Doctor of Medicine

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https://hdl.handle.net/20.500.11888/15063

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Radon detection in the drinking water supply of Nablus city, Palestine
(2011-05-20) Shaza, Yaser Issa; Dr. Hamzeh Al Zabadi, Dr. Samar Musmar
Introduction: Radon gas is the second cause of lung cancer and is found naturally in rock, soil, and water. The objective of this study is to determine the radon level in the drinking water in Nablus city and to compare it with world standard level. Methods:Samples were taken from 4 wells and 5 springs that supplied Nablus city residence with water. For each source, 3 samples were analysed by using RAD 7 device which manufactured by Durridge company. Each sample analysed for 4 cycles and the average for them was taken. Finally the average for each source was calculated. We also took 3 samples from tap water for each region of the 7 regions of Nablus city according to the division of Nablus municipality. And 10 samples from the old city. In Nablus,water pumped from main sources to pump stations, then mixed in the collecting reservoirs, then pumped to houses reservoirs and finally to taps. Results: Theconcentration of radon in main sources ranged from 2.3 to 23.4 Bq/L with a mean of 6.9 Bq/L. 4.6 Bq/L and 9.5 Bq/L are the means for springs and wells respectively. For tap water in the 7 regions the results ranged from 0.9 to 1.3 Bq/l with the mean of 1.0 Bq/L and for old city the mean was 2.3 Bq/L. Conclusion:radon concentration in wells and springs was below the United State environmental protection agency maximum contaminated level (MCL) except for Badan well. And much lower for tap water which reflects lesser risk from exposure to radon. Concentration of radon in the tap water of old city was higher than other regions of Nablus which may because the old city supplied from one source which is close to its dwellings.
Outcomes of Laparoscopic Sleeve Gastrectomy among Obesity Patients in the Northern West Bank: A Retrospective Records Review
(2012-05-20) Ahmad, Daqour; Dr. Hamzeh Al Zabadi
Background: Obesity has become a significant health problem in worldwide. Yet, conservative methods for weight loss are usually disappointing and therefore, bariatric surgeries such as Laparoscopic Sleeve Gastrectomy (LSG) should be considered. The aim of the present study was to evaluate the outcomes (mainly body mass index; BMI) of LSG among obesity patients in the Northern West Bank. Methods: Hospital medical records were reviewed after patients and administrative approvals for all patients who had undergone LSG since the year 2010 in the Arab specialized hospital in Nablus and the Palestinian Red Crescent society hospital in Tulkarem (N=36). In the second phase, patients have been invited again by phone calls to participate in the study. Those who agreed to participate (n=30; response rate=83.3%) were asked to self-report further required pre-operative and post-operative study measures. The primary study outcome was the change in BMI while the secondary outcomes included obesity associated co-morbidities’ measures; hypertension (HTN) and diabetes mellitus (DM). Results: The mean age (standard deviation; SD) of the study participants (n=30; 20 women and 10 men) was 34.06 (10.71) years. After a mean (SD) follow-up time of nearly 7.16 (5.05) months, there was a strong statistically significant reduction in the mean of BMI post-operatively. The mean±SD of the pre-operative BMI was 47.23±7.89 kg/m2 while 36.74±7.74 kg/m2 post-operatively (95% CI for mean differences and p<0.001; 8.83-12.14 and 0.001). For the 6 clinically diagnosed hypertensive patients, there was a mean (SD) reduction of 27.50 (9.87) in systolic pressure (P <0.026) and 18.33 (13.66) of the diastolic blood pressure (P<0.042). For the 3 diabetics in our study, there were clinically and biologically clear mean (SD) reductions in both fasting blood sugar and glycated hemoglobin A1c of about 82.00 (22.70) mg/dl and 1.90 (0.78) %; respectively.In multivariate linear regression analysis, only practicing sports or exercise (no/yes) remained statistically significant with post-operative BMI (regression coefficient B= -7.33;P-value and 95%CI for B; 0.009 and -12.68- -1.98). Conclusions: LSG can significantly improve the BMI and could improve or resolve obesity associated co-morbidities like HTN and DM. We suggest that LSG might be recommended as the useful and single intervention therapy for co-morbid obesity patients who usually fail to reach beneficial results from a structured weight loss programs.
