Pharmacy

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    A CROSS-SECTIONAL STUDY OF SELF-REPORTED SIDE EFFECTS OF BREAST CANCER TREATMENT AND QUALITY OF LIFE IN PALESTINE
    (An-Najah National University, 2025-01-16) Breek, Karin
    Background: Breast cancer is the most common cancer among women in terms of incidence. This study aimed to determine the side effects of breast cancer treatment reported by Palestinians with breast cancer and their quality of life. Methods: This study was a cross-sectional questionnaire-based survey. The study was undertaken in Nablus. The data collection instrument was divided into two distinctive sections. Part (A) collected data covering sex, age at diagnosis, clinical symptoms, complications, treatment measures, and side effects of the treatments. While part (B) of the questionnaire involved the quality-of-life assessment tool, the current study employed the WHOQOL-BREF (Arabic version) as an assessment tool. Results: A total of 258 patients with breast cancer participated in this study. In addition to breast cancer, 207 (80.2%) patients had one or more comorbid conditions. Of the patients, 153 (59.3%) were diagnosed less than 3 years ago. With respect to disease stage, 147 (57%) patients were in Stage I, 51 (19.8%) patients were in Stage II, 54 (20.9%) patients were in Stage III, and 6 (2.3%) patients were in Stage IV. Among the patients, 207 (80.2%) received chemotherapy, 159 (61.6%) underwent lumpectomy, 156 (60.5%) received radiotherapy, and 102 (39.5%) underwent mastectomy. When screened for the adverse effects of breast cancer treatments, the patients reported adverse effects and health issues that were categorized as follows: pain, gastrointestinal, skin and hair, health issues; pain, sleep and mental health, and respiratory/mouth and throat, hematologic, genitourinary, sensory, and general health issues. Multiple linear regression showed that the overall scores were negatively associated with having comorbidities, having advanced-stage breast cancer, receiving mastectomy, and experiencing headaches, vomiting, depression, anxiety, mood swings, mouth and throat sores (mucositis), fever, and insomnia. Conclusions: The findings of this study highlighted the heavy burden of disease and therapy-related adverse effects on the quality of life of patients with breast cancer who received treatment in Palestine. A multidisciplinary holistic care plan for breast cancer patients who integrates physical and mental health support is urgently needed to improve the quality of life of these patients.
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    Analysis of beliefs about medicines and medication adherence in patients with chronic diseases at the Military Medical Services, Nablus, Palestine
    (2014) Raniah Majed Fares Jamous; Prof. Waleed Sweileh; Dr. Adham Abu-Taha
    Background: very few studies in the Arab world investigated patients’ behavior toward medications, particularly in those with multiple co-morbid and different chronic diseases. Furthermore, most studies in this field were carried out among patients with governmental insurance which could affect the reliability and validity of the results since medications are not always available in governmental pharmacies. Objective: to investigate how the presence of multiple chronic illnesses could affect the association between attitudes toward medicines and adherence practices in a non-governmental settings. Methodology: The Palestinian Medical Military Services in Nablus, Palestine was the main setting for the study. Presence and number of multiple chronic diseases were obtained from patients through interview setting and were confirmed by information available at the medical files. Attitudes toward medicines were evaluated by the Beliefs about Medicines Questionnaire (BMQ) while compliance / adherence behavior was evaluated by Morisky Medication Adherence Scale (MMAS-8). Results: One hundred and eighty seven patients were interviewed. Most participants (79.6%) had positive attitude that their medicines were necessary to maintain their good health status while 58.2% of the study sample were afraid and had negative attitude or concern about taking medicines on regular basis and 57.8% were afraid that they will get addicted and become dependent on their medicines. In the presence of multiple chronic diseases, demographic and clinical factors were not significantly associated with adherence practices. However, in patients with multiple chronic diseases, those who had higher positive attitudes and feeling of necessity had higher odds [1.4 (1.1 - 1.9)] of having adherence practices while those who had higher negative attitudes or concerns or fear about medicines had lower odds [0.8 (0.65 – 0.98)] of having adherence practices. Conclusions: In patients with multiple chronic diseases, positive and negative attitudes toward medicines are significant determinant of adherence practices.
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    Analytical and Dissolution Method Development and Validation for a Home Formulated Rutin Tablet
    (2015) Jumana Saleh Mohamed Mansour; Dr. Murad Abualhasan; Dr. Nidal Jaradat
    Rutin can be classified as flavone, colorant and vitamin. It is highly available in some foods, fruits, vegetables and plant-based beverages. Rutin is highly attracted to the researchers due to its variant beneficial medical effects making rutin used in the treatment of various ailments. Rutin is available in different oral dosage forms such as tablets or capsules either alone or in combination with other active ingredients. Rutin pharmaceutical preparations are widely available in international market as well as Palestinian market. In this study we formulated a 250mg rutin tablet and we developed an easy and simple validated analytical method to quantify rutin in our formulated tablet as well as the internationally marketed Rutin® tablet of Solgar. The method was validated in accordance to international guidelines of the ICH and USP. The dissolution profile of our formulated tablet was also inspected. The shelf and the accelerated stability of the locally formulate tablet was studied. The results clearly show that our developed method was a valid method with a good linearity, precision and accuracy. The validated method was sensitive with LOD and LOQ value of 4.34*10-3 and 0.013mg/ml respectively. The locally formulated rutin tablet was stable under accelerate as well as room temperature for 150 days, only with slight and tolerable drop in the %assay with no detrimental effect on the physical properties of the tablets. The dissolution profile of our locally formulated tablet show slightly better dissolution in phosphate buffer compared with the internationally marketed Rutin® tablet of Solgar. Our study encourages and helps companies that manufacture herbal products especially those present in Palestine to improve their formulated herbals and apply validation analytical methods to check their product quality. In conclusion we succeeded in developing a validated analytical method to quantify rutin in our locally formulated rutin tablet as well as the available rutin formulations present in the local and international markets. Our formulated tablet showed a slight improvement in the dissolution profile and was stable in normal as well as under stress condition
