Faculty of Pharmacy, Nursing and Health Professions

Heba Hamed, Raed Madia, Hosniyeh Ladadweh, Hiba Falana, Abdallah Damin AbuKhalil

Infection and Drug Resistance DOI https://doi.org/10.2147/IDR.S356465

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Background: Mucormycosis is a fulminant and rapidly progressing fungal infection associated with a high mortality rate. Mucormycosis is primarily seen in immunocompromised patients, especially those with uncontrolled diabetes mellitus (DM), and recently in coronavirus disease 2019 (COVID-19) patients.

Case Presentation: In this case report, we present a rare case of fatal mucormycosis in Palestine. A 34-year-old Palestinian female patient presented to the emergency department one-month post-COVID-19 infection with left facial pain. During her hospital stay, she deteriorated, with a random blood sugar level of 400 mg/dl and a hemoglobin A1c of 18% with metabolic acidosis and the appearance of swelling and black eschar on her left side of her face. Finally, she was diagnosed with mucormycosis and expired two days later.

Conclusion: In this unfortunate case report of mucormycosis, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection, delayed diagnosis, misuse of corticosteroids, inappropriate use of antibiotics, and uncontrolled diabetes with ketoacidosis contributed to patient mortality and fatality. Therefore, appropriate patient assessment, rapid diagnosis, and selection of appropriate treatment are important and lifesaving.

Noyal Aweidah, Hani Naseef , Ramzi Muqdi, and Mohammad A. Farraj

Journal of Food Quality https://doi.org/10.1155/2021/3761865

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Thymol and carvacrol found in Origanum syriacum “Za’atar” plant leaves have triggered interest among researchers for their natural antimicrobial and antifungal properties. However, their applications in modern pharmaceutical and cosmetic industries as natural preservatives remain challenging. In this research, extraction of thymol and carvacrol from Za’atar leaves has been investigated using the ultrasonic-assisted method and the use of sesame oil as the primary extraction solvent compared with other vegetable oils including sunflower and olive oils. In addition, a high-performance liquid chromatography (HPLC) analytical method was developed by using a C8 column and 0.05% trifluoroacetic acid as a buffering agent. The method was validated for specificity, linearity, repeatability, accuracy, and robustness for the analysis of the content of the two terpenes thymol and carvacrol in different Za’atar extracts. Using the validated analytical method, thymol and carvacrol content results revealed the best vegetable oil for extraction. Results showed that sesame oil had the highest content of thymol and carvacrol, followed by sunflower oil, and the least amount obtained by using olive oil. A consistent extraction result opens an opportunity for application in the pharmaceutical and cosmetic industries. For this reason, the essential extraction key parameters that influence the final content of thymol and carvacrol were evaluated. The highest impact originated from the quality and volume of sesame oil. Cold-pressed sesame oil resulted in a 23% higher content of thymol and decreased amount of carvacrol. It was found that wetting the Za’atar leaves powder with sesame oil was enough for extraction; any additional sesame oil volume dilutes the extracted sample. The second impact was the Za’atar cultivation conditions; less than 10% difference of thymol and carvacrol content was observed within Za’atar of Hebron origin. Finally, the origin of sesame seeds used for sesame oil production had the least impact.

Hani A. Naseef, Ni’meh A. Al-Shami, Lilian S. Abu Hadba, Leen A. Humos, Ruba N. Shaheen, Tanya T. Mitwasi & Lina El-Khairy

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Aim

COVID-19, the novel coronavirus, has been characterized as a pandemic, as it spreads all over the world and has so far infected more than 20 million worldwide. In Palestine, the first seven cases were documented on March 5 2020, followed by the declaration of the state of emergency. This study aimed to assess knowledge, attitudes and practices toward COVID-19 among Birzeit University students.

Subject and methods

A cross-sectional study was carried out; a questionnaire was developed based on the WHO, CDC, and ECDC recommendations. The questionnaire was distributed online and filled out by Birzeit University students. Chi-square testing was performed to check for significant association between KAP (knowledge, attitude, and practices) and different socio-demographic variables. Binary logistic regression was performed to identify and control the confounding factors. Data were analyzed using SPSS (version 22).