Laparoscopic versus open cholecystectomy in high risky patients” An-Najah National University, Faculty of Medicine and Health Science, 2011-2012
(2012-05-20) Ahmad, Isleem; Dr.Mahmoud Mustafa
Laparoscopic cholecystectomy (LC) is a minimal invasive procedure , however ,in elderly patients the situation is notthe same . the aim of this study is to compare the LC with open cholecystectomy (OC) and to define significant predictors of complications after surgery in elderly patient s. the records of patient who underwent LC or OC in Rafidia surgical hospital , from Jan/2009 to May/2011 were reviewed . the study cohort was divided into three group , group1 (60 -70 years) , group2 (70-80 years) , and group3 (> 80 years). The pre-, intra- and post –operative parameter including age, gender,length of stay (LOS) , complecations, conversion rate ,and mortality were reviewed for each group. Risk factors were examined using uni-and multivariate analysis. Total of 124 patients were included : 58 patient (46.8%) underwent LC and 66 patients (53.2%) had OC . the females were the dominant gender in both tyepes of operation . patients who underwent OC were older ,and more comorbidity and more emergency surgery than LC patients . the percentage of male gender, emergent surgeries, presence of acute inflammation , more comorbid diseases and increased time to surgery than LC patients . the percentage of male gender , emergent surgeries, presence of acute inflammation, more comorbid diseases and increased time to surgery from addition increase with age. Conversion rate was found to be 10.34% . LOS was longer in OC than than in LC ( mean 7.38 day and 5.21, respectively, p 0.013 ). Complication rate was significantly lower in LC 27.6% than in OC 48.5% ( p0.017 ). Male gender ( p<.0001 ) , presence of comorbidity ( p0.007 ) and increased time to surgery ( p < .0001 ) were all significantly associated with the incidence of complications. Shorter LOS, lower post-operative complications and lower mortality rate are among the most important consideration of LC. We believed that LC is a feasible and safe procedure with a pleased comparable result to OC in elderly patients with Gallbladder disease
Pattern of fine needle aspiration breast lesion, results in north west bank-a cross sectional study
(2013-05-20) An'am, Dweikat; Dr. Rami Zagha
Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women and is the second leading cause of cancer death among women after lung cancer. Breast cancer detection, treatment, and prevention are prominent issues in public health of medical practice. The aim of the study was revealing the pattern of FNA results of breast lesions and assessing the ability of this modality to detect benign Vs malignant lesions. Common benign pattern of this tests are consistent with international results.
Outcomes of Bristow-Latarjet Procedure in the Treatment of Recurrent Anterior Shoulder Dislocation
(2013-05-20) Saja Omar Adas; Dr. Marwan Al-Jayousi
Operative stabilization is considered the usual treatment for recurrent shoulder dislocation after failure of the supervised rehabilitation program. Many types of procedures have been proposed for the treatment of recurrent shoulder dislocation with different long term results in terms of shoulder function and stability. In the present study we aimed to analyze the clinical and radiological outcomes of Bristow-Latarjet procedure in patients with recurrent anterior shoulder dislocation. Thirteen patients who underwent Bristow-Latarjet operation from 2002 to 2011 were followed up for 2-10 years. Rowe score for instability, physical and radiological examinations were used to assess outcomes. There had been no recurrences of dislocation after surgery among all patients, but two patients (15.4%) reported subluxation. Six cases (46.2%) had limitation of external rotation compared with the non-operated shoulders. The mean postoperative Rowe score at follow-up was 88 excellent (range 55-100).10 patients had excellent scores (76.9%), one had a good score (7.7 %) and two had scored fair (15.4 %). In conclusion, Bristow-Latarjet procedure is a good reliable surgical method for treatment of patients with recurrent anterior shoulder dislocation and is associated with high rate of satisfaction and good functional results.