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    Antimicrobial Utilizing Pattern in a Governmental Hospital in Palestine Measured Using WHO ATC/DDD Methodology
    (2014) Marina Zeyad Bada; Dr. Adham Abu Taha; Prof. Waleed Swieleh
    BACKGROUND: Increased consumption of antimicrobial agents is related to a worldwide increased in bacterial resistance, increased costs and dispensable effects of drugs on patients. OBJECTIVES: To investigate the pattern of antimicrobial consumption data using WHO ATC/DDD methodology in a governmental hospital in Palestine, and to assess the obstacles for implementing rational use of antimicrobial agents in hospital. METHODS: Antimicrobials consumption in Rafidia hospital was retrieved prospectively. The ATC/ DDD and DU90% methodologies were used. Defined Daily Dose (DDD) per 100 Bed-Days and DDD per 1000 inhabitants per day were calculated for total systemic antimicrobial use and by antimicrobial class. RESULTS: Antimicrobials were administered to 554 patients (55.4%) out of 1000 who were hospitalized in Rafidia hospital over two months period. The total consumption of antimicrobial agents was 1656.1 DDD that corresponding to 70.55 DDD/100 Bed-Days and 3.31 DDD/1000 Inhabitants/ Day. The most highly used antimicrobial were ceftriaxone followed by cefuroxime and metronidazole. The bulk prescription (DU90%) was made up of 8 out of 22 total antimicrobial agents. And the highest rates of antimicrobial use were found in intensive care unit (ICU) 132.64 DDD/100 Bed-Days and surgical department 98.52 DDD/100 Bed-Days. CONCLUSIONS: We found that antimicrobial utilization in Rafidia hospital was relatively high, and there were a high tendency for wide-spectrum antimicrobial utilization such as third-generation cephalosporins, carbapenems and aminoglycosides. This study proved that there is an urgent demand for national antimicrobial stewardship and education programs in infection control and prevention in Palestinian hospitals. Key words: Antibiotic, Consumptions.
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    Assessing Appropriate Use of Inhaler Devices among Asthmatic Patients
    (2013) Ola Adel Fawzi Salah; Prof. Waleed Sweileh; Dr. Samah Al-Jabi
    Background: Appropriate use of inhaler devices such as metered-dose inhalers (MDIs) and dry-powder inhalers (DPIs) in clinical practice is not well studied in Palestine and few were carried out in the Arab world. Objectives: The objectives of this study were to assess patients’ administration technique of inhaler devices and its association with other variables. Method: A cross sectional observational evaluation was conducted at a pulmonary clinic in Nablus, Palestine. Administration technique was evaluated based on a pre-defined checklist. Asthma control was assessed using Asthma Therapy Assessment Questionnaire (ATAQ) scale. Results: MDIs (without spacer) and DPIs (turbuhalers and aerolizers) in patients with asthma disease were studied. The study included 149 patients with mean ± standard deviation (SD) age of 47.5 ± 18.5 years. Fifty five (36.9%) of the study patients had college education and higher. Forty two (28.2%) patients were using MDIs, 38 (25.5%) were using DPIs and 69 (46.3%) were using both devices. A total of 217 inhaler devices were evaluated: 111 (51.2%) for MDI and 106 (48.8%) for DPI. Mean scores ± SD for correct inhaler technique were 61 ± 20.1, 71.4 ± 14.9 and 66.2 ± 15.7 for MDIs, turbuhalers and aerolizers respectively (p = 0.00). For MDI and DPI devices, step 3 “exhale to residual volume” was the least correctly done (22.5% and 13.2% respectively). There was a significant relationship between correct score of handling inhaler device and educational level (r = 0.187; p=0.006) where higher educated patients had higher correct scores. Among patients, ATAQ scale indicated that 22 (14.8%) patients had well controlled asthma, 56 (37.6%) patients were not well controlled and 71 (47.7%) patients were poorly controlled. There was significant difference in scores of correct inhaler device handling and asthma control category (p < 0.01) where patients had higher correct scores were with higher control for their asthma. Among patients using inhaled corticosteroids (ICS), there was a significant difference between adherence score and correct handling scores (p = 0.002) where patients with better adherence had higher correct scores. Conclusion: Correct handling of inhaler devices was not common particularly among MDI devices. Regular checking of inhalation technique and proper practical teaching of patients is crucial for optimal use of most inhaler devices.
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    ASSESSMENT OF ANTIBIOTIC PRESCRIBING AND COST IN PALESTINIAN HOSPITALS
    (2022-11-14) Rufayda Dawood Manassrah
    Background: One of the largest problems facing the world today is the enormous morbidity and mortality caused by antibiotic resistance in bacterial infections. A major factor in antimicrobial resistance (AMR) is the irrational use of antibiotics. The objective of this study was to assess the prescribing and cost of antibiotics in two major governmental hospitals in the West Bank of Palestine. Methods: A retrospective cohort study was conducted on 428 inpatient prescriptions containing antibiotics from two major governmental hospitals in the West Bank of Palestine, from December 2020 to March 2021, they were evaluated by some drug use indicators. Descriptive statistics were performed using IBM-SPSS version 21. Results: The mean ± SD number of drugs per prescription (NDPP) was 6.72 ± 4.37. Of these medicines, 38.9% were antibiotics. The mean ± SD number of antibiotics per prescription (NAPP) was 2.61 ± 1.54. The average ± SD cost per prescription (CPP) was 392 ± 744 USD. The average ± SD antibiotic cost per prescription (ACPP) was 276 ± 553 USD. The most commonly prescribed antibiotics were ceftriaxone (52.8%), metronidazole (24.8%), and vancomycin (21.0%). About 19% of the antibiotics were prescribed for intra-abdominal infections; followed by 16% used as prophylactics to prevent infections. Almost all antibiotics prescribed were administered intravenously (IV) 94.63%. In general, the average duration of antibiotic therapy was 7.33 ± 8.19 days. The study indicated that the number of antibiotics per prescription was statistically different between the hospitals (p = 0.022), and it was also affected by other variables like the diagnosis (p = 0.006), the duration of hospitalization (p < 0.001), and the NDPP (p < 0.001). The most commonly prescribed antibiotics and the cost of antibiotics per prescription were significantly different between the two hospitals (p < 0.001); The cost was much higher in the Palestinian Medical Complex. Conclusion: The practice of prescribing antibiotics in Palestine's public hospitals may be unnecessary and expensive. This has to be improved through education, adherence to recommendations, yearly immunization, and stewardship programs; intra-abdominal infections were the most commonly seen infection in inpatients and ceftriaxone was the most frequently administered antibiotic. Keywords: Antibiotics, Antimicrobial resistance, Cost analysis, Prescribing, Rational use of medicine.
