Medical Laboratory science علوم المختبرات الطبية
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- Item“Evaluation of antibody titers and serotypes in COVID-19 vaccinated human being”(Al-Quds University, 2025-01-04) Ahmad Ziyad Khalil Abdelkader; أحمد زياد خليل عبد القادرIntroduction: SARS-CoV-2 is a novel coronavirus that emerged in 2019 and is now classified in the genus Coronavirus with closely related SARS-CoV. Due to the high pathogenicity of this virus in humans, It is classified as biosafety level 3 (BSL-3) pathogen, which makes manipulating it relatively difficult due to its infectious nature that killed high number of people. Methods: To assessment immune system and antibodies titer the serum samples collected from 85 hospitalized vaccinated patients against COVID-19 disease or were previously infected patients and from normal non vaccinated negative donors. To evaluation of antibody titers an Enzyme-linked immunosorbent assay (ELISA) technology performed in laboratories, and evaluation the virus infection, and proteins M and S spike proteins of SARS-CoV-2 evaluated and determined for detection of spikebinding neutralizing antibody titers in sera from hospitalized COVID-19 vaccinated patients by using commercial enzyme and ELISA technology. Furthermore, to measure SARS-CoV-2 neutralizing antibodies under BSL conditions, an ELISA for SARS-CoV-2 was developed. Recording the results of laboratory analyzes and saving them in a database using a computer. Result: An analysis and assessment the antibodies titer was conducted and obtain results about the Corona virus, its spread and its effect on people, where the immunological and microbiological results of the people were analyzed and then enter this data as input into the laboratory database, and it was found from this study that there is a clear discrepancy between the data of vaccinated and healthy people, as it appeared that the vaccinated show higher titer than unvaccinated normal individuals. In conclusion, this study aimed to evaluate the long-term effectiveness of COVID-19 vaccination in Palestine people by analyzing they response to the vaccine after two years, based on anti-SARS-CoV-2 protein S and M antibody titer levels. This study demonstrates the importance of knowing the impact of the Corona virus on people, efficacy of vaccines and presence of neutralizing antibodies against Covid19. To evaluate an immune system throw examination by assessment antibody titer and serotypes specially using high specificity and sensitivity ELISA technology to COVID-19 system, which easily can be implemented and performed within a biosafety level laboratory (BSL) for evaluating the occurrence of neutralizing antibodies against SARS-CoV-2 and assessment of both S and M antigens to control and limit the transmission of the COVID 19 in order to find an appropriate treatment for this virus and improve new vaccination in Palestine
- ItemEvaluating Peripheral Blood Smear Testing in Palestine: A Step Towards Quality Assurance and Diagnostic Excellence(Al-Quds University, 2025-05-10) Wisam Abdallah Ahmad Alshalash; وسام عبدالله أحمد الشلشPeripheral blood smear (PBS) test is a critical diagnostic tool in hematology for identifying various blood disorders and malignancies. The absence of a national external quality assurance scheme (EQAS) for PBS testing in Palestine suggests a significant gap in ensuring test quality and standardization. This study aimed to evaluate laboratory technicians’ knowledge and practices regarding PBS preparation, staining, and examination, and evaluate laboratory performance regarding PBS examination, and contribute to the establishment of an EQAS program for PBS testing in Palestine. Methods: A mixed-methods approach was utilized, consisting of two parts: (1) assessment of laboratory technicians' knowledge and practice about PBS test through a structured questionnaire targeting laboratory technicians across Palestine, with a total of 235 participants, and (2) evaluation of laboratory performance in PBS examination using three pre-stained PBS smears distributed to 39 laboratories that performed both PBS preparation and examination, identified through a preliminary screening survey. Participants were evaluated based on Z-scores for inter-laboratory agreement and the coefficient of variation (CV%) for intra- and inter-laboratory precision. Results: Knowledge assessment revealed high performance in smear preparation (92.5%±11.3) but marked deficiencies in staining process (56.7%±21.3), examination methods (60.7%±18.4), and blood cell morphology (64.1%±21.0), with an overall score of 65.9%±14.4. Higher qualifications and active PBS involvement correlated with improved knowledge outcomes. Practical inconsistencies were found in staining process, fixation, drying, and microscope usage. Performance evaluation showed acceptable Z-scores in most parameters (94.3% in WBC counts, 97.1% in lymphocyte differentials, and 100% in platelet counts), yet CV% analysis revealed high intra- and inter-laboratory variability. Morphological agreement with experts was notably low, especially for identifying microcytosis (11.4%), spherocytes (8.6%), and ovalocytes (11.4%). Conclusion: The findings highlight significant deficiencies in laboratory technicians’ knowledge and substantial variability in PBS-related practices and examination of PBS across clinical laboratories in Palestine. These findings highlight the urgent need for standardized protocols, targeted training, and the establishment of a national EQAS program for PBS examination to enhance diagnostic accuracy and ensure consistent testing quality.