The prevalence and predisposing factors of urinary incontinence in female patients visiting gynecology out patients clinics
(2013-05-20) Raya Bedar; Lana Daraghma; Dr.Mahmoud Mustafa
Objectives:To determine the percentage and risk factors of urinary incontinence (UI) in general and stress UI in particular in women of north West Bank. Methods:In this cross-sectional study, 300 women aged over 25 years were interviewed and a data collection form was filled. Results:The overall prevalence of UI was 58.7% (n = 185). Among these women, 115 (38.3%) had stress, 28 (9.3%) urge and 33 (11%) mixed type UI. The prevalence rate increased with advancing age. UI was significantly associated with obesity, smoking, hypertension and hysterectomy. On the other hand, stress UI was significantly associated with episiotomy, DM, smoking, hypertension and obesity. Overall, 123 (70%) women stated that UI have negative impact on the quality of life, but only 20 (10.7%) sought medical attention. Conclusions:UI affect approximately half of North West Bank women. The results emphasize that UI is a major health problem that many women are ashamed to talk with their physicians about it, so preventive measures should be taken and women should be educated about this problem.
The Prevalence of Uncontrolled Hypertension among Patients Taking Antihypertensive Medications and Associated Factors in Nablus Governorate-North West Bank
(2013-05-20) Issa Alawneh; Ahmad Yasin; Dr. Samar Musmar
Background: Uncontrolled hypertension (HTN) is a challenge for public health professionals all over the world. It is the leading and most important modifiable risk factor for coronary artery disease, congestive heart failure, stroke, renal diseases and retinopathy. Objectives: The aim of the present study was to estimate the prevalence of uncontrolled HTN among Palestinian hypertensive patients on treatment and under primary health care( PHC) settings follow-up in Nablus governorate – North West Bank. In addition, the study aimed to explore the relationship of some socio-demographic and clinical factors with HTN control. Methods: A cross sectional study was conducted at central PHC setting in Nablus city. By using convenience sampling method, the sample size was 218 adults, aged 18 years and above who satisfied the inclusion criteria and consisted of 87 (39.9%) men and 131 (60.1%) women. A systematic random method was used for the selection of the above sample. A structural questionnaire was completed during a face -to- face interview. Blood pressure (BP) was measured using a mercury sphygmomanometer according to the recommendations of the 7th report of The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC-7). Height was measured with an ordinary measuring tape to the nearest centimeter (cm). Weight was measured with ordinary scale- non electronic portable balance to the nearest 0.5 kilogram (kg). Chi Square Test and multivariate logistic regression were applied for data analysis. Results: The targets for adequate BP control were achieved in 37.6 % of the studied patients. Lower BP control was found among hypertensive patients who were smokers (OR = 4.068, P
The prevalence and predisposing factors of urinary incontinence in female patients visiting gynecology out patients clinics
(2013-05-20) Raya, Bedar; Lana, Daraghma; Dr.Mahmoud Mustafa
Objectives:To determine the percentage and risk factors of urinary incontinence (UI) in general and stress UI in particular in women of north West Bank. Methods:In this cross-sectional study, 300 women aged over 25 years were interviewed and a data collection form was filled. Results:The overall prevalence of UI was 58.7% (n = 185). Among these women, 115 (38.3%) had stress, 28 (9.3%) urge and 33 (11%) mixed type UI. The prevalence rate increased with advancing age. UI was significantly associated with obesity, smoking, hypertension and hysterectomy. On the other hand, stress UI was significantly associated with episiotomy, DM, smoking, hypertension and obesity. Overall, 123 (70%) women stated that UI have negative impact on the quality of life, but only 20 (10.7%) sought medical attention. Conclusions:UI affect approximately half of North West Bank women. The results emphasize that UI is a major health problem that many women are ashamed to talk with their physicians about it, so preventive measures should be taken and women should be educated about this problem.