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    Assessment of Knowledge and Practice for Safe Handling of Antineoplastic Drugs among Healthcare Providers in Oncology Departments in Palestinian Hospitals
    (جامعة النجاح الوطنية, 2021-02-06) موسى سعيد, راية
    الخلفية: بسبب زيادة الإصابة بالسرطان وإدخال نظم علاج أكثر تعقيدًا، من المتوقع أن يزداد الطلب على استخدام الأدوية المضادة للأورام (ANPDs)، مما سيؤدي إلى مزيد من التعرض المهني لهذه الأدوية بين مقدمي الرعاية الصحية (HCPs) وبالتالي فإن هذه الأدوية تتطلب احتياطات شديدة عند التعامل معها واستخدامها. الأهداف: هدفت هذه الدراسة إلى تقييم المعرفة والممارسة بين الممرضين والصيادلة ومساعدي الصيادلة حول كيفية التعامل الآمن مع الأدوية المضادة للأورام، وأيضا لتحديد ارتباط هذه المعرفة بالممارسة، ولتحديد العوائق التي تمنع مقدمي الرعاية الصحية من استخدام تدابير السلامة. المنهجية: أجريت دراسة مقطعية من آب إلى تشرين الثاني 2018 في ستة مستشفيات فلسطينية، تم جمع المعلومات عن طريق استبيان احتوى على اسئلة تساعد في جمع المعلومات الديموغرافية لمقدمي الرعاية الطبية وممارستهم حول كيفية تداول الأدوية المضادة للسرطان بشكل آمن والحواجز التي قد تمنعهم من حماية انفسهم من التعرض لمثل هذه الأدوية، تم إجراء التحليل باستخدام الإصدار 25 من برنامج الSPSS، تم اعتبار ان القيمة الاحتمالية أقل من 0.05 على انها ذات دلالة إحصائية. النتائج: اشترك 96 شخص من مقدمي الرعاية الصحية في هذه الدراسة، متوسط اعمارهم كان 31.9±8.6 سنة، تراوحت اعمارهم ما بين 22 الى 55 سنة. اغلب المشتركين كانوا ممرضين (62.5%,60)، مع أغلبية نسوية (66, 68.8%). لم يتم تدريب حوالي ثلثي المشتركين على التعامل الآمن مع الأدوية المضادة للأورام. كانت درجة معرفتهم وممارستهم تجاه التعامل الآمن مع هذه الأدوية جيدة نسبيًا، حيث كان متوسط درجات المعرفة والممارسة 84.6 ± 13.8، 74.33 ± 25.8 على التوالي. ارتبط تلقي التدريب بمستوى معرفة بدرجة متوسطة. عبء العمل الكبير، ونقص الرقابة، وعدم توفر معدات الحماية الشخصية كانت العوائق الرئيسية لعدم استخدام معدات الوقاية الشخصية كما بلغ المشتركين. الإستنتاج: بالرغم من أن معرفة مقدمي الرعاية الصحية بالتعامل الآمن مع الادوية المضادة للأورام كانت مقبولة، إلا أن توفير التدريب لهم لم يكن كافيا. يوصى بالتدريب الدوري والمستمر لمقدمي الرعاية الصحية بدعم من السياسات لاتباع المبادئ التوجيهية بهذا الشأن.
