Medicine

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PROPHYLACTIC UTERINE ARTERY EMBOLIZATION VERSUS CESAREAN SECTION ALONE FOR PLACENTA ACCRETA SPECTRUM: A SYSTEMATIC REVIEW AND META-ANALYSIS
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Omran MHD Marwan Shrebaty; Leen Alhamd; Moaz Safwan; Mariam Safwan Bourgeh; Batoul Aibour; Mohammad Fateh Martin; Mohammad Samir Mohammad Badr; Mohamed Tharwat Ghazala
Background: Placenta accreta spectrum (PAS) is a severe obstetric disorder characterized by abnormal placental invasion into the myometrium, frequently leading to massive hemorrhage, maternal morbidity, and the need for cesarean hysterectomy with consequent loss of fertility. Prophylactic uterine artery embolization (UAE) has been proposed as a uterine-sparing adjunct during cesarean delivery; however, its clinical effectiveness and safety remain uncertain. Aim: This study aimed to evaluate whether prophylactic UAE performed during cesarean delivery improves maternal outcomes in patients with PAS compared with cesarean delivery alone. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251266306). Electronic databases were searched through December 2025 for comparative studies assessing prophylactic UAE performed intraoperatively or immediately post-cesarean delivery versus cesarean delivery alone in patients with PAS. Primary outcomes included the rate of hysterectomy, intraoperative blood loss, and blood transfusion requirements. Secondary outcomes were length of hospital stay and intensive care unit (ICU) stay. Pooled risk ratios (RR) and weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Certainty of evidence was assessed using the GRADE framework.
TRENDS IN ANTIMICROBIAL RESISTANCE IN STAPHYLOCOCCUS AUREUS ISOLATES AMONG HOSPITALIZED PATIENTS IN THE WEST BANK (2020–2025) AND THE IMPACT OF DIABETES MELLITUS ON INFECTION PROGRESSION AND MULTIDRUG RESISTANCE
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Samer Mohammad; Duha Bani Odeh; Mohammad Alayan; Naif Suleiman; Sara Hjeiji; Qais Abu Alia; Sundus Shalabi
Background: Antimicrobial resistance (AMR) in Staphylococcus aureus represents a growing clinical and public health challenge, particularly in low-resource and fragmented healthcare settings such as the West Bank. Current local evidence is limited to short-term, single-center studies, which are insufficient to describe long-term resistance trends. Meanwhile, the increasing prevalence of diabetes mellitus, a known risk factor for impaired immunity and infection susceptibility, may contribute to both infection progression and the emergence of multidrug-resistant organisms. There is a critical need for longitudinal, multi-center data to inform antibiotic stewardship and clinical decision-making. Study Purpose/ Objectives: This study aims to evaluate temporal trends in antimicrobial resistance among Staphylococcus aureus isolates from hospitalized patients in the West Bank between 2020 and 2025. It also investigates whether diabetes mellitus is associated with an increased risk of progression from colonization to active infection and a higher likelihood of multidrug-resistant isolates. Methods: A retrospective cohort design is employed using microbiology laboratory databases and patient medical records from multiple hospitals. Data collected include patient demographics, comorbidities (with emphasis on diabetes mellitus), site of isolate, antimicrobial susceptibility testing (AST) profiles, and clinical classification of colonization versus infection. Data are de-identified and subjected to standardized quality control procedures. Statistical analysis is performed using SPSS, including descriptive statistics, trend analysis, logistic regression, and risk estimation to identify predictors of multidrug resistance and infection progression.
