Package for the Social Sciences (SPSS) software. Results: Mean BMI showed a reduction from 41.9 ± 5.4 to 31.4 ± 8.4 kg/m2. Mean %EWL after the follow-up period was 74.4 ± 25.3%. A1C levels failed to show a significant difference 12 months post-op (p = 0.189). Cholesterol levels did not display a significant decrease either (p = 0.447). When it came to insulin requirements, a significant difference was perceived, with the mean number of units of insulin required dropping from 76.6 to 18.2 (p = 0.026). FBS readings also showed a drop from 15.1 ± 3.8 to 7.8 ± 2.9 mmol/L (p = 0.001). Conclusions: Laparoscopic sleeve gastrectomy resulted in significant weight loss, comorbidity resolution as well as reduction in their insulin doses post-op. However, glycemic control does not seem to show significant improvement in these patients. Larger, more long-term studies are needed to reach a definite conclusion on this topic. © 2017 Springer Science+Business Media, LLC

Malallah M.A.,Al Adan Hospital | Al-Shaiji T.F.,Al Amiri Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2015

Introduction and hypothesis: Treatment escalation from conservative directly to surgical in the management of pure stress urinary incontinence (SUI) reveals a gap for effective pharmacological treatments. The introduction of a drug therapy would fill this gap and widen the treatment options. Nevertheless, various pharmaceutical agents have been used off-label and are being investigated and becoming more widely available. In this review, we examined the latest published data regarding pharmacotherapy used in the treatment of SUI. Methods: We performed a literature review to evaluate the relevant studies pertaining to any pharmacotherapy used in the management of SUI, examining the English language literature. Results: Currently, no drug exists that is approved by the food and drug administration for the management of SUI. A few oral pharmacological agents are occasionally used off-label. Lack of proven efficacy and high incidence of bothersome side effects of these agents limit their use. Duloxetine, a serotonin norepinephrine reuptake inhibitor, represents a major therapeutic advance for the treatment of SUI based on findings from a number of controlled clinical trials. Conclusions: Several pharmacological agents have been used off-label and investigated for safety and efficacy, but none has demonstrated sufficient effectiveness to receive widespread verification for its use in the treatment of SUI. © 2015, The International Urogynecological Association.

Al-Terki A.,Al Amiri Hospital | Al-Qaoud T.,McGill University
Advances in Urology | Year: 2011

Pertinent history taking and careful examination often taper the differentials of the acute scrotum; congruently the ability to diagnose acute spermatic cord torsion (SCT) when radiological adjuncts are not available is highly imperative. This observational study serves to present a series of 46 cases of spermatic cord torsion whereby we hypothesize the identification of a clinical knot on scrotal examination as an important clinical aid in making a decision to surgical exploration in patients with acute and subacute SCT, especially in centers where imaging resources are unavailable. Copyright © 2011 Abdullatif Al-Terki and Talal Al-Qaoud.

Al Mutairi S.,Kuwait University | Mojiminiyi O.A.,Kuwait University | Al Alawi A.,Al Amiri Hospital | Al Rammah T.,Kuwait University | Abdella N.,Kuwait University
Disease Markers | Year: 2014

Background. Published studies showed conflicting results of the associations between adiponectin and leptin levels and obstructive sleep apnoea (OSA). In obese patients, plasma leptin is elevated and adiponectin is decreased, and we postulate that these adipokines could be potential markers of clinical and metabolic perturbations in patients with OSA. Methods. 147 patients with suspected OSA had polysomnography to determine the Respiratory Disturbance Index (RDI). We measured fasting plasma glucose (FPG), fasting serum insulin, plasma leptin, adiponectin, and full lipid profile. Patients were classified on the basis of the RDI, degree of adiposity, and insulin resistance (IR) (homeostasis model assessment of insulin resistance (HOMAIR)). Results. 28.6% of subjects had normal polysomnography, 34.8% had mild OSA, 19.6% had moderate OSA, and 17% had severe OSA. Obesity was more prevalent in subjects with moderate-severe OSA (47%). Adiponectin decreased significantly (P=0.041) with increasing severity of OSA. Though BMI was significantly higher in subjects with severe OSA, paradoxically, leptin was lowest in those subjects independent of gender dimorphism. Conclusions. Adiponectin is an independent marker of disease severity in patients with OSA. The paradoxical decrease in circulating leptin, which suggests impaired secretion, deserves further studies as a potential marker of severe OSA. © 2014 Sana Al Mutairi et al.

El-Reshaid K.,Kuwait University | Madda J.P.,Al Amiri Hospital
Case Reports in Dermatology | Year: 2013

We report our clinical experience with rituximab in the treatment of 2 patients with idiopathic cutaneous angiitis who relapsed after treatment with high-dose corticosteroids and cyclophosphamide. A 39-year-old woman and a 51-year-old man presented with ulcerating maculopapular rash in both lower limbs which relapsed 6 months after treatment with a combination of high-dose corticosteroids and cyclophosphamide. After treatment with 2 g of rituximab, the first patient has still been in clinical remission for 32 months while the second has finished 28 months. Interestingly, CD19 which had dropped to <0.1 one week following the start of retuximab had increased to >0.5% 8 months later in both patients. Despite that, our patients are still in clinical remission. No significant side effects were noted during infusions and up to the period of follow-up. In conclusion, rituximab is a useful and safe agent in the treatment of idiopathic cutaneous angiitis refractory to conventional therapy. Clinical remission persists years after improvement of B-cell suppression. © 2013 S. Karger AG, Basel.