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    Assessment of Patients' Satisfaction with Pharmaceutical Services in Nablus City Hospitals: A Cross Sectional Study
    (جامعة النجاح الوطنية, 2019-07-16) زهير شريم, ريناد
    مقدمة: رضا المرضى هو أحد العوامل المهمة التي تحدد نجاح مرافق الرعاية الصحية. لذلك، هناك حاجة لتقييم نظام الرعاية الصحية فيما يتعلق برضا المرضى لضمان جودة الخدمات الرعاية الصحية. تهدف هذه الدراسة إلى قياس رضا المرضى عن الخدمات الصيدلانية في مستشفيات نابلس ، فلسطين. طريقة البحث: هذه دراسة مقطعية. تم فيها اختيار ثلاثة مستشفيات في مدينة نابلس وصمم استبيان رضا لقياس مدى رضا المريض. احتوى الاستبيان على عناصر ركزت على العوامل المؤثرة: السرعة، الموقف، وقت الانتظار، التعليم الدوائي، والجوانب الديموغرافية للمجيب. تم اختيار 90 مجيبًا لملء الاستبيان من خلال أخذ عينات ملائمة. نتائج الدراسة: بلغ إجمالي عدد المرضى الذين كانوا على استعداد لملء استبيان البحث 90. الخصائص الديموغرافية للمرضى توزعت كالتالي: كان عدد المرضى الإناث أعلى من عدد المرضى الذكور (58.9 - 41.15 ٪) وكانت الفئة العمرية المهيمنة أكثر من 30-39 سنة بنسبة 30٪. كان 58.9٪ من المرضى متزوجين. وكان مستوى تعليم غالبية المرضى في المرحلة الثانوية 44.4 ٪. ما يصل إلى 58.9 ٪ من المرضى كانوا عاطلين عن العمل. من بينهم 36.7٪ دخل الأسرة لديهم أقل من 2000 شيكل . 42.2٪ منهم كانوا يعيشون في القرية. كانت هناك فروق ذات دلالة إحصائية في الرضا عن الخدمات الصيدلانية وفقا لوقت العمل بين الفترة الصباحية والمسائية، ، وكانت قيمة P-value هي 0.009. أظهرت البيانات تأثير إيجابي لوقت الانتظار في الصيدلة على رأي المرضى ورضاهم. كان 81.1 ٪ من المرضى راضين عن وقت الانتظار في الصيدلية. في حين أن 18.9٪ من المرضى لم يكونوا راضين عنه. غالبية المشاركين 70٪ لديهم مشكلة مع الدواء في آخر زيارة بسبب عدم توفر الادوية ، 97.8٪ ليس لديهم مشاكل مع الأدوية التي لها نفس الشكل واللون. أبلغت الدراسة عن درجة معتدلة (جيدة) من رضا المرضى عن الخدمات الصيدلانية في المستشفيات الثلاثة وكان متوسط الاستجابة 3.24. المرضى عموما راضون عن خدمات الصيدلانية في المستشفيات بنسبة 64.8 %. الخلاصة كان رضا المرضى عن خدمات الرعاية الصيدلانية جيدًا. وقد انعكس ذلك على الخدمات الصيدلانية الجيدة المقدمة للمرضى والتي منها العلاقات بين الصيدلي والمريض، والاحترام الذي أبداه الصيدلي تجاه المرضى، وسرعة خدمة صرف الأدوية ورضا المرضى عن وقت الانتظار. يجب مراجعة تواصل الصيدلي مع المرضى والاستشارات الدوائية لمنع المشاكل المتعلقة بالأدوية وتحسين الخدمات الصيدلانية في مستشفيات نابلس. توصي الدراسة بمزيد من التدريب للعاملين الصحيين على الخدمات الصيدلانية وزيادة وعي المريض اتجاه الخدمات الصحية المتوقعة من قبل مقدمي الخدمات الصحية.
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    The Association Between Adherence and Beliefs about Medications among Patients with Ischemic Heart Disease: A Cross Sectional Study from Palestine
    (Wafaa AL-Barbarawi, 2018-07-03) AL-Barbarawi, Wafaa
    Background: optimal medication adherence in patients with ischemic heart disease (IHD) is very important to prevent cardiac events and decrease the rate of mortality. Patients' beliefs about medicines are one of the most important factors that may affect adherence. Objectives: to measure adherence to medications among Palestinian ischemic heart disease patients, and to find the effect of some patient factors and medication beliefs on their medication adherence. Methods: the study was a cross-sectional study among patients in governmental outpatient clinics, information was obtained from patients by a face to face interview and from medical files. The Morisky Medication Adherence Scale- 8 questions (MMAS-8) and Beliefs about Medicines Questionnaire (BMQ) were used to measure medication adherence and patients' beliefs about medicines respectively. Results: a total of 400 patients were included in the study, mean age ± standard deviation was 62.35± 9.30 years. Most patients 348(87.0%) had comorbid conditions. The majority 304 (76.0%) of patients were using at least 5 medicines. According to MMAS-8 score, 195 (48.8%) of participants were non adherent to their medicines (adherence score ˂ 6) and 205 (51.3%) were adherent (adherence score ≥ 6). Multivariable analysis showed that patients who had others disease (comorbid conditions) had higher odds (O.R=2.316(95%CI (1.192-4.499)) of being non-adherent. patients who had higher concerns about medicines had higher odds (O.R=1.124(95%CI (1.063-1.188)) of being non-adherent, also patients who had positive harmful beliefs of medications had higher odds (O.R=1.092(95%CI (1.018-1.171)) of being non-adherent. On the other hand, Patients who had positive beliefs of medication necessity had lower odds (O.R=0.902(95%CI (0.847-0.960)) of being non-adherent. Conclusions: Poor adherence was very common among Palestinian IHD patients. Stronger positive beliefs about necessity of treatment was associated with lower non-adherence while high concerns of long term use of medicines or harmful effects of medications were associated with higher non-adherence, which emphasizes the importance of patients' beliefs about medicines in medication adherence.
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    ASSOCIATION BETWEEN SERUM FOLATE LEVELS AND DEPRESSION AMONG ADULT FEMALE STUDENTS AT AN-NAJAH NATIONAL UNIVERSITY IN NABLUS, PALESTINE: A CROSS-SECTIONAL STUDY
    (An-Najah National University, 2024-07-29) Elewi, Saja
    Background: Depression is considered a major public health concern worldwide. Depression is a prevalent issue among university students compared to the general population. Folate is a B complex group water-soluble vitamin that naturally occurs in food and is essential to the brain for producing norepinephrine, dopamine, and serotonin. Previous studies have indicated that levels of folate are crucial in the development and progression of depression. However, the research findings have been inconclusive when it comes to variations in folate levels among people with depression compared to those without the condition. Objective: This study aimed to assess the relationship between serum folate levels and depression among adult female students at An-Najah National University in Nablus, Palestine. Method: This study was conducted with a cross-sectional observational design. A questionnaire was distributed from 15th September 2023 until 20th October 2023 to participating female students from An-Najah National University. Depressive symptoms were assessed using the DASS-21 scale. The questionnaire also collected the social and demographic characteristics of the female students and several questions related to the factors that affect folate levels in the blood. The internal reliability of the DASS-21 questionnaire was tested using Cronbach's alpha. In addition, venous blood samples were collected within the same period in the scientific research laboratory at An-Najah University after overnight fasting, and serum folate levels were measured. The number of female students participating was 180, and their ages varied from 18 to 30 years old. Results: The mean of serum folate levels was 4.82 ng/ml (SD=3.38). The prevalence of depression among them was 16.7%, 47.2%, 14.4% 12.2%, and 9.4% for extremely severe, severe, moderate, mild, and normal depression, respectively. Levels of serum folate were significantly lower in patients with extremely severe and severe depression, the mean was (3.13 and 3.30 ng/ml) respectively. Additionally, there was a significant moderate inverse correlation between the levels of serum folate and depression severity (r=-0.537, P-value<0.001). Conclusion: Our findings showed that there is a connection between the levels of serum folate and depression among female Palestinian students. Folate serum levels may serve as indicators to evaluate the effectiveness of depression treatment. Measuring folate levels can assist physicians in effectively managing depression. In this regard, folate appears to play a more crucial role in the improvement outcomes of mood disorders and should be assessed more attentively. Keywords: Serum folate, depression, lifestyle, diet, clinical characteristics, An-Najah National University, Palestine.
