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CLINICAL, EPIDEMIOLOGICAL AND MICROBIOLOGICAL PROFILES OF PATIENTS TREATED WITH COLISTIN AT TERTIARY CARE HOSPITALS IN PALESTINE
(An-Najah National University, 2026-09-08) Ithar Moufak Abdulazeez Barghouthi
Background: Antimicrobial resistance (AMR) constitutes a major worldwide public health problem in the 21st century. Colistin (polymyxin E) was re-introduced into clinical practice as a vital last-resort salvage agent against pan-drug-resistant and carbapenemase-producing Gram-negative pathogens. In Palestine, comprehensive studies regarding colistin use and resistance patterns are severely lacking due to the absence of a national surveillance system. This study aimed to evaluate the clinical, epidemiological, and microbiological profiles of patients treated with colistin in two major Palestinian tertiary care hospitals to construct essential baseline data for antimicrobial stewardship and infection control guidelines. Methods: A retrospective multi-center cross sectional study was conducted at An-Najah National University Hospital (ANNUH, Nablus) and The Istishari Arab Hospital (IAH, Ramallah) from 2021 to 2023. Total population sampling was applied to identify all adult inpatients (≥18 years) receiving intravenous colistin. Demographic information, underlying comorbidities, risk factors, ward distribution, admitting diagnoses, colistin dosing regimens, combination therapies, culture sources, isolated bacterial strains, antibiotic susceptibility patterns, and clinical outcomes (improvement versus in-hospital mortality) were systematically retrieved from electronic health records and analyzed using SPSS version 25. Results: A total of 867 patients (296 patients from ANNUH and 571 patients from IAH). The mean age of the patients was 52.16 years, while 588(67.82%) of them were males. Indwelling catheter use (62.1%) and central line use (36.3%) were the most prevalent risk factors. The majority of colistin utilization occurred in the intensive care unit (ICU) Department (36.2%). The most common admitting diagnosis was malignancy/cancer. Meropenem was the most common combined antibiotic (40.8%). In 57% of the cases, colistin was given as targeted therapy following the culture. Colistin was given intravenously in 100% of the cases; the most prescribed dose was 4.5 million units in 95.2% of the cases, every 24 hours (90.6%). Following the regimen, the outcome was measured, and 92.5% of the patients improved while 7.5% died. Among the 323 patients with positive microbiological cultures, Acinetobacter baumannii was the most frequently isolated organism (29.7%), followed by Stenotrophomonas maltophilia (24.1%), Klebsiella pneumoniae (23.5%), Escherichia coli (21.4%), and Pseudomonas aeruginosa (1.2%). Colistin susceptibility was highest among Klebsiella pneumoniae and Pseudomonas aeruginosa isolates (100%), followed by Escherichia coli (98.5%) and Acinetobacter baumannii (91.6%), whereas Stenotrophomonas maltophilia demonstrated the lowest susceptibility rate (70.7%). ICU admission, invasive device use (central venous catheters and mechanical ventilation), recent healthcare exposure (prior hospitalization, surgery, and antibiotic use), immunosuppression, underlying comorbidities (diabetes mellitus, cardiovascular disease, cancer, renal failure, respiratory disease, and COVID-19), bloodstream and urinary tract infections, and resistance to multiple antibiotics were all significantly linked to mortality. Conclusion: This study successfully constructs the first comprehensive baseline of colistin use, susceptibility, and outcomes in Palestinian tertiary hospitals. It emphasizes that colistin is still an indispensable last-line agent to defend bacteria; Because it achieved high overall clinical improvement rate with low in-hospital mortality. Colistin has high susceptibility across Enterobacterales and Acinetobacter, while S. maltophilia's resistance rate represents an alarming challenge. This makes colistin preservation a critical national priority in addition to empowered antimicrobial stewardship and infection control. To build on this work, further prospective studies with active drug monitoring, genomic surveillance, comparative efficacy trials are proposed.