Benwan K.A.,Al Amiri Hospital | Mulla A.A.,Al Amiri Hospital | Rotimi V.O.,Kuwait University
Journal of Infection and Public Health | Year: 2012

The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents. Data were obtained from a retrospective analysis of DFI samples collected from June 2007 to July 2008. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques, and antibiotic susceptibility testing was performed according to the methods recommended by the Clinical and Laboratory Standards Institute (CLSI). Extended-spectrum β-lactamase (ESBL) production was measured using the double disk synergy test and the ESBL Etest. A total of 440 patients were diagnosed with DFIs during this period, and a total of 777 pathogens were isolated from these patients with an average of 1.8 pathogens per lesion. We isolated more Gram-negative pathogens (51.2%) than Gram-positive pathogens (32.3%) or anaerobes (15.3%). Polymicrobial infection was identified in 75% of the patients. The predominant organisms isolated were members of the Enterobacteriaceae family (28.5%), Pseudomonas aeruginosa (17.4%), Staphylococcus aureus (11.8%), methicillin-resistant S. aureus (7.7%), anaerobic Gram-negative organisms (10.8%), and Enterococcus spp. (7%). Vancomycin was the most effective treatment for Gram-positive bacteria, and imipenem, piperacillin-tazobactam and amikacin were the most effective treatments for the Gram-negative bacteria. In conclusion, DFI is common among diabetic patients in Kuwait, and most of the cases evaluated in this study displayed polymicrobial etiology. The majority of isolates were multi-drug resistant. The data gathered in this study will be beneficial for future determinations of empirical therapy policies for the management of DFIs. © 2011 King Saud Bin Abdulaziz University for Health Sciences.

Sallam H.E.,Al Amiri Hospital
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2012

An 18-year-old man presented with severe nephrotic syndrome due to focal segmental glomerulosclerosis. His disease failed to remit with corticosteroids, calcineurin inhibitors, mycophenolate and rituximab. As his disease progressed with time, his anasarca became more resistant to high-dose combination diuretics and he developed multiple life-threatening bacterial infections. He was subjected to bilateral renal artery embolization with 99.8% alcohol to ablate his kidneys. Subsequently, the patient was maintained on hemodialysis and had normal serum albumin and did not have further infections. The procedure itself was simple and well tolerated, with only a minor post-embolization syndrome.

Al-Baghli F.,Al Amiri Hospital | Al-Ateeqi W.,Al Amiri Hospital
Medical Principles and Practice | Year: 2011

Objective: To report an 11-year-old girl with encephalitis-associated pandemic influenza A (H1N1) 2009 virus infection. Clinical Presentation and Intervention: An 11-year-old girl presented with a 6-day history of influenza-like illness followed by an altered mental status for 1 day. She tested positive for pandemic influenza A (H1N1) 2009 virus by PCR of her nasal swab. Her CSF analysis was completely normal, including PCR for pandemic influenza A virus. Her brain MRI and EEG showed evidence suggestive of encephalitis. She was treated with oral Oseltamivir with good recovery. Conclusion: This case report shows that neurological complications can occur after respiratory tract infection with pandemic influenza A (H1N1) 2009 virus. Copyright © 2011 S. Karger AG, Basel.

Al-Ghimlas F.,Al Amiri Hospital | Todd D.C.,McMaster University
Respirology | Year: 2010

Background and objective: Creatine improves muscle strength in exercising healthy individuals, and in patients with neuromuscular disease and heart failure. The aim of this study was to assess whether creatine supplementation improves pulmonary rehabilitation (PR) outcomes in patients with COPD. Methods: A systematic review and meta-analysis was performed of randomized controlled trials published between January 1966 and February 2009 that evaluated the effect of creatine compared with placebo on exercise capacity, muscle strength and health-related quality of life (HR-QoL) in patients undergoing PR for COPD. The pooled estimates were expressed as mean differences (MD) or standardized mean differences (SMD). Results: Four randomized controlled trials that included 151 patients were identified. There was no effect of creatine supplementation on exercise capacity (SMD-0.01, 95% CI:-0.42 to 0.22, n = 151). Creatine supplementation did not improve lower extremity muscle strength (SMD 0.03, 95% CI:-0.55 to 0.61, n = 140) or upper limb muscular strength (SMD 0.02, 95% CI:-0.33 to 0.38, n = 128) compared with placebo. Two studies (n = 48) assessed quality of life using the St. George's Respiratory Disease Questionnaire. There were no differences in HR-QoL according to domain or total scores. Overall, creatine appeared to be safe and was well tolerated. Quality assessment of the studies showed important limitations. Conclusions: Creatine supplementation does not improve exercise capacity, muscle strength or HR-QoL in patients with COPD receiving PR. However, important limitations were identified in the quality of the available evidence, suggesting that further research is required in this area. © 2010 The Authors.

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