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    ASSOCIATION BETWEEN TREATMENT SATISFACTION AND URINARY INCONTINENCE AMONG DIABETIC PATIENTS: A CROSS-SECTIONAL STUDY FROM PALESTINE
    (An - Najah National University, 2023-07-06) Shaharzad Byadseh
    Background: Type 2 diabetes mellitus (DM) is a chronic metabolic disorder. Such diseases can harm and cause daily life complexities related to mortality and other disorders. Therefore, this disease greatly affects daily routines in life and influences health quality. Furthermore, satisfaction with treating patients' daily life and routines is a frequent and important aspect. Thus, research is needed to find further such associations with treatment satisfaction. Objectives: This study will investigate the correlation between treatment satisfaction and its domains with urinary incontinence (UI). Additionally, the researcher checked the variables of predictability of the confounding demographics and urinary incontinence to predict treatment satisfaction. Methodology: A cross-sectional study was performed to recruit diabetic patients from primary care centers in Palestine between the first of June 2022 and the first of October 2022. Four hundred diabetic patients were surveyed to fill in sociodemographic questions, urinary incontinence (ICIQ-UI-SF), and treatment satisfaction questionnaire (TSQM 1.4). The findings were analyzed for descriptive statistics, correlations, and regressions between satisfaction treatment and urinary incontinence. The analysis was performed using the statistical package of social sciences (SPSS). Results: The study included four hundred diabetic patients from primary centers in the northern part of West Bank. The patients ranged in age between 18 and 89 years, with 210 males and 190 females. The patients were asked to answer ICIQ-UI-SF, and the findings showed that 101 out of 400 patients (25.25%) had urinary incontinence. These patients' UI severity ranged from slight (15%), moderate (65%), severe (18%), and very severe (3%). In addition, the patients were asked to fill in the TSQM (1.4) to assess their satisfaction with the treatment. Analysis of the questionnaire revealed four domains' scores out of 100; the higher the score, the higher the satisfaction. For instance, domain effectiveness was 66.125±16.6, domain side effects was 94.68± 17.9, domain convenience was 68.11±14.57, and global satisfaction was 67.17±16.46. However, the correlation analysis between treatment satisfaction and urinary incontinence was insignificant (p>0.05). This means the patients did not correlate their urinary incontinence status and satisfaction with treatment. The scores were statistically significant with the level of education (p<0.05) and the use of sitagliptin (p<0.05). In addition, the quantity of leaked urine and incontinence status were significantly correlated with ICIQ scores (p<0.05). Additionally, regression analysis showed that urinary incontinence status could predict treatment satisfaction. Conclusions: The study findings showed that diabetic patients' satisfaction with their treatment is not correlated with their urinary incontinence status. However, more studies must be conducted with interventional designs to explore the relations further.
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    ASSOCIATION BETWEEN VITAMIN D-BINDING PROTEIN AND VITAMIN D3 ‎LEVEL IN HEMODIALYSIS PATIENTS
    (An-Najah National University, 2024-03-07) Hamadneh, Ayat
    Background: Vitamin D deficiency is a common problem among patients with end-stage renal failure who undergo dialysis, which requires extensive research and interventions due to its widespread repercussions in the body. Understanding the physiology of vitamin D, as well as identifying factors contributing to its deficiency, has been the focus of research. In addition, vitamin D binding protein (VDBP) and its potential role in influencing vitamin D levels have been explored, with the hope of finding therapeutic interventionsObjectives: For the time being, there is a limited research about the relationship between VDBP and other vital signs, especially among dialysis patients in Palestine. This study aimed to treat this gap by investigating the relationship between VDBP and vitamin D levels in dialysis patients. Methodology: A prospective study, conducted among hemodialysis patients‎ at Al-Najah hospital, Nablus, Palestine, over 10 ‎months. The patients were treated with different doses of ‎Alfacalcidol and ‎Cholecalciferol for a total of 17 weeks. VDBP measured by specific sandwich utilizing enzyme-linked ‎immunosorbent assay (ELIZA) technique by R&D used polyclonal ‎rabbit ‏anti-VDBP antibodies, vitamin D is also measured by ELIZA technique, both of them defined before and after course of tretment. Results: The results indicated that after a course of vitamin D treatment, VDBP levels decreased significantly while vitamin D levels increased significantly, with no correlation between them. These results were consistent with previous research that showed no significant relationship between VDBP and vitamin D levels in different population groups.Demographic variables such as age and gender did not show a conclusive association with VDBP levels among dialysis patients, which is in contrast to results from other studies. In addition, there was no significant relationship between VDBP levels and the results of other laboratory tests such as albumin, calcium, phosphorus, and parathyroid hormone (PTH). Conclusion: Overall, this study underscores the importance of vitamin D treatment in dialysis patients and ‎highlights the need for further research to fully understand the role of VDBP in vitamin D ‎metabolism and its implications for clinical management. ‎ Keywords: Vitamin D, Vitamin D binding protein, End stage renal disease, Hemodialysis patients
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    Attitudes, Knowledge and Practices of Health-Care Practitioners Toward Splitting or Crushing Oral Solid Dosage Forms in Palestine: Safety and Therapeutic Implications
    (2015) Yaser Mustafa Mahmood Abdallah; Prof. Dr. Abdel Naser Zaid; Dr. Saed Zyoud