INSIGHTS INTO MATERNAL AND NEONATAL COMPLICATIONS ASSOCIATED WITH CAESAREAN SECTION AMONG WOMEN: FINDINGS FROM A NATIONWIDE CROSS-SECTIONAL STUDY
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Oadi N. Shrateh; Razan Qamar; Areej A. Milhem; Malak Manasrah; Anas Abusabha; Mahmoud Hameda; Nadeen Qatto; Raghad Taha; Areen Amleh; Saja Rabee; Bara'Ah M. Huseein; Ebtehal Qaoud; Sarah Awad; Mashhour Naasan; Nor Azlia Abdul Wahab
Background: Cesarean section (CS) is the most common obstetric surgery, with rates rising globally and in Palestine. While lifesaving in complicated pregnancies, unnecessary CS may increase maternal and neonatal risks. Women’s awareness of these complications is essential for informed decision-making. This study aimed to assess Palestinian women’s knowledge of CS complications and indications. Methods: A nationwide cross-sectional study was conducted from January 2024 to February 2025 across governmental and non-governmental hospitals in Palestine. A total of 2007 women aged 10–49 years, currently pregnant or recently delivered, completed a structured questionnaire assessing sociodemographic factors, obstetric history, and knowledge of CS-related complications and indications. Data were analyzed using descriptive statistics, chi-squared tests, and regression models.
THE ROLE OF CIRCULATING MICROBIAL DNA (CF-MBDNA) AS AN EARLY BIOMARKER OF CHRONIC INFLAMMATION IN LONG-STANDING DIABETES MELLITUS AND ITS ASSOCIATION WITH MICROVASCULAR COMPLICATIONS: A SYSTEMATIC REVIEW
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Abdullah Talal Salem; Faisal Aljohani; Nuha Al Yousfi; Bashayr Alkuhayli; Ahmed Isa; Arwa Hammouda; Yara Alamri; Abdullah Almohamad Almustafa; Alaa Habashi; Siraj Fakiha; Rahaf Alqahtani; Mohammed Alsaeed
Background: Circulating microbial DNA (cf-mbDNA) and related cell-free DNA (cfDNA) fragments have emerged as novel biomarkers reflecting metabolic stress, inflammation, and vascular injury in diabetes mellitus (DM). This systematic review aimed to synthesize current evidence on their diagnostic potential for detecting chronic inflammation and microvascular complications in long-standing diabetes. Study Purpose/ Objectives: The role of circulating microbial DNA (cf-mbDNA) as an early biomarker of chronic inflammation in long-standing diabetes mellitus and its association with microvascular complications: A systematic review Methods: Following PRISMA 2020 guidelines, ten peer-reviewed studies published between 2010 and 2025 were systematically analyzed across multiple databases. Eligible studies assessed cfDNA or cf-mbDNA in plasma or serum samples from patients with type 1 or type 2 diabetes, investigating associations with inflammatory and vascular markers.
ASSESSING THE VALIDITY OF A SINGLE-ITEM MEASURE FOR PROBLEMATIC INTERNET USE IN ADULTS: EVIDENCE FROM SAUDI ARABIA
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Juliann Saquib; Mohamed Ghaith Al Abdin; Mohamad Ayham Muqresh; Idris Sula; Fathin Ahamed Lebbe; Mansour Alsoghair; Abdulrahman Almazrou; Nazmus Saquib
Background: Internet addiction (IA) is a universal health problem that is linked with a negative impact on mental, physical, and social health, especially among the young population. The prevalence of IA is accelerating dramatically in Saudi Arabia; this surge contributed to an alarming rise in IA, particularly among adolescents. This study aims to determine the prevalence of IA among adults from four different cities in Saudi Arabia and to investigate the validity of a single-item self-rating measure against Young’s Internet Addiction Test (IAT). Moreover, to assess the association between the IA and mental, physical, and social health. Methods: A cross-sectional study of 1429 adult participants was conducted in four cities of Saudi Arabia (Riyadh, Jeddah, Dammam, and Buraidah) to assess internet use, lifestyle, and self-reported health by using a validated questionnaire. IA was measured using both single-item self-rating and the validated Young’s IAT scale. The study was conducted via online interviews with the participants by the senior students of Sulaiman AlRajhi University. A univariate logistic regression identified the significantly associated factors.
