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- ItemHealthcare-associated respiratory viral infections among hospitalized children at Caritas Baby Hospital: The impact of the infection control program(Al-Quds University, 2024-01-10) Nur Adnan Mithqal Jaber; نور عدنان مثقال جابرBackground: Healthcare-associated respiratory viral infections (HA-RVIs) could be an underestimated infection. It is one of the leading causes of morbidity and mortality among hospitalized patients especially in pediatric patients. This study aims to determine the role of HA-RVIs on children under five years old who are admitted to Caritas Baby Hospital (CBH) in Palestine (southern area) and explore the impact of the currently followed infection control program of preventing HA-RVIs at CBH. Study methodology: A retrospective cohort study design was used. The study was conducted among 11570 registered cases that were tested for the presence of HA-RVIs (possible and definite) for the five different respiratory viruses, including RSV, influenza viruses, human adenoviruses, parainfluenza viruses, and human Metapneumoviruses, during the study period from January 2018 until December 2022 at CBH. Results: Among 11570 of registered cases, 82 were classified as HA-RVIs. Of these, 50 were definite cases, and 32 were possible cases during the five years. The incidence rate was found to be 1.02/1000 admission days (AD) (definite cases = 0.62/1000AD, possible cases = 0.40/1000 AD), with the highest incidence in the year 2019. The most commonly identified viruses were RSV, Parainfluenza viruses, and Adenoviruses, with incidence rates of (0.42, 0.20, and 0.19/1000ad respectively). The infant group was the most affected, accounting for 75.6% of all cases. Respiratory symptoms were reported in 98.8% of cases, with fever being the most common symptom at 78%. 61% of cases had one or more underlying comorbidities with an odds ratio of 3.31(95% confidence interval= 1.30 -8.39). For Definite HA-RVIs, odds ratio=1.64 (95% confidence interval= 1.07- 2.52). Also, 37.8% of HA-RVIs required respiratory escalation support, and 8.5% of HA-RVI cases required ICU transfer. The mean length of stay was found to be 18.5 days with definite cases requiring a longer length of stay (23.54) compared to possible HA-RVIs (10.56). For infection multi-component, the mean of hand hygiene compliance increased from 81% to 86% over the years, and the mean of transmission-based precaution compliance (TBP) ranged from 95.3% in 2018 and decreased to 93.6% in 2022. Environmental cleaning started at 94.5% in 2018, peaked at 97% in 2022, and slightly decreased in 2021 to 88.5%. Hand hygiene compliance was found to be negatively associated with the incidence of HA-RVIs (Spearman correlation coefficient = -0.275, and p-value = 0.012). Meanwhile, environmental cleaning and TBP were positively associated with the incidence of HA-RVIs. The visitor restriction policy was found to be effective in reducing the incidence rate (m=0.92 (SD±0.29), p-value =0.000). Multiple linear regression revealed an association between hand hygiene compliance and a reduction in the yearly incidence of HA-RVIs (B = -0.047, Beta = -0.392, t = -7.680, p < 0.05). Conversely, TBP and environmental cleaning were associated with an increase in yearly incidence (B = 0.031, Beta = 0.260, t = 4.172, p < 0.05), (B = 0.079, Beta = 0.719, t = 11.365, p < 0.05) respectively. Together, these factors explain about 86% of the variation in yearly incidence(R square=0.858) Conclusion: This study provides significant insights into the understanding of HA-RVIs within the Palestinian context (southern area) and the impact of infection control measures. Comorbidities were considered a risk factor for developing definite HA-RVIs, and compliance with hand hygiene impacted reducing HA-RVIs. Meanwhile, a safe environment and transmission-based precautions need to be further explored and modified to reduce HA-RVIs.