    Background: Tablet splitting and crushing is a widespread practice among health-care providers and patients for different reasons, such as: (i) increasing dose flexibility, (ii) making tablet parts easier to swallow, and (iii) allowing cost savings for medications. However, this practice may be dangerous because some formulations and classes of drugs are unsuitable for crushing or splitting and may cause significant problems, especially in drugs with low therapeutic indices. Objectives: This thesis was conducted to examine the attitudes, knowledge and practice of pharmacists and nurses toward splitting or crushing oral solid dosage forms (OSDFs) in Palestine. It also aimed to determine the factors that affect health-care practitioners with regard to splitting or crushing OSDFs, in addition to determining the differences in attitudes and knowledge between nurses and pharmacists regarding this very important issue, and to determine the safety and therapeutic problems that resulted from splitting or crushing OSDFs. Methodology: This is a self-administered cross-sectional questionnaire survey involving 550 respondents and was conducted during the period May 2013 to August 2013 among pharmacists and nurses who work at community pharmacists and hospitals in the West Bank area of Palestine. Data were collected using a pretested questionnaire consisting of four sections and analysed using descriptive statistics and correlation. Results: A total of 615 questionnaires were distributed and 550 were completed. About 67.3% of the pharmacists and only 5.6% of the nurses had good knowledge. Nearly 69% of the pharmacists and 36.4% of the nurses had a good attitude. There was a positive correlation (p=0.002, r=0.18) between knowledge and attitude scores among pharmacists. There was a positive correlation (p<0.001, r = 0.24) between knowledge and attitude scores among nurses. Approximately 83.7% of the pharmacists and 41.6% of the nurses had good practices. Conclusion: This study has identified knowledge, attitude and practice gaps among health-care practitioners, especially among nurses. Therefore improving appropriate knowledge regarding splitting and crushing OSDFs is required by planning and developing programs for local health education purposes
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    BACTERIAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERNS IN HOSPITALIZED PATIENTS WITH INFECTED DIABETIC FOOT
    (An-Najah National University, 2025-08-05) Hammad, Aseel
    Background: Diabetes mellitus (DM) represents a major public health concern and has been increasingly associated with serious complications. One of the most complex and costly complications of diabetes is diabetic foot infection (DFI). Early diagnosis, promote an appropriate treatment based on pathogen identification and antibiotic susceptibility testing, is essential for achieving favorable clinical outcomes. The aim of this study is to assess the bacterial profile and antibiotic susceptibility patterns in patients with infected diabetic foot. Methodology: A retrospective design to evaluate bacterial profile and antibiotic susceptibility patterns in patients with infected diabetic foot ulcers (DFUs) was used. The study was conducted at Salfeet Governmental Hospital. The files of all type 2 diabetes mellitus patients who meet the inclusion criteria during the previous three years were included. Statistical Package for Social Sciences (SPSS) was used for data analysis. Results The study included 211 participants, in which the majority (45.0%) aged between 50-59 years, & males comprised 66.8% of the sample. Regarding diabetes mellitus (DM) duration, most participants (87.2%) had been diagnosed for > 10 years. Neuropathy was present in 34.6%, nephropathy in 24.6%, and angiopathy in 8.5% of the study population. Among the study participants, the most common ulcer site was the forefoot (33.1%). Ulcers penetrating to the bone (Grade D) were present in 20.4% of cases, and 7.1% had ulcers with osteomyelitis or abscess (Grade E). A statistically significant association was found between nephropathy and severity of ulcer grade (p = 0.007). The most commonly isolated microorganism was Escherichia coli, detected in 26.5% of cases, followed by Staphylococcus aureus (20.9%) and Pseudomonas aeruginosa (10.9%). Among the antibiotics tested for sensitivity, Meropenem/Ertapenem showed the highest sensitivity, with 63.03%, followed by Amikacin at 47.39%, Gentamycin (40.28%), and Piperacillin+Tazobactam (39.81%). Amoxicillin + Clavulanic acid showed the lowest sensitivity, at only 3.79%, Conclusion: The microbiological profiles revealed a high prevalence of Gram-negative bacteria, notably Escherichia coli, and Pseudomonas aeruginosa, accompanied by considerable treatment resistance. Meropenem, was the most often prescribed and effective antibiotic. The results affirm the necessity for multidisciplinary management strategies that encompass early detection, prompt surgical and antimicrobial interventions to enhance clinical outcomes and reduce amputations.
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    Bio-Functionalization of SWCNTs with Combretastatin A4 for Targeted Cancer Therapy
    (An-Najah National University, 2017-05-25) حمد, ديمه فهيم محمد رشدي; العسالي, محي الدين
    Chemotherapy is a mainstay approach in the management of cancer. Unfortunately, it can affect not only the cancerous cells but also the healthy ones resulting in a number of severe side effects. Therefore, many researchers are keen to developing new Drug Delivery Systems (DDS) that may in one hand help reducing the used doses and on the other hand target the delivery of the chemotherapy to cancer cells. Some modern investigational DDS in this field are based on carbon nanotubes (CNTs) technology. The aim of this work is to covalently functionalize single walled carbon nanotubes (SWCNTs) with Combretastatin A4 (CA4) through click reaction in the presence of tetraethylene glycol linker to improve the solubility and dispersibility of the developed nano-drug. Moreover, in order to specifically target the cancer cells, a targeting agent folic acid was also loaded on the nano-system. The characterization of the developed nano-drug by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) showed good dispersibility of the functionalized SWCNTs with diameters of (5-15) nm. Moreover, the efficiency of functionalization was determined by thermogravometric analysis (TGA) showing 45% of functionalization in the case of CA4-SWCNTs (7) and 50% for CA4-FA-SWCNTs (13). The in vitro release profile of CA4 showed that approximately 90% of the loaded drug was released over 50 hrs at pH 7.4 and 37 ºC. MTS proliferation test was implemented to determine the suitable concentration for the CA4-SWCNTs (7), which was found to be 15 ng/ml. After that the cytotoxic activity of the nano-drug was evaluated by flow cytometry using Annexin V/Propidium iodide (PI) test. In comparison with free CA4, CA4-SWCNTs (7) treatment demonstrated a significant increase in necrotic cells (around 50%) at the expense of the proportion of the apoptotic cells. Moreover, cell cycle PI test demonstrated that free CA4 and CA4-SWCNTs (7) caused G2/M arrest. However with CA4 treatment higher proportion of cells were in the S-phase while with CA4-SWCNTs treatment greater proportion of cells appeared to be in the G1-phase. Taken together, the provided data suggest that the novel CA4-SWCNTs (7) has a significant anticancer activity that might be superior to that of free CA4. The anticancer activity of CA4-FA-SWCNTs (13) is under investigation.