Pattern of fine needle aspiration breast lesion, results in north west bank-a cross sectional study
(2013-05-20) An'am Dweikat; Dr. Rami Zagha
Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women and is the second leading cause of cancer death among women after lung cancer. Breast cancer detection, treatment, and prevention are prominent issues in public health of medical practice. The aim of the study was revealing the pattern of FNA results of breast lesions and assessing the ability of this modality to detect benign Vs malignant lesions. Common benign pattern of this tests are consistent with international results.
The relation between serum prostate specific antigens values and serum testosterone level in health men.
(2013-05-20) Haythem Abu khadija; Osama Mareshdeh; Osama Mareshdeh; Dr. Mahmoud Mustafa , Dr.Basma Damiri
Background: PSA is present in small quantities in the serum of men with healthy prostates, but is often elevated in the presence of prostate cancer or other prostate disorders. Prostate epithelium which is under direct effect of dehydroepiandrosterone (DHEA), which is a metabolite of testosterone, secrete PSA, there is a known relation between testosterone and PSA in case of prostate cancer, in which there is increase in level of PSA. Thus, it is logically to expect relation between testosterone level and PSA value which is the most common marker for prostate cancer, When the PSA below 4 ng/ml . Objectives:To evaluate the relationship between the levels of total testosterone and total prostate specific antigen (PSA) in men with PSA values ˂ 4ng/ml in North West Bank, and also to see relation of PSA and testosterone changes with age. Material and Methods: A cross sectional study was conducted,the study comprised 388 participants with mean age 51+6 years (yr) who visited outpatient urology clinics between January 2013 and June 2013. The men were divided into two subgroups; men with PSA ≤2.5 (group 1, 361 men), men with PSA values >2.5 ng/ml (group II, 27 men). The relationship between levels of PSA and testosterone were investigated in both groups and in men as whole. Results:In all sample the mean value for serum PSA values and total testosterone level were 1.1± 0.8ng/ml and 3.8±2.3 ng/ml respectively. No correlation was detected between serum PSA and testosterone levels neither in the subgroups (group I, r= 0.06, p=0.24, group II, r= 0.24, p=0.21) nor in men as a whole (r=0.05, p=0.34).There is significant positive relation between PSA and age (r= 0.2, p ˂ 0.01) and significant negative relation between Testosterone and age (r= - 0.29, p ˂ 0.01). Conclusions:No impact of testosterone hormone on PSA level in men with PSA ˂4ng/ml. Therefore, high serum testosterone level may not mandate adjustment of PSA values. Serum sex hormone showed significant decrease of testosterone with age after 40 years. Further studies including larger number of people should be carried out to confirm the findings of this study.
The Prevalence of Inherited Color Vision Deficiency Among Male School Children Aged 14-18 in the Palestinian Governorate of Nablus
(2013-05-20) Ammar Aghbar; Mu'ath Salman; Dr.Abdul Fattah Arafat , Dr.Mazen Khwaire Dr. Liana Al-Labadi
BACKGROUND: Inherited color vision deficiency (CVD) is one of the most common inherited vision disorders. It is a sex-linked recessive trait with a prevalence that is both racial and gender dependent. The frequency of color vision deficiency in Palestine has not been studied previously. This study surveyed the prevalence of inherited CVD among male-school students aged 14-18 in the Palestinian governorate of Nablus. METHODS: Six hundred thirty-four male subjects (N=634) aged 14-18 from Palestinian Governorate of Nablus were randomly selected and screened using Ishihara pseudoisochromatic plates. Subjects who failed Ishihara screening were tested further with a computer software of Farnsworth-Munsell 100 Hue test. RESULTS: Out of the 634 male participants, 597 were included and (48males) 8.0% of them demonstrated red-green CVD. 5.4%, 2.3% and 0.3% of the 48 males exhibited deutan, protan and total color vision defects, respectively. CONCLUSION: The results show that the prevalence of red-green CVD among the male school children from Palestinian Governorate of Nablus is not significantly different from that of male populations in nearby and Western countries. Key words: Color vision deficiency, Ishihara color test, Prevalence, Redgreen defects, Palestine, Males, Nablus.