GENOTYPE-PHENOTYPE CORRELATION AND THE SEVERITY OF NEUROLOGICAL MANIFESTATIONS IN PALESTINIAN PATIENTS WITH HYPERORNITHINEMIA HYPERAMMONEMIA HOMOCITRULLINURIA (HHH) SYNDROME: CASE SERIES WITH REVIEW OF PREVIOUSLY REPORTED PALESTINIAN PATIENTS
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Tolin Qtefan; Sulaf Daraghmeh; Mohammad Khalifeh; Mohammad Sawalmeh; Ahmad Itawy; Imad Dweikat
Hyperornithinemia–hyperammonemia–homocitrullinuria (HHH) syndrome (OMIM 238970) is a rare autosomal recessive urea cycle disorder caused by SLC25A15 gene mutations, leading to defective mitochondrial ornithine transporter. Clinical presentations include vomiting, encephalopathy, coma, developmental delay, intellectual disability, seizures, ataxia, pyramidal signs, and hepatitis-like attacks/coagulopathies. Diagnosis relies primarily on genetic testing, then on the biochemical triad of hyperammonemia, hyperornithinemia, and homocitrullinuria, which may be subtle or absent. This is a Case series of newly reported Palestinian patients and a review with comparison to previously reported ones. Clinical data were collected through structured interviews with patients, focusing on medical history, disease progression, performing a neurological examination, and laboratory and genetic testing from medical records, as it showed founder mutations, although patients belong to different Palestinian families. This research focused on pediatric patients to assess the importance of the early diagnosis, early management, and liver transplantation on neurological outcomes and their reversibility. Additionally, correcting metabolic status to enhance quality of life. This study focuses on the progression of neurological impairment, with particular focus on pyramidal tract signs, motor dysfunction, and speech delay. These results will help to give a better understanding of the correlation between the genotype and phenotype of the Palestinian patients as their associations are not fully deterministic due to the factors that affect outcomes beyond the primary condition. Finally, we reported new Palestinian cases despite the rarity of the disease. So, this will enrich the data about Palestinian patients and enhance the quality of knowledge, so practitioners can deal with such cases
ADVANCED RESISTIVE EXERCISE VERSUS INTERIM RESISTIVE EXERCISE IMPACT ON BIOMARKERS OF BONE TURNOVER AND SUBSEQUENTLY SPINE HEALTH FOR ASTRONAUTS UNDERGOING PROLONGED SPACE FLIGHT: A SYSTEMATIC REVIEW AND META-ANALYSIS
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Basil Mohammed Ibdah; Abdallah M. A. Sayegh; Dana A. F. I. Farghaly; Medha Chakrapani; Sara I. T. Abdelnabi; Anahit Galstyan; Natalie Shulaia
Background: Spaceflight, once a distant dream for many, is potentially becoming a commodity with recent advancements. Microgravity-related spine abnormalities are expected to increase with the increase of spaceflights conducted by individuals. Objectives: To examine whether Advanced Resistive Exercise (ARED), Interim Resistive Exercise (IRED), or Bisphosphate and ARED (Bis+ARED) best maintained bone turnover biomarkers, minimizing subsequent effects on the spine during extended spaceflight Methods: Following PRISMA guidelines, 86 studies were identified from PubMed, EmBase and SCOPUS. Studies had to be double-arm discussing ARED as the intervention with IRED and/or Bis+ARED as a comparison throughout multiple flight phases for calcifediol, calcitriol, and urinary calcium. Studies had to be in English; no limit on years was set. Meta-analysis of Mean Difference (MD) with 95% CI was conducted using STATA MP (v.17.0). A total of 3 studies encompassing 2 prospective cohorts and 1 clinical trial were examined in the quantitative comparison between ARED and IRED/Bis+Ared. With a total number of 52 participants.