- ItemAntibiotic Resistance Patterns and Molecular Typing of Acinetobacter baumannii Clinical Isolates and Hospital Environment at Alia Governmental Hospital, Palestine(Al-Quds University, 2024-05-28) Donia Mohammad Mosbah Khderat; دنيا محمد مصباح خضيراتBackground:In recent years, Acinetobacter baumanniireceived increasing attention;due to theircabability of acquiring multi-resistance to antibiotics and their potential to cause disease in humans. It is also known for its intrinsic antimicrobial resistance mechanisms: several studies documentedthe increase in the percentage of resistance to antimicrobial agents in four majorantimicrobialclasses: Fluoroquinolones,aminoglycosides, β-lactams including Carbapenems. The increase in Carbapenems resistance is of important concern, as thisclass of antibiotics isusually considered the last choice in treating resistant A.baumannii.This opportunistic pathogen able to survive in the environment under unfavorable conditions for prolonged periods,this contributes to its increased virulance. Thus, the hospital environment may serve asa reservoir for the resistantA. baumannii strainsallowing easily spread in hospital,serve as a nosocomial infections in patients, healthcare personnel, and visitors. Aims: This study aimed at characterization of A. baumanniiisolates from inpatients and hospital environments.To find out their antimicrobial resistance pattern, detect Carbapenems resistant A.baumannii(CRAB), and to find out genetic relatedness between isolates using random amplification of polymorphic DNA (RAPD) typing technique. Methodology: In this study, a total of 24 clinical isolates obtained from various clinical specimenssuch as wounds, blood, urine, earswabs and sputumduring the period April1, 2023, and December 31, 2023fromAlia Governmental Hospital, Hebron,Palestine. The Vitek2 system was used for identification and antibiotic susceptibility testing. Concurrently a total of 126 specimen were collected from different environments of the hospital identified as A. baumanniiusing conventional identification methodsand CHROMagar Acinetobacterselective medium. The isolates then tested for antibiotic susceptibility testing using disk diffusion methods.All isolates (both clinical and v environmental) were tested for the presence ofblaOXA-51 gene using PCR. And finally, the genetic relatedness between isolates was determined using RAPDtyping technique. Results:Twenty fourclinical isolates and 29 environmental isolates were identified as A. baumannii. All isolates were confirmed to be A. baumanniiby detecting blaOXA-51-like gene.Among the environmental isolates patient’s beds were the most contaminated site (20.6%, 6/29),while the largest number of clinical isolates were obtained from wounds (10 isolates: 41.7%). The majority of clinical and environmental isolates were collected from intensive care unit (ICU).Multidrug resistant A.baumannii (MDRAB) was detected in approximately 74% of clinical isolates and in 100% of environmental isolates.Co-trimoxazole (COT) was the most effective antibiotic against both clinical and environmentalA.baumannii isolates. For other antibiotics, clinical and environmentalA.baumanniiisolates showed high resistance rates:86.2% and 96.6% of environmentalisolates were resistant to imipenem (IM) and meropenem (MEM) respectively,while clinical isolates had a resistant rate of 72.7% and 77.3% to IM and MEM, respectively.Using the RAPD-PCR typing technique, four clusters grouped A-D had more than one isolateand the remaining isolates each had unique pattern. Some RAPD clusters were seen with environmental as well as clinical isolates. Conclusion and recomendations:Thisstudy clearly suggests that the rate of MDRAB and CRAB are increasing and considered an important cause of nosocomial infections.The relatednessbetween clinical and environmental isolates and the detection of high rate of antimicrobial-resistant A.baumanniiin various hospital environments suggested the potential role of the hospital environments through various clinical activities in the cross contamination of A.baumanniiinfections, particularly in the ICU. These findings highlight the importance of identifying A.baumannii infections early and implementing very strict infection control strategies.It is recommended that hospital wards must be vigorously sanitized and disinfected periodically.