- ItemThe Power of C-Reactive Protein Biomarker in Detecting the Severity Progress of COVID-19 Patients’ Illness.(Al-Quds University, 2024-01-03) Mohammed Yousef Hasna Awad; محمد يوسف حسن عوادBackground: Identification of COVID-19 patients at high risk increases the risk of admission to intensive care units (ICUs); mechanical ventilation and advanced management (use of inotropic dialysis machines) and patient mortality can significantly improve patient management and resource allocation within hospitals. This study seeks to identify reliable biomarkers for patient outcomes, which has been critical. This study focuses on C-reactive protein (CRP) as a significant indicator and examines its relationship with patient outcomes (discharged or deceased) and patient status (severe illness or critical illness) in COVID-19 cases. Method: A quantitative retrospective descriptive and correlation study was conducted at Istishari Arab Hospital (IAH) – in Ramallah, Palestine. A consecutive non-probability sampling method was used, SPSS, to present descriptive results, frequencies, percentages, means, and standard deviation. We also employed quantitative analysis with chi-square tests and adjusted residuals to investigate the association between CRP levels with patient outcomes (discharge or deceased) and patient status (severe illness or critical illness) in COVID-19 cases. Results: The study found a statistically significant association between CRP levels and patient outcomes. Elevated CRP levels correlated with increased severity of illness and higher mortality rates. Adjusted residuals indicated a clear gradient in patient outcomes based on CRP levels. Conclusion: CRP levels are a valuable prognostic biomarker in assessing the severity and outcomes of COVID-19. These findings provide actionable insights for healthcare professionals and contribute to the broader understanding of COVID-19 management and prognosis. The study recommends further research for comprehensive analysis and application in clinical practice
- Itemالتوافق الزواجي وعلاقته بأعراض الاضطرابات النفسية لدى عينة من الأزواج في محافظة بيت لحم(al-quds University, 2021-05-08) وعد خالد عبد الرحمن مقبل; Wa'ad Khaled A.Rahman Moqbelهدفت هذه الدراسة إلى التعرف على العلاقة بين التوافق الزواجي والاضطرابات النفسية لدى الأزواج في محافظة بيت لحم، إضافة إلى التعرف على درجة التوافق الزواجي ودرجة الاضطرابات النفسية لدى الأزواج في محافظة بيت لحم، وأيضاً معرفة مدى تأثير المتغيرات التالية( الجنس، والعمر، وعمر الزوج/ة، وفارق العمر بين الزوجين، وعدد سنوات الزواج، وطريقة الزواج، وعدد الأبناء، وعمل الزوجة، ومستوى الدخل، وطبيعة السكن، والمستوى التعليمي للزوج، والمستوى التعليمي للزوجة) على درجة التوافق الزواجي ودرجة الاضطرابات النفسية لدى الأزواج في محافظة بيت لحم. ولتحقيق هذه الأهداف قامت الباحثة باستخدام مقياس التوافق الزواجي لـ ( سبينر، 1976)، ومقياس الحالة النفسية BSI-53 المترجم والمقنن على البيئة الفلسطينية من خلال أ.د. عبد العزيز موسى. وقامت الباحثة باختيار عينة تتكون من 379 زوجاً وزوجة من محافظة بيت لحم، وكان أسلوب توزيع العينة حسب العينة المتاحة وطريقة كرة الثلج من خلال توزيع الاستبانة على مواقع التواصل الاجتماعي، حيث كانت نسبة الذكور 21.4%، ونسبة الإناث 78.6%. وأوجدت النتائج أن درجة التوافق الزواجي لدى الأزواج في محافظة بيت لحم جاءت بدرجة عالية، وبنسبة مئوية( 74.4%)، ومتوسط حسابي( 3.72). أما بالنسبة للاضطرابات النفسية، فقد بينت النتائج أن درجة الاضطرابات النفسية لدى الأزواج في محافظة بيت لحم جاءت بدرجة متوسطة بما نسبته( 52.4%)، وبمتوسط حسابي( 2.61)، ولقد حصل مجال أعراض الاضطهاد على أعلى متوسط حسابي ومقداره (3.07)، يليه مجال أعراض الوسواس بمتوسط حسابي (2.89)، ومن ثم مجال أعراض الاكتئاب بمتوسط حسابي (2.77)، ومن ثم مجال أعراض القلق بمتوسط حسابي (2.64)، ومن ثم مجال أعراض الحساسية الشخصية بمتوسط حسابي (2.61)، ومن ثم مجال الأعراض الجسدية بمتوسط حسابي (2.56)، ومن ثم مجال أعراض العدائية بمتوسط حسابي (2.55)، ومن ثم مجال أعراض الذهان بمتوسط حسابي (2.52)، ومن ثم مجال أعراض المخاوف القلقية بمتوسط حسابي (2.36)، وجميعها بدرجة متوسطة. وأشارت النتائج إلى أنه توجد علاقة عكسية سلبية ذات دلالة إحصائية عند مستوى