THE COMPARISON OF REMIMAZOLAM AND MIDAZOLAM IN BRONCHOSCOPIC SEDATION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Al-Hareth M. Amro; Yahya Kayed AbuJwaid; Salahaldeen Deeb; Yousef Abu Asbeh
Background: Effective sedation is essential for bronchoscopy to ensure patient comfort and procedural success. Midazolam is commonly used; however, it is associated with longer induction and recovery times. Remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as a potential alternative due to its rapid onset, shorter duration of action, and favorable safety profile. Study Purpose. Objectives: This study aimed to evaluate the efficacy and safety of remimazolam compared with midazolam for sedation during bronchoscopy. Methods: A systematic review and meta-analysis of four randomized controlled trials (RCTs) including 630 patients undergoing bronchoscopy was conducted. Patients receiving remimazolam were compared to those receiving midazolam. Primary outcomes included induction time, recovery time, and the need for rescue sedation. Secondary outcomes included procedure duration and the incidence of intraoperative and postoperative adverse events. A random-effects model was applied for statistical analysis, and the quality of evidence was assessed using the GRADE framework.
BEYOND GRADES TO LEARNING ENHANCEMENT: DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF A CONVERSATIONAL AI AGENT IN MEDICAL EDUCATION
(Deanship of Scientific Research - Al-Quds University, 2026-05-12)
Background: Artificial intelligence (AI) is transforming medical education by offering personalized, interactive learning. However, evidence on their educational impact remains limited. Objective: To evaluate the educational impact of a custom GPT agent for undergraduate medical students. Methodology: The intervention involved the development and deployment of a curriculum-aligned custom GPT-4 conversational agent supporting individualized learning in a 4-week pharmacology block in Year 2 of MBBS program at the College of Medicine, Sulaiman Alrajhi University in 2024-2025 academic year. A mixed- Methods: A sequential-explanatory design was conducted for its evaluation after the block. Phase 1 included a survey with the enrolled students (n=58) assessing usage, perceptions, and satisfaction, alongside a comparative analysis with two historical cohorts (2022–2023, n=33; 2023–2024, n=37). Phase 2 involved semi-structured interviews with nine volunteers. Quantitative data were analyzed using SPSS v28, and qualitative data via thematic analysis. Ethical approval was obtained prior to the start of the block. Informed consent was also obtained from all the students at the start of the block.
RESPIRATORY SYNCYTIAL VIRUS (RSV) BURDEN AMONG HOSPITALIZED CHILDREN <5 YEARS AND ASSESSMENT OF VACCINE INTRODUCTION IN PALESTINE: A 5-YEAR RETROSPECTIVE COHORT STUDY
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Ihab K. Hemieid; Yousef Sajdieh; Philip Abu Mohor; Yousef Alhroub; Mohammad Khalawi; Aws Horoub; Musa Y Hindiyeh; Balqees Mohamad
Background: Respiratory Syncytial Virus (RSV) is the leading cause of acute lower respiratory tract infection in infants and young children — a pathogen that disproportionately affects low- and middle-income countries (LMICs), where 97% of attributable deaths occur. In the West Bank, Palestine, data on the local clinical and economic impact of RSV remain scarce. Study Purpose/ Objectives: To quantify the clinical and financial burden of RSV infection among hospitalized children aged 0–60 months at a tertiary pediatric referral center in the West Bank; to characterize seasonal patterns, clinical features, and treatment practices; and to identify independent predictors of severe clinical course. Methods: This study is a single-center retrospective cohort study conducted at Caritas Baby Hospital. We included 2292 consecutively sampled, laboratory-confirmed RSV admissions (via direct fluorescent antibody) from June 30, 2021, until July 31, 2025. Fifty-nine variables were categorized into sociodemographic characteristics, clinical features, risk factors, and hospital resource utilization. For clinical severity modeling, a severe course was defined as a composite of intensive care unit admission, mechanical ventilation, in-hospital mortality, or prolonged hospitalization exceeding the 75th percentile of the burden subset (> 6 days). Descriptive analyses, chi-square/Fisher exact tests, Mann-Whitney U/Kruskal-Wallis tests, and multivariable logistic regression were used.