Results

A total of 665 students have completed the online questionnaire. The mean age was 20.55 ± 3.069 years. Multivariate analysis revealed that males, students from health professions and scientific faculties, and those with highly educated parents had manifested a good knowledge level (GKL) about COVID-19. With regard to students’ practices, fewer negative practices were displayed by students from health professions faculty and the students living at the middle governorate of Palestine, compared to north, south, and Jerusalem dwellers. With regard to the practices, the vast majority of the participants showed a positive and very cautious practice in relation to the COVID-19 epidemic.

Conclusion

Our results revealed that students had variable knowledge about COVID-19, and the vast majority depended on the official media briefs in Palestine as a source of information. With regard to practices, positive and cautious practices with regard to the COVID- 19 epidemic were carried out by the vast majority of participants.

Adrian D. Wood , Gillian D. Edward , Kirsten Cumming , Mohannad W. Kafri, Roy L. Soiza, Lee Hooper  , John F. Potter  and Phyo K. Myint

Healthcare https://doi.org/10.3390/healthcare9020154

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Dehydration is prevalent in hospitalised patients and is associated with increased morbidity and mortality, particularly among the elderly (≥65 years). We aimed at comparing the performance of intracellular water to extracellular water ratio (ICW/ECW), calculated through a bioelectrical impedance analysis (BIA) of blood urea nitrogen, with the creatinine ratio (BUN/Cr) to predict poor outcomes in a cohort of prospectively identified patients. Data were combined from a cohort of elderly patients (≥65 years) admitted to hospital with fragility fracture (n = 125) and older adults aged ≥50 years admitted to hospital with stroke (n = 40). The association between hydration status and study outcomes (unfavourable discharge destination (rehabilitation, another ward, or death) and prolonged hospitalisation (>10 days)) was examined using logistic regression. The overall diagnostic accuracy of each hydration status measurement was assessed using the area under the receiver operating characteristic (ROC) curve. In 165 participants (mean age (SD) of 76.7 (9.2) years), an ICW/ECW ratio below the 25th percentile was associated with increased odds of poor discharge destination (OR (95% CI) = 4.25 (1.59–11.34)). Neither the relationship between the BUN/Cr ratio and prolonged stay nor discharge destination was significant. A BIA could be used utilised in conjunction with biochemical measurements to inform patient prognosis

Abdallah Damin Abukhalil1, Liana AbuKhdeir, Malak Hamed, Ni'meh Al Shami , Hani A Naseef, Banan M Aiesh,Ali Sabateen

Infection and Drug Resistance https://doi.org/10.2147/IDR.S333985

Abstract:

Purpose: Clostridioides difficile is one of the most important nosocomial infection pathogens. It is linked with many risk factors. Unfortunately, many studies have been conducted in different countries to address the Clostridioides difficile infections (CDI), and no studies have been conducted in Palestine. This study aims to identify the prevalence and possible risk factors associated with CDI.

Patients and Methods: This was a retrospective descriptive study conducted at the An-Najah National University Hospital (NNUH) in Palestine. Data were collected for patients diagnosed with CDI who tested positive for GDH, toxins A and B between January 2018 and April 30, 2021. In addition, patient characteristics and risk factors associated with CDI were analyzed.

Results: A total of 593 participants were included in the study; 53% had hospital-acquired CDI. There was an insignificant association between participant age and CDI risk. Most patients had mild to moderate infections. Sixty-three percent of the participants were immunocompromised. About 58.5% used an antibiotic agent two weeks before CDI, and 67% were on a proton pump inhibitor (PPI). About 61.3% of patients were treated according to IDSA 2017 guidelines, and 94% responded adequately to the treatment provided.

Conclusion: There was an increased prevalence of community-acquired CDI, with a prevalence almost equal to that of hospital-acquired. In addition, most of the participants were immunocompromised. The risk factors for CDI, such as antibiotics and PPI use, were also observed with high prevalence among positive patients. Antimicrobial stewardship and the appropriate use of acid suppressors are warranted.