- ItemInvestigating β-Thalassemia Major Cases Emerged After Obligatory Premarital Testing in Palestine(Al-Quds University, 2023-11-11) Mais Khader Yousef Al Shatleh; ميس خضر يوسف الشتلةβ-Thalassemia major is a prevalent autosomal recessive disorder worldwide, affecting approximately 3-4% of the Palestinian population. Management of this condition poses significant challenges, particularly in resource-constrained settings. This study aims to investigate the factors contributing to the emergence of new cases of β-thalassemia major after the implementation of obligatory premarital screening, thereby informing strategies for prevention and intervention. Methods We conducted a cross-sectional case-series study that included all patients diagnosed with β-thalassemia born in or after 2010 in the West Bank. 69 eligible patients from 62 families were included in the study. The data used in this study were collected through a comprehensive questionnaire covering the demographic and medical information of each thalassemic child born after 2010 in the family, familial sociodemographic characteristics, background characteristics of the parents (fathers and mothers), premarital screening, and the knowledge, attitudes, and practices (KAP) of parents (mothers and fathers). In addition, we collected blood samples from 68 children and 62 parents for hematological assessment (complete blood count and hemoglobin electrophoresis). Results The largest proportion of emerging thalassemia cases were from the northern region and resided in rural localities. 71% of the cases were from families married before 2010. 56.5% of the parents reported undergoing premarital screening tests. The proportion of parents who underwent premarital screening differed significantly by type of locality, year of marriage, and age at marriage. In addition, investigating the self-reported results of the premarital screening tests of each couple, we have found that among 24 partners who did not get tested, 22 were married before 2010 and 19 had children with β-thalassemia major. Furthermore, among 12 couples who reported that the two partners were tested and were non-carriers, 4 couples had children with β-thalassemia major, 4 had children with sickle cell thalassemia, and 4 had children with thalassemia intermedia. Overall, the proportion of children with thalassemia major was lower by 20% among parents who married in/after 2010. On the other hand, comparison between the self-reported results of premarital screening and the results of the hematological assessment (mean capsular volume), a total of 24 out of 32 parents had discrepancies in their results. the hematological assessment also showed that 3 out of 62 parents had normal MCV, all of which had high HbS and were parents of children with sickle cell thalassemia. Also, 8 parents had both low MCV and high HbS and one parent had low MCV and high HbC and was a parent of two children with hemoglobin SC disease. Assessment of knowledge showed that all parents had adequate knowledge about thalassemia, 51.7% of the parents had poor overall attitudes, and 76.3% had poor attitude scores towards the termination of pregnancy. Furthermore, 47.4% of the parents had good overall practice scores. Knowledge scores were positively correlated with attitude scores (r=300; p-value=0.01) but not with practice scores (r=0.058; p-value=0.543). Attitude score towards prenatal diagnosis and overall practice scores were also positively correlated (r=0.271; p-value=0.003). Conclusions This study highlights the pressing need for proactive measures to address the prevalence of hemoglobinopathies in Palestine. Findings highlight the crucial role of Health Education and Awareness Programs, aimed at disseminating information about thalassemia, its inheritance patterns, and preventive measures. Additionally, the screening criteria should be revised to include screening for other hemoglobinopathies, and the screening must be performed in Designated Receptions Centers where trained staff perform and interpret the results in accordance with standard laboratory diagnostic protocols. Strengthening pre-marital counseling and screening services is imperative to ensure comprehensive coverage. Early detection, accurate carrier identification, and informed decision-making regarding marriage and family planning should be central in preventive efforts. Continuous training for healthcare professionals and community workers is crucial to effectively prevent and manage thalassemia.
- ItemThe Prevalence, Diagnosis, and Antifungal Susceptibility of Candida Species in Palestine(Al-Quds University, 2023-08-20) Hanaa Khairaldeen Mohammed Baniodeh; هناء خيرالدين محمد بنيعودةBackground: Candida spp are the single most common cause of opportunistic fungal infection.Various healthcare implications are associated with Candida infections, including morbidity and mortality. The significantly increased occurrence of Candida species as human pathogens can be attributed to improved identification techniques. In Palestine, minimal data have been reported about Candida infection. Methods: We performed our study at two hospitals in Palestine ( Istishari Arab Hospital, and Najah National University Hospital ). All patients diagnosed with candidiasis during the year 2022 have participated in the study. The prevalence of Candida spp,their distribution and the activity of selected antifungals against Candida pathogens were statistically analyzed using Microsoft Excel Version (16.74). In combination with phenotypic properties, Candida isolates were identified and tested for antifungal susceptibility using the colorimetric VITEK-2 Compact system at two hospitals. Results : Our results showed that the prevalence of Candida spp among infected samples was 11.6%. Twelve different Candida spp were identified. Among these isolates, C. albicans (49.88%) was the most frequent, followed by C. glabrata (17.3%), C. tropicalis (14.83%), C. parapsilosis (5.16%), C. krusei (3.82%), C.auris(2.69%) ,C.dubliniensis (2.24%), C.ciferrii (1.79%) C.lusitaniae (0.89%), C. guilliermondii (0.67%), C.Kefyer (0.44%) and C.spherica(0.22%). Among C. albicans, all isolates were 100% susceptible to fluconazole, and micafungin .The susceptibility rates to Amphotericine B and flucytosine were 95 % and 99 % respectively. As a comparison, the susceptibility rates of non-albicans candida to fluconazole, voriconazole, amphotericine B, caspofungin ,flucytosine and micafungin were 70 %, 99 %, 97 %, ,72% , 92% and 100 %, respectively. Patients in the intensive care unit are more susceptible to candida infections than patients in other hospital departments. Conclusions: Four pathogens are responsible for the most invasive infections: Candida albicans, Candida glabrata, Candida tropicalis, and Candida parapsilosis. Those in an immunocompromised state are more likely to develop Candida infections. A notable characteristic of this study was the high frequency of non-albicans Candida Spp, which were often more resistant to antifungal agents. A quick and accurate system like Vitek 2 compact was suggested for careful species identification of clinical isolates of Candida. We suggest that continued surveillance of species distribution and susceptibility to antifungals will enhance future burden estimates and assist in evaluating preventative measures' effectiveness.