الدلالة(α≥0.05)، بين درجة التوافق الزواجي والاضطرابات النفسية لدى الأزواج في محافظة بيت لحم، أي أنه كلما زادت درجة التوافق الزواجي قلل ذلك من درجة الاضطرابات النفسية لدى الأزواج في محافظة بيت لحم، وكان ذلك لكل المجالات، ما عدا مجال أعراض الاضطهاد مع مجال (الاتفاق الزواجي، والتعبير العاطفي، والتماسك الزواجي). وبينت النتائج أيضاً أن هناك فروقاً ذات دلالة إحصائية في درجة التوافق الزواجي لدى الأزواج في محافظة بيت لحم تعزى لمتغيرات( الجنس، والعمر، وعمر الزوج/ة، وفارق العمر بين الزوجين، وطريقة الزواج، وعدد الأبناء، والمستوى التعليمي للزوج). ووجدت فروق في درجة الاضطرابات النفسية تعزى لمتغيرات( فارق العمر بين الزوجين، وطريقة الزواج، وعدد الأبناء، وعمل الزوجة، ومستوى الدخل، والمستوى التعليمي للزوج، والمستوى التعليمي للزوجة). وأوصت الباحثة بضرورة تنظيم دورات وندوات إرشادية للمقبلين على الزواج؛ لتهيئتهم للمرحلة الجديدة في حياتهم، وتكثيف دور المؤسسات الإعلامية والتربوية في التوعية الأسرية. Abstract The relationship between Marital Adjustment and mental disorders among married couples in Bethlehem District. Student: Wa’ad Moqbel Supervisor: Dr. Fadwa Halabiyah The current study aimed to examine the relationship between marital adjustment and mental disorders among married couples in Bethlehem district, in addition to identifying the degree of marital adjustment and the degree of mental disorders among married couples in the Bethlehem district, and also to know the impact of the following variables (gender, age, age of the husband /wife, age difference between the spouses, number of years of marriage, manner of marriage, number of children, wife's work, the income level, living place, the educational level of the husband, the educational level of the wife) on the degree of marital adjustment and the degree of mental disorders among the married couples in Bethlehem district. To achieve these goals, the researcher used the marital adjustment scale for (Spinner, 1976), and the BSI-53 psychological state scale, translated and codified on the Palestinian environment by Prof. Abdul Aziz Musa. The researcher selected a sample consisting of 379 husbands and wives from Bethlehem district, and they were chosen by available method, the questionnaire was distributed on social media by snowball method. With the percentage of males was 21.4%, and the percentage of females was 78.6%. The study found that the degree of marital adjustment among married couples in Bethlehem district is high, with a percentage (74.4%) and mean (3.72). for mental disorders, the results showed that the degree of mental disorders among married couples in the Bethlehem district was of a moderate degree, with a rate of (52.4), and a mean of (2.61). The results indicated that there is a negative reversible relationship with statistical significance at the level of significance (α ≤ 0.05) between the degree of marital adjustment and mental disorders among married couples in Bethlehem district, which suggest that the higher the degree of marital adjustment, the lower the degree of mental disorders among spouses in Bethlehem, and that in all fields, except for the field of symptoms of persecution with the field (marital agreement, emotional expression, marital cohesion). The results also showed that there were statistically significant differences in the degree of marital compatibility among husbands in Bethlehem governorate due to variables (gender, age, age of the spouse, age difference between spouses, marriage method, number of children, the husband's educational level). There were differences in the degree of mental disorders due to variables (the difference in age between the spouses, the manner of marriage, the number of children, the wife's work, the income level, the educational level of the husband, the educational level of the wife). The researcher recommended the necessity to organize counseling sessions and seminars for those who are about to get married, to prepare them for the new stage in their lives, and to intensify the role of media and educational institutions in family awareness.