Abdallah Damin Abukhalil,Rph, BCMTMS, PhD,  Abdelrazzaq Yahia Shaloudi, Niveen Mohammad Shamasneh, Asil Maher Aljamal

Journal of Pharmacy Practice and Research https://doi.org/10.1002/jppr.1728

Abstract

Background

The American Geriatric Society Beers criteria comprise a screening tool to identify potentially inappropriate medications (PIMs) and guide healthcare providers (HCPs) in prescribing, dispensing, and recommending appropriate medications. The extent of awareness about PIMs and geriatric medicine among HCPs needs to be assessed. Therefore, this study aimed to examine the level of awareness regarding PIMs and Beers criteria among HCPs in Palestine.

Method

This was a cross-sectional study conducted using a self-administered 20-item questionnaire involving physicians and pharmacists in Palestine. Ten clinical vignettes presenting different medical statuses in the elderly necessitating appropriate prescription advice were used to assess awareness on geriatric medication.

Results

A total of 306 participants, including 116 physicians and 190 pharmacists, participated in the study. 34.0% of the participants had poor awareness, 30.1% had average and 23.2% participants had good awareness about PIMs in the elderly. Only a small percentage of participants had very poor or very good awareness (6.9% vs. 5.9%, respectively) with no difference in the results in terms of profession. There was a

significant relationship between the familiarity with Beers criteria and the level of awareness. Finally, participants perceived drug–drug interactions as a major barrier to appropriate prescribing.

Conclusion

The majority of participating HCPs had a low level of awareness, and a close proportion had moderate awareness on PIMs and Beers criteria. Consequently, there is a need to increase HCP's awareness of medication use in the elderly. Continued education and training in geriatric pharmacotherapy may be valuable.

Abdullah K. Rabba , Ayeshe M. Abu Hussein, Bayan K. Abu Sbeih, and Somaya I. Nasser

BioMed Research International https://doi.org/10.1155/2020/9634934

Background. Drug-drug interactions (DDIs) are a common issue that leads to adverse drug reactions in hospitals. Patients in the surgical department are expected to have potential DDIs that may lead to morbidity and mortality. Objectives. To study potential DDI prevalence in the surgery departments in 3 hospitals in Palestine. Moreover, to identify pertinent factors that are associated with drug-drug interactions. Method. A cross-sectional study in 3 governmental Palestinian hospitals: Palestine Medical Complex, Rafidia Hospital, and Beit Jala Hospital. Patients who are 20 years old or above and admitted to the surgical wards between September 2017 and February 2018 were included in the study. Patient demographics, all medications given in the hospital, and hospitalization period were obtained from medical files. The digital clinical decision support system Micromedex® was used for analysis and classification of possible drug interactions. Bivariate analysis and logistic regression were used to study the risk factors for developing DDIs. Results. 502 patients were included in this report. The prevalence of potential DDIs among patients admitted to surgery wards in three Palestinian hospitals was 56%. The number of detected potential DDIs per patient was . The number of prescribed medications () was found to increase the possibility of having drug interactions. Conclusions. DDIs in Palestinian hospitals are a prevalent problem, and caution should be taken when ordering medications to hospitalized patients in surgery departments.

Imad T. Asmar, Hani Naseef*, Nimeh Al-Shami, Maram K. Jaghama, Abdallah D. Abukhalil, Areefa A. Karsh, Fuad . AlFayyah, Ro'a M. Dagher

The Open Psychology Journal DOI: 10.2174/1874350102114010227 https://openpsychologyjournal.com/VOLUME/14/PAGE/227/

Coronavirus Disease 2019 (COVID-19) rapid manifestation and spread have disrupted world norms and affected people's daily activities and life. It might have a negative impact on the population's psychological status, such as boredom, confusion, psychological stress, anxiety, depression, and physical effects.

