Nutrition and Biology

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    POTENTIAL HEALTH RISKS OF CONSUMING CONTAMINATED FLOUR
    (Deanship of Scientific Research - Al-Quds University, 2026-05-12) Sara Ahmed Nayef; Ikram Imad Alkhatib; Sara Jama Elzebda; Tahreer Hisham Muhaisen; Tala Nehad Alqishawi; Abdelraouf Ali Elmanama; Renad Ibrahim Abu Dan
    Background: Flour is an essential, widely consumed staple and an ideal vehicle for multi-micronutrient fortification. Wheat flour, in particular, is valued for its nutritional content, providing protein, B-group vitamins, minerals, and dietary fiber. The Gaza Strip, home to nearly 2.2 million people—47% of whom are children—has been under prolonged blockade and recurrent conflict. Recent hostilities have intensified food and nutrition insecurity, forcing many households to rely on flour from informal or compromised sources. Historically, flour was not considered a source of pathogenic microorganisms; however, recent evidence has identified pathogens such as *Salmonella* and *Escherichia coli* in wheat flour, linked to foodborne outbreaks. Flour is also susceptible to fungal contamination, including molds such as *Aspergillus*, *Penicillium*, and *Fusarium*, which can produce harmful mycotoxins. In addition, concerns exist regarding chemical contaminants, including pesticide residues, heavy metals, and anthropogenic radionuclides. These risks are particularly significant for vulnerable populations such as children and pregnant women. Objectives: (1) To identify and classify major microbial, fungal, and chemical contaminants found in flour; (2) to investigate reports of contaminated flour consumption in Gaza, including its scale, causes, and immediate health impacts; (3) to review current methods for detecting contamination; and (4) to evaluate preventive strategies for controlling contamination. Methods: A comprehensive literature review was conducted to identify common contaminants, including *Salmonella*, *E. coli*, aflatoxins, pesticide residues, and heavy metals. In parallel, a structured household survey was administered to collect descriptive data on awareness, storage practices, and self-reported health effects related to flour consumption.
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    FEEDING STRATEGIES AND NUTRITIONAL STATUS OF INFANTS AGED 0–6 MONTHS WITH COW’S MILK ALLERGY (CMPA): A CROSS-SECTIONAL STUDY
    (Deanship of Scientific Research - Al-Quds University, 2026-05-12) Mai Mohammed Esleemeyah; Doaa Hafez Mujahed
    Background: Cow’s milk protein allergy (CMPA) is one of the most common food allergies in infancy, affecting growth, nutritional status, and overall health if not properly managed. Dietary elimination of cow’s milk protein is the main treatment approach; however, concerns remain regarding the adequacy of such interventions in supporting optimal infant growth and development. In addition, adherence to dietary management and maternal knowledge may influence clinical and nutritional outcomes. Objectives: This study aimed to assess feeding strategies used in infants with CMPA and to evaluate their association with symptom improvement and nutritional status. Specifically, it examined the relationship between feeding type, adherence to dietary intervention, and outcomes such as symptom response, growth indicators (weight and length), and time to improvement. Methods: A cross-sectional study was conducted involving 20 mother–infant pairs. Data were collected using a structured questionnaire completed by mothers. Participants were categorized according to feeding strategies, including maternal dietary modification, exclusive breastfeeding, specialized formula feeding, or combinations of these approaches. Statistical analysis was performed using SPSS (version 23). Descriptive statistics were used to summarize the data, while inferential tests (Chi-square, t-test, ANOVA, and Spearman correlation) were applied to examine associations between variables. A p-value < 0.05 was considered statistically significant.
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    ANTIBIOTIC RESISTANCE IN E.COLI ISOLATED FROM LOCALLY CULTIVATED MINT IN HEBRON, PALESTINE
    (Deanship of Scientific Research - Al-Quds University, 2026-05-12) Ali Alkoumi; Omama Shabaneh; Ashraf Abdeen
    Background: Antimicrobial resistance (AMR) is a major global public health concern. Fresh leafy vegetables may act as reservoirs of resistant bacteria because contamination can occur during cultivation, irrigation, harvesting, transport, or sale. *Escherichia coli* is widely used as an indicator of fecal contamination and has frequently been isolated from fresh produce worldwide. In Palestine, information on antibiotic-resistant bacteria in vegetables is limited, particularly in mint, which is commonly consumed fresh. Objectives: This study aimed to investigate whether locally cultivated mint sold in grocery markets in Hebron, Palestine, is contaminated with antibiotic-resistant *E. coli*. The objectives were to isolate and confirm *E. coli* from mint samples and to evaluate the antibiotic resistance patterns of confirmed isolates. Methods: A total of 14 locally cultivated mint samples were collected from grocery stores in Hebron between January and March 2024. Presumptive *E. coli* isolates were obtained through enrichment and selective culturing. Phenotypic identification was performed using biochemical tests, and confirmation was carried out by colony PCR targeting the *uidA* gene. Confirmed isolates were tested for antibiotic resistance using the Kirby–Bauer disc diffusion method in accordance with CLSI guidelines. Results: Among 28 presumptive isolates, 13 were confirmed as *E. coli*. Resistance was observed primarily to tetracycline (53.9%) and chloramphenicol (46.2%). Heteroresistance to levofloxacin was detected in 15.4% of isolates, while 61.5% showed intermediate resistance to cefuroxime. No multidrug-resistant isolates were identified. These findings indicate the presence of antibiotic-resistant *E. coli* in mint sold in Hebron grocery markets.
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    COMMUNITY PHARMACISTS’ KNOWLEDGE, BARRIERS AND WILLINGNESS TOWARDS ORAL CONTRACEPTIVES: CROSS-SECTIONAL STUDY FROM PALESTINE
    (Deanship of Scietific Research - Al-Quds University, 2026-05-12) Sabah Abu Mayyaleh; Lana Faour; Fatima Salaymeh; Sana Malouh; Raina Ghanem; Raina Ghanem
    Abstract Background: Community pharmacists play an important role in providing oral contraceptive pills (OCPs); however, their effective use depends on pharmacists’ knowledge and counseling practices. In the Middle East, cultural beliefs and limited professional support influence women’s contraceptive choices, while in Palestine, social barriers and inconsistent counseling restrict utilization. Objective: This study evaluates the Palestinian community pharmacists’ knowledge, willingness to prescribe OCPs pharmacists’ perceived barriers and challenges towards sexual and reproductive health services in Palestine. Methods: A cross-sectional survey was conducted between November 2025 and March 2026, among community pharmacists in Palestine using a self-administered online questionnaire. The survey, which was distributed via social media platforms and local pharmacy groups, consisted of four sections covering: socio-demographics and clinical characteristics, participants’ general knowledge regarding OCPs and the knowledge about their dosing, pharmacists’ willingness to prescribe over-the-counter (OTC) oral contraceptives, and the faced barriers limiting the provision of sexual and reproductive health services by pharmacists. Data were analyzed using SPSS version 25.0. Linear regression was used to determine predictors of knowledge, willingness, and barriers.