- ItemFactors associated with Intestinal Parasitic Infection among patients attending Jericho Governmental PrimaryHealth Care Clinics(Al-Quds University, 2023-12-06) Subhi Mohammad Subhi Alshaer; صبحي محمد صبحي الشاعرBackground: Intestinal parasitic infections are a global issue, affecting millions of people, especially those in impoverished regions, with helminth diseases, particularly among schoolchildren. The Palestinian Ministry of Health (PMOH) has annually reported several cases of intestinal parasitic infestations, including giardiasis, ascariasis, and enterobiasis, strongyloidiasis, and amebiasis. The most significant risk factors for intestinal helminthic infections are low socioeconomic status, limited awareness of personal hygiene, and environmental contamination. Due to parasitic infection, anemia is considered multifactorial, which is associated primarily with iron deficiency and undernourishment in children. Aim: The aim of the study is to assess the risk factors associated with Intestinal Parasitic Infection among patients attending Jericho Governmental Primary Health Care Clinics. Study Methodology: A cross-sectional study was conducted using a simple random sampling method to select patients from governmental health care clinics in Jericho Governorate. Face-to-face interviews of patients were accompanied using a structured questionnaire asking for risk factors of infection with Parasitic diseases. Fresh feces specimens were examined macroscopically for the presence of adult worms and microscopically for parasites ova, cysts, oocysts, and/or larvae to determine intestinal parasitic infection. The statistical package for social science (SPSS) program, version 22 for windows, was used for data entry and data analysis Appropriate statistical tests (parametric or nonparametric) were selected based on the nature of the data, whether qualitative or quantitative. A P-value equal to or below 0.05 was considered significant. Results/Discussion: The results of the study provide insight into the demographic characteristics of the 495 patients who participated from the Governmental Primary Health Care Clinics in Jericho. The study included 234 male patients (47.3%) and 261 female patients (52.7%). The patients' residences were distributed as follows: 352 (71.1%) living in the city, 115 (23.2%) in a village, and 28 (5.7%) in a camp. By analyzing the participants' responses to various risk factors and hygiene practices, these possible factors might contribute to the spread of gastroenteritis. There is a significant positive correlation between the incidence of parasitic infections and the presence of family complaints related to abdominal pain, diarrhea, or medication intake. Moreover, a significant negative correlation was observed between the incidence of parasitic infections and the habit of washing hands after meals. The occurrence of bloody diarrhea was found to be significantly correlated with parasitic infections. Some factors do not exhibit a significant impact on parasitic infection prevalence, like wearing shoes and working with animals. The correlation between parasitic infections and clinical symptoms emphasizes the need for early detection and prompt medical treatment to prevent complications.
- ItemInvestigation of the Molecular Basis of Familial Mediterranean Fever-Like Disease in Palestinian population(Al-Quds University, 2023-11-08) Diaeddin Sami Qamhia; ضياء الدين سامي قمحيهBackground: Familial Mediterranean Fever (FMF), the most common inherited auto-inflammatory disease worldwide, is caused by gain-of-function mutations in the MEFV gene, which encodes the immune modulatory protein pyrin. The Familial Mediterranean Fever gene (MEFV) gene has been implicated as the main gene responsible for FMF. The aims of our study were to identify and characterize new genes involved in FMF and determine the prevalence of the known MEFV mutation associated with FMF in our patient’s cohort. Methods: clinically diagnosed FMF patients who met the Tel Hashmer’s diagnostic criteria and were confirmed to be negative for the most common mutations in exon 10 of the MEFV gene were included in our study. DNA was extracted from 22 individuals from 7 independent families and Whole Exome Sequencing (WES) was applied to 2 patients from the same family (Father and his son). Results: About 1422 patients (48.6% females and 51.4% males) with FMF were chosen to participate in our study, from 2018 till 2020, 763 patients were found to be negative for MEFV gene, and only 2 were analyzed for new genes or mutations suspecting them for FMF. Around 435 and 224 patients were found to be heterozygous and homozygous for MEFV gene mutation, respectively. Regarding the type of mutation, 595 patients were found to be likely pathogenic for MEFV gene, 222 patients were found to have variants of uncertain significance (VUS) mutation, and 605 patients were found to be pathogenic for MEFV gene mutation. The most common mutations found were R761H (41.09%), followed by V726A (18.82%), M694V (17.57%), M694I (5.7%), M680I (5.15%), A744S (3.51%), K695R (3.04%), P369S (2.73%), F479L (1.25%), and I692del (1.09%). Gender was not found to be significantly related to the presence of different mutations. Whole exome sequencing (WES), applied for 2 samples (a father and his son), showed 4 variant genes: COL3A1, ANKRD36C, WNK1, and PCDH17, that potentially may contribute to FMF-like phenotype in heterozygous variant, and MT-ND5, C1ORF109, ANKRD36B, LNP1, LRRC37A, KIR2DL4, and XKR3 in homozygous variant. Conclusion: Several candidate genes related to the FMF-like phenotype were identified in this study, and the prevalence of known MEFV mutations associated with FMF was determined.