ADHERENCE TO CHILDHOOD VACCINATION SCHEDULES AND ITS BARRIERS AND ASSOCIATED FACTORS AMONG CAREGIVERS IN GAZA DURING THE WAR: A CROSS-SECTIONAL STUDY
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Samar Alshorbaji; Yazid Abu Sheha; Aya Obaid; Lina Okasha; Ali Abu Sweireh; Yazan Abu Daqqa; Meram Mohammed Ali Azzani; Ayda Helles
Background: The ongoing armed conflict in Gaza has severely disrupted the healthcare system, creating major challenges to the delivery and utilization of essential health services, including routine childhood immunization. Extensive damage to health infrastructure, population displacement, insecurity, and transportation barriers have significantly limited access to vaccination services. Despite historically high immunization coverage prior to the war, these disruptions have increased the risk of missed and delayed vaccinations, thereby increasing children’s vulnerability to vaccine-preventable diseases. In such fragile settings, adherence to vaccination schedules is no longer determined solely by caregiver knowledge or attitudes, but is increasingly shaped by conflict-related barriers and shifting sociodemographic conditions. Objectives: This study aimed to assess the prevalence of adherence to childhood vaccination schedules among caregivers in Gaza during the war, as well as its associated barriers and sociodemographic factors. Methods: A cross-sectional study was conducted among 475 caregivers of children aged 0–24 months across multiple governorates in Gaza. Data were collected on sociodemographic characteristics, vaccine-specific adherence, overall vaccination adherence, and perceived barriers. Adherence was defined as each vaccine dose being administered within the recommended schedule, allowing a maximum delay of 30 days. Bivariate analysis using Pearson’s chi-square test was employed to examine associations between adherence and explanatory variables.
QUALITY OF LIFE AND ASSOCIATED PREDICTORS IN PALESTINIAN MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Mohammad Isbeih; Amer Rahhal; Hamid Ghanem; Nour Jaber; Shahd Idais; Ibrahim Amer Ghannam; Maha Nubani Husseini; Maha Nahal
Medical students experience tremendous stressors related to the demanding nature of medical education programs, which can negatively impact their health and overall quality of life (QoL). This particular study aimed to evaluate the QoL of medical students at Al-Quds University (AQU) in Palestine across various academic years and demographic variables, concerning physical health, psychological well-being, social relationships, and environmental conditions. A cross-sectional comparative study involving 522 medical students representing all six academic years was conducted from May to July 2024. QoL was assessed via the culturally adapted Arabic version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Demographic variables (gender, age, place of residence, number of bedrooms) and academic (academic year) variables were examined as correlates of QoL domains. Descriptive statistics, independent t-tests, and one-way ANOVA were applied, and linear regression was used to identify predictors. A p-value of ≤0.05 was considered statistically significant. Social relationships were the highest-rated domain (M = 3.58, SD = 0.862), followed by physical health (M = 3.38, SD = 0.721), environment (M = 3.28, SD = 0.638), and psychological conditions (M = 3.12, SD = 0.693). Gender differences emerged, with males reporting better physical health (p = 0.002). Linear regression further identified academic level as a key predictor of physical health (p < 0.001). Medical students at AQU have shown resilience in their social relationships. However, concerns arise from their lower psychological health and limited access to recreational opportunities. These findings highlight the importance of targeted institutional strategies that address mental health and foster supportive environments. Ultimately, this approach aims to enhance student well-being and create a more balanced and sustainable quality of life for students.
