Medical and Health Sciences

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    THE DEVELOPMENT AND VALIDATION OF IMAGE-BASED QUESTIONNAIRE FOR WEIGHT BIAS AND STIGMATIZATION ASSESSMENT AMONG SCHOOL-AGED CHILDREN: A CROSS-SECTIONAL STUDY
    (An-Najah National University, 2024-11-14) Bustami, Lina
    Background: Obesity is a well-recognized complex global epidemic. There are multiple causes and complications of obesity, physical and psychological ones. The experiences of weight bias and stigmatization against individuals with obesity is one challenge, which often goes unnoticed. Weight stigma is associated with many negative outcomes, including psychological disturbances, eating disorders, weight gain, and avoiding physical activity. Weight stigmatization is prevalent among different age groups, and was identified to be high among children at a young age. Objective: The main purpose of the study is to assess the percentage of weight bias and stigmatization among school-aged children, through the development of an image-based tool that is suitable for children’s cognitive abilities. This study is conducted as a step-1 for further educational intervention studies to reduce weight stigma among children. Methodology: A cross-sectional study was conducted on 150 children aged 6-9 year in three schools in Nablus City, Palestine: Pioneers Baccalaureate School, Ethar School (2nd grade), and UNRWA school. The assessment was carried after the development and validation of a questionnaire, designed specially to assess weight stigmatization percentage among children at early age. Result: 71% of children attributed “Ugly” adjective to characters with overweight compared to only 8.7% to those with under and normal weights. Also, 89% of children chose the character with overweight for “lazy” trait, 72% for “careless”. In contrast, 81.9%, 81.9%, of participants chose the figures with underweight and overweight for “loved”, and “good”, adjectives, respectively. Only one child chose the figure with overweight as a best friend. 84.6% (n=126) chose figures with under or normal weights as the one they like the most, while the one with overweight was chosen only 1.3% of time (n=1.3). Additionally, 81.9% (n=122) of children agreed with the statement that the character with overweight eats more than required, whereas only 18.1 (n=18.1) disagreed. 61.7% expressed their agreement with “I think he/she sleeps a lot”. In addition, 59.1% (n= 88) of children disagreed that the character can’t lose weight even when he/she stops overeating. Conclusion: The study indicated a high percentage of weight stigmatization among school aged children in the current study. Stereotyping, weight bias and judgmental attitudes towards individuals with overweight were common in all the three sections of the developed image-based questionnaire. These findings highlight the importance of acting towards reducing weight stigma among children, and suitable educational programs are recommended to be established. Keywords: weight stigma, weight bias, obesity, children, tool validation
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    THE EFFECTS OF USING AUTOLOGOUS PLATELET-RICH PLASMA VERSUS TRADITIONAL MEDICAL MANAGEMENT TO IMPROVE WOUND HEALING PROCESS IN CRITICAL ILL PATIENT: A COMPARISON STUDY FROM PALESTINE
    (An-Najah National University, 2024-10-14) Halaika, Rami
    Background: Chronic and poorly healed wounds represent a failure in achieving complete re-epithelialization in the appropriate sequence of tissue repair. Impaired healing process has been related to numerous inherent causes, such as neuropathy, vascular problems in addition to extrinsic factors such as wound infection and trauma. There are many methods can be used for chronic wound management. One of these techniques is autologous platelet-rich plasma (PRP), It has the potential to enhance chronic wound healing and contains fibrin along with high concentrations of platelets and growth factors. Objective: to assess the effects of using Autologous Platelet-Rich Plasma in improving wound healing in chronic wounds in comparing to the traditional medical management used in critical ill patient in Palestine. Methods: retrospective, comparison study between 20 critical ill patients with chronic poorly healing ulcers divided in two equal groups. One group was received Autologous Platelet-Rich Plasma at critical care unit, while the other group treated by daily dressing. Both groups was followed over period of time (2years) 2020-2022 to assess the difference in healing presses between them. The results showed that the diabetes was the most common medical history illness among ICU patients with chronic wounds (50%), followed by IHD (45%) and hypertension (40%). While ESRD occurred at a 10% prevalence, 35% of those affected had additional chronic conditions. 75% of the ICU patients with chronic wounds had a positive surgical history. Finally, 70% of ICU patients with chronic wounds had a positive family history. Although the percentage of individuals with a history of hypertension and IHD were greater among the ICU patients with chronic wound participants in the PRP group than in the ICU patients with chronic wound in the conventional group (62.5% & 66.7% vs. 37.5% & 33.3%), no group nor demographic characteristic could predict the development of chronic wounds and poor wound healing in Palestine among ICU patients, as the p values for all factors were more than 0.05. The model was not statistically significant (F=.809, p=.597) but could predict roughly 32% of the variance. Conclusions: among ICU patients in Palestine , PRP is beneficial and effective in improvement the healing process in chronic wounds, but to a less than treatment with traditional methods, as the complete healing rate in the group in which traditional treatment was used was 63.5%, while the other group was 36.5%, and this is consistent with some studies that were used. The same tool that’s used in my study.