The role of factor V leiden and associated risk factors in venous thromboembolism among Palestinians in the city of Nablus
(2013-05-20) Afnan Shehadeh, Amal Al-Shaikh Ibrahim; Dr. Ayman Hussein
Deep vein thrombosis (DVT) is a common condition that can lead to complications such as postphlebitic syndrome, pulmonary embolism and death. It is a typical multifactorial disease involving the interaction of many factors such as aging, obesity, surgery, pregnancy, postpartum and oral contraceptives or cancers, with genetic predisposing risk factors. This condition is increased when combined with acquired or inherited risk factors that lead to thrombophilia. Among the inherited risk factors is factor V leiden mutation, an autosomal dominant disorder. In the present study, we performed a case- control study to investigate the association between FVL mutation and deep vein thrombosis. The study included 100 subjects with DVT and 100 matched control subjects without DVT. Leiden mutation was detected in 25 (25%) of the 100 study cases, and in 9 (9%) of the 100 control subjects. Data analysis indicates a significant association between the mutant allele and DVT (p-value< 0.05). In conclusion, these results provide a significant correlation between deep venous thrombosis and factor V leiden mutation among DVT patients in the city of Nablus .
Distribution and Factors Associated with the Occurrence of Road Traffic Crashes in West Bank
(2013-05-20) Mohammed Awad, Omar Abu-Zaydeh; Dr. Amira Shaheen , Dr. Jon Mark Hirshon
Background: Road Traffic Crashes (RTCs) are one of the leading causes of morbidity and mortality worldwide. RTCs take approximately 1.2 million lives per year, 86% of deaths occurring in low- and middle-income countries. 20-50 million people are seriously injured each year. Objective: To investigate the distribution and factors associated with the occurrence of road traffic crashes in the West Bank (Septemper2009- September2012). Methods: This cross-sectional study included all RTCs recorded by the MoH in West Bank over the period (Septemper2009- September2012) which are equal to 24756 cases. The study based on the database of MoH for RTC that was collected upon an information sheet filled by the doctors in the hospitals who are responsible for the management of the cases. Data was analyzed by using descriptive statistics and correlation through SPSS16. Results: There were 24756 cases of injuries due to RTCs over the period (Septemper2009- September2012) including 134 deaths, 74.4% of injured people were males. The mean age was 27.2 years and the majority of RTCs (52.3%) were observed to occur between the age group 18-45 years. North West Bank had the highest percentage of RTCs (48.4%).RTCs was varied between months, with the highest to be reported in each of July (10.03%), August (10.21%), and September (11.06%) respectively. Passengers travelling in a vehicle with four wheels were observed to have the highest percentage of injuries due to RTCs (44.8%). Most of the deaths was observed among persons who reported to have a head injury (n=52, 38.80%). Significant associations were observed between the occurrence of road traffic crashes with age (=7.25, P-value=0.027) and district (=20.80, P-value < 0.0001). Conclusions: The study revealed that there were low rates of injuries and death in the West Bank during the mentioned period comparing to the other countries in the region but it’s higher in comparison with many global countries. There were high death rates among pedestrian comparing to other mode of transportation. Significant increase in the rates of injuries and death was noticed during the month of Ramadan.