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    Biological Activity of Newly Synthesized Aromatic Thio and Amino Acid Ester Derivatives
    (جامعة النجاح الوطنية, 2021-11-24) عدنان عساف, إيمان
    تم تخليق تسعة مركبات من السترات (IX-I) عن طريق تفاعل نوعين مختلفين من الكحوليات 2- (فينيل ثيو) إيثان و 2- (فينيل امينو) إيثان مع خمسة أنواع من الأحماض الكربوكسيلية المختلفة بطريقة تقليديه المعروفة باسم fisher reaction) (. تم فحص مركبات الإستر بواسطة Fourier Transform Infrared (FT-IR) ، والرنين المغناطيسي النووي البروتوني (1H-NMR) ، والرنين المغناطيسي النووي للكربون 13. تم اختبار فعاليه المركبات إذ لها نشاط كمضادة للأكسدة أو مضاد للميكروبات أو إذا كان لها مقدره على تثبيط عمل كل من إنزيم الأميليز والليباز. أظهر اختبار فحص نشاط المركبات كمضادات أكسدة أن المركبين V و IX لهما نسبة تثبيط تساوي 84.70٪ و 84.79٪ ، على التوالي ، عند تركيز 100 ميكروغرام / مل مقارنة مع ترولوكس الذي لديه قيمة تثبيط تساوي 99٪ عند نفس التركيز. بالإضافة إلى ذلك ، فإن جميع مركبات الإستر لها فعاليه لتثبيط نمو البكتيريا سواء كانت بكتيريا من النوع موجبة الجرام أو من نوع سالبة حيث تروحت قيمه التثبيط عند اقل تركيز مستخدم لتثبيط نمو البكتيريا (MIC) (7.5 - 0.47 ميكروغرام / مل). بينما أظهرت المركبات التاليه III و V و VII و VIII و IX فعاليه عاليه على تثبيط بنسبة 95٪ ضد فطريات الكانديدا حيث كانت قيمه اقل تركيز لتثبيط نشاط الفطريات يساوي ( MIC (1.875 ميكروغرام / مل) مقارنة بالعقار المضاد للفطريات فلوكونازول بقيمه تساوي (1.62 ميكروغرام / مل). أظهرت مركبات الإستر نتائج واعده كمركبات لها المقدرة على تثبيط عمل إنزيم α-amylase مقارنة مع Acarbose كمعيار. كانت نسبة تثبيط كل من المركبات IX , V و VI 99.5 ٪. 79.3٪ و 73.5٪ عند تركيز500 ميكروغرام / مل على التوالي. كانت قيمه التثبيط بالنسبة المئوية ل 5 مركبات أعلى من 50٪ عند 10 ميكروغرام / مل وهي نتيجة مهمة للغاية وكانت هذه الخمس مركبات لها IC50 أقل من IC50 للأكاربوز. قيمة IC50 للمركب III هي 0.0206 وهي أقل 3000 مرة من الأكاربوز. بالرغم من عدم وجود مجموعة أميد الوظيفية المسئولة عن نشاط إنزيم الليباز ، فإن المركبين V و IX أظهروا تثبيط 59.5٪ و 72.3٪ على التوالي عند 500 ميكروجرام / مل.
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    BIOLOGICAL ACTIVITY OF SYNTHESIZED XANTHONE AND THIOXANTHONE ANALOGS
    (جامعة النجاح الوطنية, 2022-06-05) Aqel, Samah
    Introduction: Xanthone and thioxanthone were used to synthesize a derivative of compounds to test for anticancer, anti-inflammatory, antioxidant and antimicrobial activity. In order to do this, Grignard reagent was added to xanthone and thioxanthone to give a library of tertiary alcohol of phenyl and benzyl xanthone and thioxanthones. After that, some of them were followed by coupling with cysteine to make cysteine analogous. A total of seven compounds were synthesized. The compounds were characterized using the proton and carbon NMR and IR. The synthesized structures were tested for their anticancer, antioxidant, antimicrobial and ant-inflammatory activities. Results: The test results were promising; compounds Ⅲ showed a very good activity (IC 50= 2.79 µg/ml) against Colon cancer cells (CaCo). While compound 2 showed a good inhibition activity against hepatic HEPG cells (IC 50= 49.2 µg/ml) and compound Ⅰ showed a very good inhibition activity against HeLa cells (IC 50= 60 µg/ml). Compound Ⅳ has a potent antioxidant inhibition activity (IC50= 4.22 µg/ml). Moreover, compound Ⅶ Showed a good anti-inflammatory activity with a COX2 inhibition activity (1.72 µg/ml) and also good selectivity for COX2 (3.81). However, none of the compounds showed antimicrobial activity. The future work requires further an in-vivo testing to understand its pharmacokinetic and pharmacodynamic activity in living system. Conclusion: Further future work will be carried out to better understand the SAR effects of these compounds.