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    HUMAN PAPILLOMA VIRUS PREVALENCE, CHARACTERIZATION AND ASSOCIATION WITH CERVICAL CANCER AMONG PALESTINIAN WOMEN
    (An-Najah National University, 2024-12-12) Salhi, Ibrahim
    Background: Human Papillomavirus (HPV) is a significant global public health concern due to its strong association with cervical cancer. This study evaluates HPV prevalence, genotyping, and phylogenetic relationships among women in the West Bank, Palestine. It also investigates the incidence of HPV in cervical cancer tissue to inform public health strategies. Methods: A total of 379 Palestinian women aged 18 and above from 11 West Bank governorates participated in a cross-sectional study conducted from September 2023 to April 2024. Cervical samples were analysed using nested PCR for HPV genotyping, and a questionnaire collected data on the women's medical history, testing history, and demographics. Phylogenetic analysis was performed, and 40 paraffin-embedded cervical cancer tissue specimens were tested for HPV DNA. Results: The overall HPV prevalence was 14.5%, with the highest rates in the middle region of the West Bank (19.0%) and among the 20–29 age group (19.6%). HPV 11 and HPV 6 were the most common low-risk types, while HPV 16 was the most prevalent high-risk type. The detection of HPV 1 and HPV 53, classified as non-categorized (NC), adds to the diversity of identified genotypes. Phylogenetic analysis showed regional clustering of HPV isolates, indicating localized transmission patterns. Of the 40 cervical cancer tissue specimens, 33 (82.5%) were HPV-positive. The most prevalent high-risk genotypes in these samples were HPV 16 (32.5%) and HPV 18 (10%), with additional genotypes like HPV 33 (5%), HPV 51 (5%), HPV 31 (2.5%), and HPV 45 (2.5%) detected at varying frequencies. HPV 16 was most prevalent in patients aged 40–49, while HPV 18 was more frequent in those aged 50–59. City-wise, HPV 16 was predominantly found in Ramallah, Nablus, and Tulkarm, suggesting regional differences in genotype distribution. Conclusion: The findings emphasize the need for targeted HPV vaccination and screening programs, particularly for younger women. The high prevalence of HPV 16 and 18 in cervical cancer tissues underscores the virus's critical role in cancer development. Continued surveillance and research are essential to reduce the burden of HPV-related diseases in the West Bank. Keywords: HPV genotypes, phylogenetic analysis, HPV prevalence, human cervical cancer, sexually transmitted infections, women's sexual health.
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    PHENOTYPIC AND MOLECULAR CHARACTERIZATION OF MULTI-DRUG RESISTANT ENTEROBACTERALES ISOLATED FROM CLINICAL SAMPLES, PALESTINE.
    (An-Najah National University, 2024-11-11) Ibaideya, Mamoun
    Background: Infections resulting from multidrug-resistant Enterobacterales (MDRE) pose a growing global threat, presenting challenges in treatment and contributing significantly to morbidity and mortality rates. The main objective of this study was to characterize phenotypically and genetically MDRE isolated from clinical samples in the West Bank, Palestine. Methods: A cross-sectional study was conducted in October 2023 on clinical bacterial isolates collected from five governmental hospitals in the West Bank, Palestine. The isolates obtained from the microbiology laboratories of the participating hospitals, underwent identification and antibiotic susceptibility testing (AST) using the VITEK® 2 Compact system, and colistin tests. MDRE was determined by the Vitek2 Compact system. A modified carbapenem inactivation method (mCIM) was employed to identify carbapenemase-producing Enterobacterales (CPE). Resistance genes were detected by real-time PCR. Results: Out of the total 1380 collected isolates, we randomly selected 600 isolates for analysis. Our analysis indicated that 287 (47.83%) were extended-spectrum beta-lactamase producers (ESBLE), and 102 (17%) were carbapenem-resistant Enterobacterales (CRE) isolates. A total of 424 isolates (70.67%) were identified as multidrug-resistant Enterobacterales (MDRE). The most prevalent ESBL species were Klebsiella pneumoniae (n=124; 43.2%), Escherichia coli (n=119; 41.5%) and Enterobacter cloacae (n=31; 10.8%). Among the CRE isolates, 85 (83.33%) were CPE. The most frequent CRE species were K. pneumoniae (n=63; 61.7%), E. coli (n=25; 24.5%) and E. cloacae (n=13; 12.8%). Additionally, 47out of 600 (7.83%) isolates exhibited resistance to colistin, with 38 out of 101 (37.62%) being colistin-resistant CRE, and 9 out of 274 (3.3%) being colistin-resistant ESBLE. MDRE exhibited varied resistance patterns across different none ꞵ-lactam antibiotic classes. We noticed that 11 isolates (6 K. pneumoniae and 5 E. cloacae) demonstrated sensitivity to carbapenems by phenotype but carried silent CPE genes (1 blaOXA48, and 6 blaNDM, 4 blaOXA48, blaNDM). Conclusion: This study showed the high burden of the ESBLE and CRE among the samples collected from the participating hospitals. The most common species were K. pneumoniae and E. coli. There was a high prevalence of blaCTXm. Adopting both conventional and molecular techniques is essential for better surveillance of the emergence and spread of MDRE infections in Palestine.