QUALITY OF LIFE DOMAINS AND CLINICAL PREDICTORS OF MEDICATION ADHERENCE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Salem K. Qupp; Mohammad Alnees; Nizar Abu Hamdeh; Mohammad Masu'd; Yahya Z. Fraitekh; Duha Najajra; Abdalaziz Darwish; Nora I. Baraghithi; Monther M. Hroub; Aesha L.E Enairat; Shymai Abdallah; Anwar Zahran; Saleem Majadleh; Omar Abu-Khazneh; Yazan Hamdan; Ameer Mahamid; Omar Ayyad; Lilian Jofa; Ammar Barakat; Amir Haim; Ibraheem AbuAlrub; Omar Y. AbuAlayan; Qusay Abdoh; Idiberto José; Zotarelli Filho; Haitham Abu Khadija
Background: Quality of Life Domains and Clinical Predictors of Medication Adherence in Patients with Inflammatory Bowel Disease. Medication non-adherence in inflammatory bowel disease (IBD) increases relapse risk, emergency healthcare utilization, and costs. While quality of life (QoL) is known to influence adherence broadly, the independent contributions of specific QoL domains and clinical disease markers remain poorly characterized, particularly in the Middle East Objectives: This multicenter study aimed to determine whether specific health-related QoL domains, including bowel, systemic, emotional, and social, measured by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and objective clinical and inflammatory markers independently predict medication adherence in adults with IBD during short-term follow-up. Methods: A multicenter cross-sectional study was conducted from December 2024 to June 2025 across ten major hospitals serving the Palestinian population in the West Bank. A total of 298 adults (18–65 years) diagnosed with Crohn's disease or ulcerative colitis were enrolled. Medication adherence was measured using a purpose-built, team-developed 14-item Arabic-language questionnaire (Cronbach's α = 0.70), yielding three ordinal categories: Low (0–15), Medium (16–25), and High (26–32). Health-related QoL was assessed using the validated SIBDQ (total and four-domain scores: Bowel, Systemic, Emotional, Social). Clinical predictors included comb sign, intestinal stenosis, fecal calprotectin at 3 months (FC-3), serum albumin, ESR, platelet-to-lymphocyte ratio (PLR), and comorbidities. The primary analysis used generalized ordered logistic regression (partial proportional-odds models; gologit2) with high adherence as the reference, applying LASSO-guided covariate selection and robust standard errors.
GENDER-BASED DIFFERENCES IN MEDICAL STUDIES IN PALESTINE: A CROSS-SECTIONAL STUDY OF CLINICAL STUDENTS AND INTERNS
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Malak Awad; Iman Abu Nawa; Abeer Radi; Salsabil Al-Shaieb; Jana Faroun; Peter Bael
Background: For many, studying medicine is a childhood dream; the idea of being a respected doctor is a cherished escapade. But what many don't realize is that compromises should be made along the road, a road that might seem idyllic from afar. Gender discrepancies are one of the least-discussed struggles for any gender, and they can lead to sacrifices along the way. These discrepancies could influence academic performance, clinical exposure, mental health, and specialty preferences; however, evidence remains inconsistent across our cultural settings. In Palestine, a conservative society, social norms may uniquely shape the clinical training experiences and opportunities among medical students. Our study aims to evaluate gender-based differences in academic, clinical, psychological, and career-related outcomes among Palestinian clinical-year medical students and interns. Methods: A multicenter cross-sectional observational study was conducted among 400 clinical-year medical students and interns from the five major Palestinian universities in the West Bank. Participants completed a structured questionnaire assessing their demographics, academic performance, clinical exposure, specialty preferences, and mental health using the Depression Anxiety Stress Scale-21 (DASS-21). Statistical analyses were carried out with ‘R statistical software” using chi-square tests, Mann–Whitney U tests, Kruskal–Wallis tests, and multivariate regression modeling.
GLOBAL PREVALENCE AND CHARACTERISTICS OF CONGENITAL HEART DISEASE IN CHILDREN: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS (2018-2025)
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Usra Ghanem; Mohammed Amer Kamel; Shankar Biswas; Mohamed Fayez Fouda; Hamid Ghanem; Mirna Hussein; Mohammed A Mahmoud; Muhammad M AbuKhalaf; Nofouz I.A. Maswada; George Alsous; Dalia Atef Abouda
Background: Congenital Heart Disease (CHD) is the most common major congenital anomaly, accounting for one-third of all serious birth defects. Despite therapeutic advances, it remains a leading cause of mortality and disability in children under five. Reported global prevalence remains highly variable, often influenced more by diagnostic infrastructure than biological factors. Objective: This systematic review and meta-analysis aim to provide a contemporary global estimate of CHD birth prevalence and evaluate how methodological and regional factors influence reported rates. Methods: Following PRISMA and MOOSE guidelines, we searched PubMed, Embase, Scopus, WOS, and Science Direct for observational studies published between January 2018 and August 2025. We included 37 studies encompassing 24,559,331 participants. Primary outcomes included birth prevalence per 1,000 live births. Due to extreme heterogeneity (I^2 = 100%), data were synthesized using random-effects models, meta-regression, and sample-size weighted medians.