The Effect of Passive Smoking Exposure during Pregnancy on the Central Nervous System Structure and Behavior of the Hamster’s Offspring
(2013-05-20) Waseem Khraim Wathiq Sharqia, Wathiq Sharqia; Dr. Waleed Basha , Prof. Waleed Ajaj
Background:Exposure to tobacco smoke is considered to be the single major preventable risk factor for morbidity and mortality of the mother and fetus. Although there are many epidemiological studies about passive smoking, a little animal-based researches focusing on the effect of tobacco on the nervous system development so that a quasi-experimental study is conducted. Objective:The main objective is to examine the effect of passive smoking exposure during pregnancy on structural integrity of central nervous system of the hamster’s offspring, in addition to assess their neurobehavioral functions such as short term memory, anxiety and social interaction. Methods: About 35 pregnant hamsters were divided into five groups, based on which pregnancy trimesters they were exposed to smoke (1st, 2nd/3rd) and duration of exposure (4 hours, 6 hours). Then, 78 of their babies were evaluated at age 4 weeks for memory function by T-maze test, anxiety by using marble burying test and social behavior by social dominance test. After that, the offspring of the five groups were examined by CT scan looking for gross structural abnormalities in the brain and spinal cord. Results:The collected data showed a significant correlation between exposure to passive smoke during 1st trimester and presence of short term memory impairment [p= 0.047] as well as increasing anxiety level [p = 0.024]. While exposure to passive smoke during 2nd/3rd trimesters were also associated with memory dysfunction, but without affecting anxiety level compared with the control group. On the other hand, research data cannot establish the dose-dependent effect of smoking as no significant difference was found between high and low doses. CT scan revealed the presence of lumbar spinal stenosis in the group that was exposed to 6 hours-smoking during 1st trimester of pregnancy. Conclusions and recommendations: There is a relation between exposure to passive smoking during pregnancy and presence of neurobehavioral changes, especially in short-term working memory and anxious behavior. Therefore, the research recommends conducting more experimental studies focusing on 1st trimester to establish good evidence about these behavioral changes. In addition, the presence of structural abnormality like spinal stenosis indicates the need for brain and spinal cord dissection to examine the effect at tissue level.
Types and distribution of epilepsy among children in Palestine
(2013-05-20) Nimer Abu-Shanab; Alaa’ Abubeih; Dr. Reham Khalaf
Introduction:Epilepsy is the predisposition to two or more unprovoked seizures. This condition has been recognized since ancient history, and overtime, the understanding has profoundly developed in regard to its pathophysiology and potential treatment options. A classification system is also needed to enhance the communication between neurologists, for teaching, and planning management. The classification should be based on two points, the electroclinical characteristics and underlying etiology. Most of the attention, however, was spent on the former and much less on the latter. On the other hand, epidemiologic studies of epilepsy, as in other disorders, need to be done in every community, as they define the base for further studies and understandings, and modify the health care in regard. Methodology and Results:Herein, we have conducted a retrospective study that included 736 pediatric patients, ranging between 0-17 years of age, diagnosed with epilepsy in the period from 1991 to 2000. 62.5% of the patients were males, and 37.5% were females. Most of the patients (58.0%) were less than 1 year, 20.9% between 1-5 years old, 16.3% between 6-12 years, and 4.8% between 13-17 years. Around 70% of the patients were from southern West Bank. We found it more suitable for our study and for future similar studies to adopt a simple etiologic classification system that can be effectively and easily applied. Thus, we have adopted a proposed classification of epilepsy based on etiology and according to the presence of underlying precondition into two broad categories: epilepsy with underlying preconditions, representing 30.3% of the patients; and epilepsy with no underlying preconditions, representing 69.7% of the patients. This latter was further subdivided into familial (7.9%) and non familial (61.8%) according to the presence of family history of epilepsy. Looking into the etiology of infantile spasms (West syndrome), we found that most patients had unknown (non familial) etiology, constituting 79.4% of the cases, underlying precondition was found in 13.2% of the patients, and the remaining 7.4% had familial etiology. One of the most common associated disorders was the psychomotor delay (PMD), which was found in 22.1% of the patients. Attention deficit hyperactivity disorder (ADHD) was found in 1.5% of the patients, and 0.1% of the patients had an associated autism.