This study aimed to find the impact of the COVID-19 pandemic on the Palestinian adults' psychological status by assessing the participant's practices, reports of anxiety and depression during the pandemics

Around one-third of respondents revealed having many signs of anxiety, and around 42% of respondents expressed having many signs of depression. Females were significantly more likely to have signs of depression, whereas front-line COVID-19 health care workers were significantly the least likely to have signs of depression.

In conclusion COVID-19 pandemic has a negative effect on mental status; most participants have signs of anxiety and depression.

Hosniyeh E. Ladadweh, Hiba H. Falana, Jannat M. Ma’ali, Pinar A. Aweis, Hanan N. Nofal and Hani A. Naseef

American Journal of Pharmacology and Toxicology DOI: https://doi.org/10.3844/ajptsp.2021.1.8

Antibiotic resistance is rising to dangerous levels worldwide. The emergence of drug-resistant bacterial species is becoming increasingly prevalent in many healthcare facilities around the world. Pseudomonas aeruginosa is a pathogen that has developed resistance to many antibiotics.

The purpose of this study is to review the antibiotic resistance patterns of Pseudomonas aeruginosa in different clinical samples based on a review of studies conducted in different countries.

The high rate of antibiotic resistance of Pseudomonas aeruginosa observed through a literature review indicates the need for steps to be taken to limit the effect of that resistance and limit its spread.

Jamal A. S. Qaddumi, Ashraf Abuejheisheh, Omar Tarawneh, Omar Almahmoud, Muhammad Darawad

The Journal of Health Care Organization, Provision, and Financing https://doi.org/10.1177/0046958020902323

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This study aims to identify the predictors of evidence-based practice among intensive care unit nurses in Jordan. A descriptive cross-sectional design was used to conveniently recruit 132 participants. Self-reported questionnaires were utilized including the Evidence-Based Practice Questionnaire and Evidence-Based Practice barrier scale. Participants’ rate of evidence-based practice was 60% (M = 4.2/7), which was significantly correlated with their knowledge (r = 0.739, P < .01) and attitudes (r = 0.564, P < .01) of evidence-based practice. The results revealed a 2-predictor model that explained 62.2% of the variance in evidence-based practice among intensive care unit nurses. The 2 variables were attitude (β = 0.245) and knowledge (β = 0.563). The outcomes of this study added new information regarding the prediction of evidence-based practice among intensive care unit nurses. An educational program for nurses regarding this issue is crucial to improve their practice aiming at enhancing nursing care. Also, nursing schools should update their curricula to explain the importance of evidence-based practice and to enhance students’ competencies in research utilization and statistical skills.

Omar  H. Almahmoud

Nursing Made Incredibly https://dx.doi.org/10.1097%2F01.NME.0000793084.77160.c1

This article uses an exploratory single case study approach to offer an in-depth and inside view of an older woman's experience with COVID-19 within her social context. Five main themes emerged: denial, fear, coping strategies and preventive measures, confusion, and positive family relationships.

Omar H. Almahmoud

The American Nurse https://www.myamericannurse.com/florence

Florence Nightingale is usually the first name that comes to mind when nursing is discussed anywhere in the world. This great and inspirational woman was born on May 12, 1820. She played a wide range of roles in nursing, including practitioner, educator, and researcher. As a tribute to her incredible contributions, NURSING was created as acronym for her.

Jamal A. S Qaddumi, Mariam Al-Tell, Omar Almahmoud, Dina T. N Issa, Majed Sulaiman Alamri, Jestoni Dulva Maniago, Omar Mohamed Khraisat, Abdullah Sameh Khawaldeh, Reem Nassar AL-Dossary

Saudi Journal for Health Sciences https://www.saudijhealthsci.org/article.asp?issn=22780521;year=2020;volume=9;issue=1;spag=50;epage=55; ;aulast=Qaddumi#:~:text=DOI%3A%C2%A010.4103/sjhs.sjhs_88_19

The study aimed at assessing the stressors among hemodialysis (HD) patients and finding out whether there is any relation between these stressors and patients' characteristics in the North of the West Bank.