MELANOMA IN PALESTINE: FIRST REAL-WORLD OUTCOMES FROM A NATIONAL RETROSPECTIVE COHORT
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Elie G. Malki; George Alsous; Ahmad Nassar; Gessila Khalil; Laith Ishtayeh; Waleed Nabulsi; Adham Itbaisha; Marwan Qubaja; Farah Awad; Elias Lahham; Musa Y. Hindiyeh
Background: Melanoma in Palestine presents a significant public health challenge, with cancer being the third leading cause of mortality in the region as of 2020. The healthcare context is characterized by fragmented studies on cancer prevalence, a lack of a national registry, and constrained healthcare access due to regional instability, movement restrictions, limited molecular diagnostics, and resource limitations, particularly in Gaza. These factors contribute to delayed diagnosis and treatment access. The Palestinian Ministry of Health reported only 59 cases between 2017-2021, while GLOBOCAN (2022) estimated 24 cases per year in Palestine. Augusta Victoria Hospital (AVH) serves as the primary national tertiary referral center for melanoma cases across the West Bank and Gaza. Objectives: The primary objective of this study was to analyze and highlight the disease characteristics and real-world outcomes of cutaneous melanoma patients in Palestine, a region with significant resource constraints.
THE IMPACT OF CHARCOAL AND WOOD USE FOR COOKING DURING WAR ON RESPIRATORY SYMPTOMS: A CROSS-SECTIONAL STUDY AMONG CIVILIANS IN THE GAZA STRIP
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Nagham Mezied; Huda AlWadiya; Saja Saqar; Abdallah AlJadba; Habiba Masood; Tareq Kishawi; Farah Miqdad
Background: The 2023-2025 war and blockade in the Gaza Strip have severely disrupted daily life basics and aspects, including electricity supply and cooking gas availability. As a result, many civilians have relied on traditional cooking methods such as wood and charcoal. Smoke from these fuels contains toxic pollutants that may adversely affect the respiratory system. Objective: The study aimed to determine the effect of charcoal and wood use for cooking during the war on respiratory symptoms among civilians in the Gaza Strip, examining prevalence, severity, exposure patterns, and associated factors. Methods: A quantitative cross-sectional study was conducted among 390 adults who used wood or charcoal for cooking during the war. Data were collected using a structured questionnaire that included demographic, environmental, exposure, and respiratory symptoms variables. Descriptive statistics were applied, and analyses were conducted using SPSS. Chi-square test and logistic regression analysis were conducted to examine associations between respiratory symptoms and biomass fuel use, as well as related factors. A p-value <0.04 was considered statistically significant.
CAN MACHINES WRITE YOUR EXAMS? A SYSTEMATIC REVIEW OF GENERATIVE ARTIFICIAL INTELLIGENCE FOR MULTIPLE-CHOICE QUESTION DEVELOPMENT IN MEDICAL EDUCATION
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Ahmed M.J. Rabee; Abdulrahman Kharsa; Ammar Y.M. Saadawy; Mohammad Wasim Alnajjar; Ahmad M.A. Adi; Majid Ali
Background: Multiple-choice questions (MCQs) are essential for assessing medical education, whereas conventional item development is labour-intensive, inconsistent in quality, and often mismatched with evolving curricula. Generative artificial intelligence (AI), particularly large language models such as ChatGPT, has emerged as a promising tool for streamlining MCQ creation. However, evidence on the quality, psychometric properties, and educational effectiveness of AI-generated MCQs remains fragmented. Study Purpose/ Objectives: This review aimed to systematically assess the quality and effectiveness of generative AI in producing MCQs for medical education. Examining psychometric properties, content quality, cognitive level, resource efficiency, and user perceptions compared to human-authored questions. Methods: This systematic review followed PRISMA 2020 guidelines and was registered on PROSPERO (CRD420251153109). Six databases (PubMed, Scopus, Embase, Web of Science, ERIC, and Europe PMC) were searched from January 2018 to November 2025. Two reviewers independently screened studies, extracted data, and assessed methodological quality using modified MERSQI and the Newcastle-Ottawa Scale.