Outcomes of Bristow-Latarjet Procedure in the Treatment of Recurrent Anterior Shoulder Dislocation
(2013-05-20) Omar Adas, Saja; Dr. Marwan Al-Jayousi
Operative stabilization is considered the usual treatment for recurrent shoulder dislocation after failure of the supervised rehabilitation program. Many types of procedures have been proposed for the treatment of recurrent shoulder dislocation with different long term results in terms of shoulder function and stability. In the present study we aimed to analyze the clinical and radiological outcomes of Bristow-Latarjet procedure in patients with recurrent anterior shoulder dislocation. Thirteen patients who underwent Bristow-Latarjet operation from 2002 to 2011 were followed up for 2-10 years. Rowe score for instability, physical and radiological examinations were used to assess outcomes. There had been no recurrences of dislocation after surgery among all patients, but two patients (15.4%) reported subluxation. Six cases (46.2%) had limitation of external rotation compared with the non-operated shoulders. The mean postoperative Rowe score at follow-up was 88 excellent (range 55-100).10 patients had excellent scores (76.9%), one had a good score (7.7 %) and two had scored fair (15.4 %). In conclusion, Bristow-Latarjet procedure is a good reliable surgical method for treatment of patients with recurrent anterior shoulder dislocation and is associated with high rate of satisfaction and good functional results.
Exhaustive Extraction of Verbascum sinuatum a Member of Palestinian Flora- and Its Biological Activity
(2013-05-20) Batool Masoud; Prof. Mahmoud Abu-hadid
Background:A wide proportion of the populations throughout the world use traditional medicine mainly medicinal plants in the treatment of infectious and other diseases, including Palestinians. This focus the attention on the possibility of the presence of antimicrobial compounds in the extracts of plants. Thus they may offer a new source of antibacterial agents in facing up the growing antibiotic resistance among human pathogens. Objective:To test the antimicrobial activity of the aqueous extract ofverbascum sinuatum(which is common in Palestine) against common human pathogens, which arecandida albicansand bacteria (three gram positive:Bacillus subtilis, Staphylococcus aureusandstaphylococcus epidermidis.And two gram negative:Eschrichia coliandPseudomonas aeruginosa). Methods:Well diffusion method was used in screening antimicrobial activity for the plant extracts in which the diameters of inhibition zones were measured, and serial dilution method was used for measuring the MIC for each microorganism. Results:In well diffusion method, the plant’s aqueous extract has antimicrobial activity to all the organisms except forPseudomonas aeruginosaandcandida albicans,with variable diameters of inhibition zone. The largest forStaphylococcus aureus18 mm (39.13% of the zone of Imipenem the positive control antibiotics), then forBacillus subtilis14 mm (30.43%), 12 mm (37.5%) forstaphylococcus epidermidis, and the least forEschrichia coli11 mm (41.66%). The organic extract exhibited activity againstBacillus subtilisandEschrichia coliwas 12 mm (26.08%) and 18 mm (50%) inhibition zones respectively. In the serial dilution method, the aqueous extract exhibited inhibition for all the test
Outcomes of Bristow-Latarjet Procedure in the Treatment of Recurrent Anterior Shoulder Dislocation
(2013-05-20) Saja, Omar Adas; Dr. Marwan Al-Jayousi
Operative stabilization is considered the usual treatment for recurrent shoulder dislocation after failure of the supervised rehabilitation program. Many types of procedures have been proposed for the treatment of recurrent shoulder dislocation with different long term results in terms of shoulder function and stability. In the present study we aimed to analyze the clinical and radiological outcomes of Bristow-Latarjet procedure in patients with recurrent anterior shoulder dislocation. Thirteen patients who underwent Bristow-Latarjet operation from 2002 to 2011 were followed up for 2-10 years. Rowe score for instability, physical and radiological examinations were used to assess outcomes. There had been no recurrences of dislocation after surgery among all patients, but two patients (15.4%) reported subluxation. Six cases (46.2%) had limitation of external rotation compared with the non-operated shoulders. The mean postoperative Rowe score at follow-up was 88 excellent (range 55-100).10 patients had excellent scores (76.9%), one had a good score (7.7 %) and two had scored fair (15.4 %). In conclusion, Bristow-Latarjet procedure is a good reliable surgical method for treatment of patients with recurrent anterior shoulder dislocation and is associated with high rate of satisfaction and good functional results.