EFFICIENT PRECONDITIONER FOR IMPLICIT RUNGE-KUTTA METHODS OF PARABOLIC EQUATIONS
(An-Najah National University, 2026-08-27) Marah Bilal Shaikh Ibrahim
This research talks about the numerical solution of the one-dimensional heat equation using the Finite Element Method (FEM) for spatial discretization using two high-order implicit Runge–Kutta schemes for time integration Gauss–Legendre and Radau IIA. The aim of the study is to evaluate the stability, accuracy and computational efficiency of these fully implicit collocation methods when applied to parabolic partial differential equations PDEs with study the effectiveness of preconditioning in reducing the iterations and improving the convergence of GMRES. The numerical experiments reveal that Gauss–Legendre, while it is slightly less energy wasting, keep high time-related accuracy and exhibits reliable performance with cut-price computational cost. Radau IIA supplies excellent stability and strong damping of high-frequency numerical modes, leading to smooth and highly exact solutions even for relatively large time steps. Comparisons with analytical solutions evidence the correctness of the spatial FEM scheme and the high-order convergence of both time integrators. In general, the outcomes highlight the effectiveness of combining FEM with advanced implicit Runge–Kutta schemes for long-time heat diffusion simulations. The study shows an evident assessment of the advantages and disadvantages between Radau IIA and Gauss–Legendre, offering useful insight for selecting robust and efficient time-integration strategies for parabolic PDEs.
CHALLENGES OF DEVELOPING AND IMPLEMENTING AN ORAL HEALTH POLICY IN PALESTINE
(An-Najah National University, 2026-09-10) Rawan Nabeel Melhem
Background: Oral health in Palestine remains poorly integrated into the national healthcare system, and oral health policy faces structural, administrative, financial, and political challenges. Objectives: To explore structural and administrative barriers to oral health policy development and implementation in Palestine, examine financial, resource, and political challenges to service provision, assess the accessibility and effectiveness of existing policies for vulnerable populations, and identify strategies to strengthen policy integration. Methodology: A quantitative, descriptive-analytic, cross-sectional design was used. Based on an estimated population of 5,600 professionals, Cochran’s formula gave a minimum sample of 232; 231 valid questionnaires were analyzed in SPSS using descriptive statistics, Cronbach’s alpha, one-sample t-tests, Pearson correlation, and multiple linear regression. Five exploratory interviews informed questionnaire development. Results: Structural and administrative barriers (M = 4.033), financial constraints and resource availability (M = 4.095), and service accessibility and policy effectiveness (M = 3.866) were all rated significantly above the neutral value of 3.00 (p < 0.001). Together they explained 67.4% of the variance in oral health policy development and implementation (R² = 0.674, p < 0.001), with financial constraints the strongest predictor (β = 0.339), followed by structural and administrative barriers (β = 0.312) and service accessibility (β = 0.261). Stakeholder cooperation was the most strongly endorsed strategy (M = 4.234). Conclusions: Governance, financing, and political conditions are interrelated challenges to oral health policy in Palestine. Dedicated financing, stronger coordination and data systems, and integration of oral health into primary healthcare are needed.
NeuroLand
(Dr. Ashraf Armoush, 2026-06-15) Almotasembellah Yaser Jararaa; & Siwar Diab
NeuroLand is a full-stack platform that consolidates the fragmented workflow of paediatric and disability-focused therapy into a single product spanning web and mobile. Guardians register their dependents, search an admin-verified therapist directory, book and pay for sessions, message therapists in real time, and read progress reports that an AI layer can simplify into parent-friendly language. Therapists manage assigned patients, set their availability, run video sessions, draft reports with AI assistance, build treatment plans with measurable goals, and assign therapeutic activities. Institutions oversee a roster of therapists, monitor analytics, and manage enrolments, while administrators verify therapist credentials, manage roles and custom fields, generate per-user reports, and watch an append-only activity log of every sensitive action. The system is delivered as three independent applications sharing one REST and Socket.io backend: a React web client, an Expo / React Native mobile app, and an Express + MongoDB server secured with JWT authentication, Helmet, rate limiting, and input validation. AI features are served by a locally hosted Ollama model behind a safety layer that redacts personally identifying information, blocks diagnostic prompts, and detects crisis language. Notifications are delivered across three channels — in-app, email, and mobile push — chosen per event from the recipient's preferences and online presence. The result links every record — session to report to treatment plan to activity to progress timeline to guardian feedback — into a single longitudinal view, with a verification-and-audit posture suited to a healthcare-adjacent domain and a child-accessible, PIN-based patient interface offering adjustable font, contrast, text-to-speech, and a simplified mode. Keywords: care coordination, telehealth, accessibility, role-based access control, real-time messaging, treatment plans, AI-assisted documentation, MERN, React Native, MongoDB.
KNOWLEDGE, ATTITUDE AND PRACTICE OF EMERGENCY CARE NURSES TOWARD THE INITIAL MANAGEMENTS OF ACUTE POISINING IN NORTHEN WEST BANK
(An-Najah National University, 2026-08-26) Ameer khateeb