CHRONIC KIDNEY DISEASE AND ITS IMPLICATIONS OVER MUSCULOSKELETAL SYMPTOMS IN WAR CONFLICT ZONE: A CROSS-SECTIONAL STUDY
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Mohammad F. Zhour; Mohammed Imad; Salah Wajdi Alaloul; Khalil Mostfa Alinaby; Seraj Hazem Alamassi; Hesham Fawzi Al Amassi; Mohammed Zughbur; Arslan Ahmed; Kashif Memon; Ashraf Joma Al Bayya⁵
Background: Chronic kidney disease (CKD) patients undergoing maintenance hemodialysis (HD) commonly experience musculoskeletal (MSK) symptoms that substantially reduce quality of life. In active conflict zones such as the Gaza Strip, where healthcare infrastructure is severely disrupted and war-related stressors are widespread, the burden of MSK symptoms is expected to be markedly amplified. Objectives: This multicenter cross-sectional study aimed to assess the prevalence of MSK symptoms and identify sociodemographic, clinical, and war-related predictors among HD patients in Gaza during ongoing hostilities. Methods: The study was conducted between April and May 2025 across five operational HD centers in the Gaza Strip. A total of 336 adult patients on maintenance hemodialysis for ≥3 months completed the Arabic-validated Nordic Musculoskeletal Questionnaire (NMQ) through face-to-face interviews. Data on sociodemographic characteristics, clinical factors, dialysis adequacy, and war-related exposures were also collected. Chi-square tests and multivariate binary logistic regression were used to identify independent predictors of MSK symptoms.
ASSOCIATION BETWEEN HABITUAL MSG CONSUMPTION AND COMPULSIVE EATING BEHAVIORS IN UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY
(Deanship of Scientific Research - Al-Quds University, 2026-05-12) Lina K. Al Jabry; Abdallah Shawwa; Rola Issa; Omar Abweh; Yomna Sarhan; Haneen Qashqeesh; Hazem Alagha
Background: Monosodium glutamate (MSG) is a widely used flavor enhancer in processed foods that increases palatability and may influence eating behaviors. Although considered safe from a toxicological standpoint, its potential association with compulsive eating patterns remains unclear. University students are particularly vulnerable to irregular dietary habits and increased consumption of ultra-processed foods. Objectives: This study aimed to determine whether higher MSG intake is associated with increased food addiction and binge-eating severity among university students. It also examined the relationship between MSG consumption and food addiction symptom counts, assessed the presence of a dose–response effect, and evaluated these associations after adjusting for key confounders such as age, gender, body mass index, perceived stress, and academic year. Methods: A cross-sectional study was conducted among 555 Palestinian university students aged 18–30 years. MSG intake was assessed using a composite dietary exposure scale and categorized into tertiles (low, moderate, high). Food addiction was measured using the Yale Food Addiction Scale (YFAS), binge-eating severity using the Binge Eating Scale (BES), and perceived stress using the Perceived Stress Scale-4 (PSS-4). Logistic regression models were used to examine the association between MSG intake and food addiction diagnosis, while linear regression models evaluated associations with binge-eating severity and YFAS symptom counts. All models were adjusted for age, gender, body mass index (BMI), perceived stress, and academic year.

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