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    Biological and phytochemical screening of Erodium laciniatum and Lactuca orientalis
    (An-Najah National University, 2017-01-12) Othman, Dua'a; Jaradat, Nidal
    From ancient times, various herbal remedies and various medical agents containing flavonoids, tannins and phenols have been utilized for prevention and treatment of different diseases and disorders. Currently, such groups of bioactive compounds have become the subject of many antimicrobials researches, with possessed antiviral, antifungal and antibacterial activities. Moreover, many of high quality studies assessed the relationship between flavonoid's, tannin's and phenol's chemical structures and their antibacterial activities, and also studied their mechanisms of action on the microbial growth. These investigations approved that such classes of natural compounds can possess many therapeutic properties, including oestrogenic, antiinflammatory, enzyme inhibition and antimicrobial activities. In this study we aimed to screen Erodium laciniatum and Lactuca orientalis phytoconstituents and to evaluate their total flavonoids, tannins and phenols contents. An additional aim is to evaluate their antioxidant and antimicrobial activities. Phyto-constituents, total flavonoids, phenols and tannins were screened and evaluated by using standard analytical and phytochemical methods. Antioxidant activity was evaluated by using DPPH method meanwhile antibacterial activities were examined by using several reference bacterial strains obtained from the American Type Culture Collection (ATCC) and multidrug resistant clinical isolates. The tested strains included Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (MRSA Positive), Enterococcus faecium (ATCC 700221), Shigella sonnei (ATCC 25931), Enterobacter cloacae (clinical) and Klebsiella pneumoniae (clinical). In addition to that anti-fungal activities of these extracts were also examined against two reference strains Candida albicans (ATCC 90028) and Epidermatophyton floccosum (ATCC 52066). Antibacterial and antifungal activity of all prepared Erodium laciniatum and Lactuca orientalis organic and aqueous extracts were determined by using several methods including agar diffusion well-variant method, agar diffusion disc-variant method and broth micro-dilution method. The results of the phytochemical screening showed that L. orientalis and E. laciniatum contain phenols, tannins, flavonoids, saponins, monosaccharides, reducing sugars, carbohydrates, cardiac glycosides, and steroids, while alkaloids were not detected in both of the studied species. However, proteins, starch and terpenoids were not detected in L. orientalis and detected in E. laciniatum which means that E. laciniatum had more phyto-constituents than L. orientalis. Moreover, total flavonoid, tannins and phenols content in E. laciniatum extract were higher than the L. orientalis extracts. The IC50 values of the antioxidant activity were almost the same in L. orientalis and E. laciniatum extracts. Additionally the lowest value of MIC was for organic extract of E. laciniatum against Staphylococcus aureus. The same organic extract also showed to have the largest diameter of inhibition against Enterococcus faecium. However, L. orientalis aqueous extract showed to have the largest diameter of inhibition against Staphylococcus aureus. Whereas, the antifungal activity which was tested by using agar dilution method against Epidermatophyton floccosum showed that the organic extract of E. laciniatum had the lowest MIC which was 0.391mg/ml. In conclusion, both of the studied species have a mixture of phytochemicals and rich in flavonoids, phenols and tannins and have potential antioxidant and antimicrobial activities which can be used as therapeutic agents or can be used in cosmeceutical and pharmaceutical industries.
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    BIOLOGICAL EVALUATION OF 2-OXO-BENZOXAZOLE DERIVATIVES
    (2023-09-07) Haneen Marwan Abu Katab
    Benzoxazole derivatives are essential building blocks for innovative drugs due to their wide range of biological activities in medicinal chemistry, particularly their pharmacological effects (such as analgesic, antibacterial, antifungal, anti-inflammatory, and anticancer properties). The importance of benzoxazole derivatives in drug development is emphasized by this work, which also highlights their potential as therapeutic targets with a variety of pharmacological actions and structural flexibility. This study investigates the 1,3-oxazole nucleus, which is a very effective molecule with antibacterial, anticancer, analgesic, and anti-inflammatory characteristics. These substances are created both naturally and artificially by several organisms, including bacteria and marine life. Pharmaceutical compounds belonging to the 1,3-oxazole family can be used to synthesize a wide range of molecules with various therapeutic applications, such as antiviral and anticancer effects. The fascinating possibility of benzoxazole derivatives inhibiting anaerobic choline metabolism and their possible anticancer effects is examined in this work. Certain compounds based on benzoxazoles exhibit enhanced cytotoxicity, especially towards particular cancer cell lines, suggesting that they may be useful in stopping the spread of cancer cells. The promise of benzoxazole derivatives in pharmaceutical research is highly praised, and more investigation into the benzoxazole scaffold and its functionalization is encouraged to find more powerful and selective molecules with enhanced activity and decreased toxicity. The study's findings on sixteen artificial chemicals tested against seven cancer cell lines are presented in the article. The compounds BNZ-2, BNZ-4, BNZ-7, BNZ-9, and BNZ-10 show promise as anticancer agents. Key moieties, such as chlorobenzoyl, piperazine, piperidine, morpholinomethyl, and 4-methylpiperidin-1-yl, that are responsible for their actions against different cell lines are identified by a structural analysis using Structure-Activity Relationship (SAR) study. BNZ-10 has a lower IC50 value than other well-known anticancer medications, which suggests that it may be a more effective treatment against particular cancer cell types. It's important to remember, nevertheless, that doxorubicin (DOX) has far lower IC50 values than the majority of BNZ-1-16 drugs and is nonetheless a powerful anticancer agent. The study concludes by highlighting the tremendous promise of benzoxazole derivatives in drug development, particularly in the treatment of cancer, and the significance of particular structural motifs in controlling their biological activity. Novel treatment approaches in hepG2-associated malignancies require further research on molecular interactions and processes, especially those that affect hepG2 cells. The research advances the hunt for new medicines and helps to rationally develop anticancer drugs. Keywords: Benzoxazole Derivatives; Anticancer Efficacy; Structure-Activity Relationship (SAR); IC50 Values