A quantitative, cross-sectional, descriptive–analytical study was carried out. Data collection took place at three governmental hospitals and one private hospital where 120 HD patients responded to the HD stress scale.

Results:

Hemodialysis patients were mildly to moderately stressed, the greatest perceived sources of stress appeared to be “physiological stressors”(mean= 2.655), but the item with the highest percentage was' limitation on time and place for vacation'(84.2%) which belong to psychosocial stress subscale, and the item stress with the least percentage was “dependency on nurses and technicians”(45%).

Conclusions:

There was significant difference between the psychosocial stressors and duration of treatment. The study concluded that HD patients are in need for continuous support, and it is recommended different contributions to improve the quality of their life.

Omar Almahmoud

Journal of Neonatal Nursing https://doi.org/10.1016/j.jnn.2021.03.009

The aim of this exploratory essay is to explore the communication style between newborns and neonatal intensive care nurses. An in-depth literature reviewing was used to explore newborn behavior and communication, various neonatal assessment scales were analyzed. It is concluded that newborn used both verbal and non-verbal ways to express themselves but they need someone to understand their behavior.

Mu’taz M. Dreidi, Imad Tawfiq Asmar, Maram K Jaghama, Khloud Tawil

Journal of Diabetes Nursing October 2021 https://diabetesonthenet.com/journal-diabetes-nursing/qol-palestinians-diabetes/

This cross-sectional study assessed the levels and impact of diabetes on quality of life (QoL) among people with type 2 diabetes, and compared QoL between male and female participants. A convenience sample of 200 people was recruited from diabetes clinics in Palestine. The Audit of Diabetes-Dependent Quality of Life

(ADDQoL) questionnaire was used to assess overall and domain-specific QoL. The results showed, despite having a lower HbA1c, women had lower (more negative) ADDQoL scores than men. There were significant differences between men and women across QoL domains when controlling for diabetes duration, BMI and HbA

Mu'taz Dreidi, Imad Asmar

The aim of this research was to assess the level of sleep hygiene among the Palestinian universities’ students. A cross-sectional design was used to approach a sample of 300 undergraduate students to participate in this study from three different Palestinian universities in Palestine. They were given the demographic and the sleep hygiene questionnaires to be self-administered. The results showed the mean for academic achievement was 75.7%. Regarding the sleep hygiene, the mean of total score was 79 ± 24. The mean of the subscales was as follows: distress 57 ± 18, sleep 11 ± 5.6 and the quality of sleep was 11.3 ± 4.5. The resul ts showed that there were significant differences in gender for distress and academic achievement (p < 0.05). The female students have more academic achievement and more distress compared with male students. There are also significant differences for the students who work compared with students who do not across academic achievement (p = 0.002) and sleep (p = 0.047). The current study showed a mild to moderate distress, and low sleep quality and hygiene. Despite that female student showed higher level of academic achievement than male students, they still have more distress. This study highlights the importance of this issue among university students especially that the undergraduate studies is the beginning of independence for those students from parenting supervision.

Asmar, Imad T, Yaseen, Khalid S; Jaghama, Maram K., Khawaja, Yaqin F, Alwredat, Aseel A, Sadaqa, Marah H

Critical Care Nursing  Quarterly April/June 2021 https://journals.lww.com/ccnq/pages/default.aspx

Delirium is a critical issue in the intensive care unit (ICU), and the correct diagnosis and treatment of this disorder by the ICU team are doubtful on many occasions due to a lack of information. This research is intended to test the awareness and control of ICU delirium by the ICU nurses. A nonexperimental, quantitative, descriptive, cross-sectional study was conducted using a previously adopted and translated to Arabic and validated questionnaire. The sample include nurses who work in ICUs of 10 Palestinian hospitals (private and public) located in the West Bank and Jerusalem participated in this study; each gave consent to be part of this study. Approval was received from the Palestinian Ministry of Health and the Ethical Committee at Birzeit University. Version 19 of the Social Sciences Statistical Package (SPSS) software was used to analyze the data. The results showed that ICU nurses hold moderate to low levels of knowledge and lack of adequate clinical experience to handle delirium. Delirium is a common complication in the ICU that increases morbidity and mortality and increases the length of ICU stay, therefore the cost of health care rise and the quality of life is decreased. In clinical practice, there are no assessment guidelines and protocols for patients with delirium