Extraction of Eryngium campestre (L.) Bioactive Compounds and Their Antimicrobial Activity
(2013-05-20) Mahdi Mohammad Al_khawaja; Prof. Mahmoud Abu-hadid, Dr. Nidal Jaradat
Medicinal plants are the richest biosource of pharmaceutically active compounds for traditional and modern systems of medicine. Aims of study:The present study aims to evaluate the antibacterial activity against three gram-positive bacteria (Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis), two gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa), and antifungal activity against Candida albicans of aqueous and organic extracts of Eryngium campestre (L.) Materials and methods: The well diffusion method was used to evaluate antibacterial and antifungal activities of aqueous and organic extracts of E. campestre (L.). Minimum inhibitory concentration (MIC) and minimum bactericidal-fungicidal concentration (MBC-MFC) were determined by the serial dilution method. Results: The aqueous extract showed antibacterial activities using well diffusion method against all gram-positive bacteria with the greatest activity against Bacillus subtilis, its inhibition zone diameter was 18 mm {39.1% of the diameter of the inhibition zone (DIZ) of Imipenem}, while Staphylococcus aureus, and Staphylococcus epidermidis, were 12 mm (26.1%) and 8 mm (25%) respectively. In addition, it showed antibacterial activity against one gram-negative bacteria, Pseudomonas aeruginosa with inhibition zone diameter of 6 mm (23.1% of the DIZ of Imipenem). Using serial technique, of the stock concentration (50 mg/ml), the MIC values against all gram-positive bacteria, B. subtilis, S. aureus and S. epidermidis were 0.2 mg/ml, 0.2 mg/ml and 2 mg/ml respectively of E. campestre (L.) extract, and the MIC values against Pseudomonas aeruginosa and E. coli were 2 mg/ml and 20 mg/ml respectively, and against Candida was 0.02 mg/ml. There is bactericidal activity against all gram-positive bacteria, one gram-negative bacteria (Pseudomonas aeruginosa) and against Candida, all at MBC of 20 mg/ml of the stock concentration (50 mg/ml), but no bactericidal effect of E. campestre (L.) extract against E. coli. The organic extract showed almost the same antibacterial activity of aqueous extract except in that it had no activity against Pseudomonas aeruginosa, as well as it had antibacterial activity against Escherichia coli with inhibition zone diameter of 12 mm (33.3% of the DIZ of Imipenem).
Maternal Mortality Among Women In Rafidia Hospital In The Period 2000 – 2012 A cross sectional retrospective study
(2013-05-20) Mohammed Abualdarak; Muaath Itmaizeh; Dr. Diab Abdelmahdi
Background: Maternal mortality is an indicator for the quality health system. It is important to manage the cause of death in order to decrease avoidable causes. The causes of maternal death can be classified into two broad categories, the direct and indirect obstetric causes. The direct obstetric deaths resulting from complications arising during pregnancy, labor or during the postpartum period. Deaths may result from interventions, omissions, incorrect treatment or from a chain of events resulting from any of the above. Objectives: the main objective of this study is to establish the maternal mortality rate in pregnant women who attended Rafidia hospital during twelve years.Moreover, to evaluate the most common causes of maternal mortality among Palestinian women in Rafidia hospital. Methods: a cross sectional study was conducted by reviewing hospital archive files, extracting maternal death files. A thorough review for each file was applied. The inclusion criteria for cases are: death must had occurred between 2000-2012 andmust be classified as a maternal death according to the International Classification of Diseases (ICD-10) definition.The deceased woman must had been a resident in west bankand must be between ( 15-49) years of age. Dependent variable is considered to be maternal mortality,Independent variables are socioeconomic status, Attendance at birth by trained personnel, hospital stay and parity. Results: the most common cause of maternal mortality was eclampsia. There is noticeable progress in the documentation and reporting on maternal mortality cases since 2009. Conclusions: the results of the present study will help medical workers , the government, and international organizations understand the current status and factors influencing maternal deaths in Rafidia hospital

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