Imad T. Asmar; Belal M. Alrajoub; Omar H. Almahmoud ,Dina N. Nakhleh ,Sara I. Makharzeh; Yazeed M. Falaneh

Critical Care Nursing Quarterly July/September 2020 https://journals.lww.com/ccnq/pages/default.aspx

The management of critically ill patients is complicated and often involves complex devices including mechanical ventilators (MVs), which may be associated with many complications. Protective lung strategies (PLSs) are used to prevent complications associated with MVs, but nurses may not possess adequate knowledge to optimize the efficacy of PLSs. This article reports findings from what is thought to be the first study in Palestine that explores critical care nurses' knowledge about PLSs. The purpose of this study was to assess the critical care nurses' attitude, behavior, and knowledge regarding PLSs of mechanically ventilated patients. This descriptive, cross-sectional study was conducted at both public and private hospitals in Palestine. The sample included nurses who worked in intensive care units and cardiac care units and utilized a previously developed and validated questionnaire. The result of the study concludes that the majority of the Palestinian critical care nurses agree with the utilization or application of PLSs but have a severe lack of knowledge about the strategies. This highlights the need to provide additional educational programs related to the optimum use of mechanical ventilation

Mutaz Dreidi, Intima Alrimawi & Maha Atout

Progress in Palliative Care https://doi.org/10.1080/09699260.2021.1981566

Background: Cancer is the second most fatal disease in the world, following cardiac diseases. Throughout the cancer trajectory, patients experience symptom clusters and malnutrition. Both affect the quality of life for these patients. Limited studies had focused on these issues in Palestine. Purpose: This study aims to assess and evaluate the relationships between multiple symptoms, altered nutritional status, and their effects on the quality of life of patients diagnosed with cancer in Palestine. Methods: An explorative cross-sectional study was conducted to collect data from 120 patients with cancer. Results: Fatigue, dry mouth, and pain were the most prevalent symptoms experienced by participants with mean scores of 5.5, 4.9, and 4.5 respectively. For the quality of life, general activity and work were the worst variables experienced by patients. More than half of the patients were malnourished (53%). Nutritional status was significantly correlated and predicted most of the symptoms and quality of life dimensions (P < 0.05). Conclusion: The current study highlighted the importance of symptom clusters in cancer, quality of life, and nutritional status. It also focused on nutritional status as an essential factor and critical predictor that may affect and correlate with the worst symptom clusters and low quality of life. Implication: Symptom clusters and malnutrition predict the poor quality of life among Palestinian oncology patients. Therefore, symptom clusters and nutritional status should be taken into consideration at an earlier stage in the nursing care plan, and in the oncology assessment guidelines in Palestine.

Maha Atout, Intima Alrimawi, Mutaz Dreidi, Ahmad Saifan, & Nabeel Al-Yateem

Global Pediatric Health https://doi.org/10.1177/2333794X211045967

The objectives of this study were to explore parenting practices from the perspectives of Palestinian parents and their children, and concordance between parents and children in their reports of parenting practices, in a culture that is underrepresented in the literature. A descriptive cross-sectional design was used. The Alabama Parenting Questionnaire (APQ) was administered to 120 parents and 120 children drawn from 4 districts in Palestine. Children had higher scores on parental involvement, positive parenting, poor monitoring, inconsistent discipline, and corporal punishment. Three significant parent–child relationships were obtained1: parental involvement (r=.276, P=.003), positive parenting (r=.0301, P=.001), and poor parental monitoring (r=−.241, P=.008). The findings of this study might be used by Palestinian authorities and policy-makers to formulate guidelines and training to aid parental decision-making about child rearing.