An-Najah Staff

Arid and semi-arid regions are generally characterized by water scarcity and low per capita water allocation. This situation is further exacerbated when such areas are agriculturally dominated with high-density residential areas. Faria catchment (320 km2), located in the northeastern part of the West Bank, Palestine, is one of these arid to semi-arid catchments where recently, the prolonged drought periods in the catchment and the increasing water demand have made the existing obtainable water resources vulnerable. Catchment drought analysis provides useful information for a sustainable water resources management. In this study, spatial and temporal dimensions of meteorological drought vulnerability in Faria catchment have been investigated using the Standardized Precipitation Index (SPI) as a measure for drought severity. The SPI method was used to detail geographical variations in the drought vulnerability based on frequency and severity of drought events at 1-year time step. This study is applied to rainfall records (1960-2003) for six rainfall stations located within the Faria catchment. Magnitude-duration curves are plotted to depict the relationships between drought duration and magnitude. Critical (threshold) drought values were derived spatially to determine the least amount of rainfall required to avoid from drought initiation. Once drought duration and magnitude have been found objectively, it is possible to use this when manage water resources for bridging the supply-demand gap to drought affected areas either from alternative water resources or from water stored during wet periods.

Background Medical research productivity reflects the level of medical education and practice in a particular country. The objective of this study was to examine the quantity and quality of medical and biomedical research published from Palestine.
Findings Comprehensive review of the literature indexed by Scopus was conducted. Data from Jan 01, 2002 till December 31, 2011 was searched for authors affiliated with Palestine or Palestinian authority. Results were refined to limit the search to medical and biomedical subjects. The quality of publication was assessed using Journal Citation Report. The total number of publications was 2207. A total of 770 publications were in the medical and biomedical subject areas. The annual rate of publication was 0.077 articles per gross domestic product/capita. The 770 publications have an h-index of 32. One hundred and thirty eight (18%) articles were published in 46 journals that were not indexed in the web of knowledge. Twenty two (22/770; 2.9%) articles were published in journals with an IF > 10.
Conclusions The quantity and quality of research originating from Palestinian institutions is promising given the scarce resources of Palestine. However, more effort is needed to bridge the gap in medical research productivity and to promote better health in Palestine.

Aims The main aims of the study were to investigate the prevalence of pre-diabetes and diabetes mellitus (DM) in patients with schizophrenia, to compare it with those published in the general population, and to assess significant associations with dysglycemia defined as having either pre-DM or DM.
Methods A cross-sectional study carried out in 4 governmental primary psychiatric healthcare centers in Northern West-Bank, Palestine. Fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were measured. The World Health Organization (WHO) criteria for defining pre-DM and DM were used. Dysglycemia was defined as FBG >110 mg/dl.
Results Based on WHO criteria, 27 patients (10.8%) had diabetes and 34 (13.6%) had pre-diabetes. The prevalence of DM in patients with schizophrenia was not significantly higher than that reported in the general population of Palestine. However, the prevalence of pre-DM was significantly higher than that reported in the general population of Palestine. Regression analysis showed that advancing age and abnormal waist circumference were significant predictors of dysglycemia in patients with schizophrenia.
Conclusions This study confirmed the high prevalence of dysglycemia in patients with schizophrenia, supporting the need for monitoring of blood glucose in this category of patients. The presence of primary risk factors is more important in the development of dysglycemia in patients with schizophrenia than exposure to antipsychotic drugs.  

Objective

Reports about medication adherence and satisfaction in patients with epilepsy in Arab countries are lacking. The objective of this study was to assess medication adherence and its relationship with treatment satisfaction, number of antiepileptic drugs (AEDs) taken, and epilepsy control in a sample of Palestinian patients.

Methods

This cross-sectional descriptive study was carried out at Al-Makhfya Governmental Outpatient Center in Nablus, Palestine, during the summer of 2010. A convenience sampling method was used to select patients over the study period. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS); treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Epilepsy was arbitrarily defined as “well controlled” if the patient had had no seizures in the last 3 months and was defined as “poorly controlled” if he or she had had at least one seizure in the last 3 months.

Results

A convenience sample of 75 patients was studied. On the basis of the MMAS, 11 patients (14.7%) had a low rate, 37 (49.3%) had a medium rate, and 27 (36%) had a high rate of adherence. Adherence was positively and significantly correlated with age (P = 0.02) and duration of illness (P = 0.01). No significant difference in adherence was found between patients with well-controlled and those with poorly controlled epilepsy. Similarly, there was no significant difference in adherence between patients on monotherapy and those on polytherapy. Mean satisfaction with respect to effectiveness, side effects, convenience, and global satisfaction were 73.6 ± 20.7, 82.4 ± 29.8, 69.5 ± 15.5, and 68.4 ± 18.3, respectively. There were significant differences in mean values in the effectiveness (P < 0.01) and convenience (P < 0.01) domains, but not the side effect (P = 0.1) and global satisfaction (P = 0.08) domains among patients with different levels of adherence. Patients on monotherapy had significantly higher satisfaction in the effectiveness domain (P = 0.04) than patients on polytherapy. Similarly, patients with well-controlled epilepsy scored significantly higher in the Effectiveness (P = 0.01) and Global Satisfaction (P = 0.01) domains than those with poorly controlled epilepsy.

Conclusion

In our convenience sample, we found that adherence to and satisfaction with AEDs were moderate and were not associated with seizure control or number of AEDs.

Factor V leiden G1691A/R506Q (FVL), prothrombin G20210A (FII) and methylenetetrahydrofolate reductase (MTHFR) C677T are related genetic risk factors for venous thromboembolism. Analysis for those mutations is increasingly being performed on patients exhibiting hypercoagulability. The objective of this study was to determine the prevalence of FVL, FII-G20210A and MTHFR-C677T polymorphisms and their coexistence among apparently healthy Palestinians. After institutional approval, 303 apparently healthy students from An-Najah University representative to North and South regions of West Bank with no previous history of cardiovascular diseases participated in this study. A uniform questionnaire was used to collect relevant information through personal interview with the subjects. The collected information included gender, age, smoking habits, weight and height, diseases such as diabetes, cardiovascular and family history of CVD. The frequencies of allelic distribution of the three prothrombotic polymorphisms factor V G1691A/R506Q), prothrombin G2010A, and MTHFR-C677T were 0.114, 0.050 and 0.071, respectively. The prevalence of the three thrombotic polymorphisms (FVL, FII G20210A and MTHFR-C677T) were 20.1, 9.1 and 13.8 %, respectively. Statistical analysis for factor V leiden showed no significant association between place of residence (P value = 0.953) and gender (P value >0.082). The data presented in this study showed the highest prevalence of FVL among healthy Palestinians compared to other populations and this important finding should be followed in terms of clinical significance.

The objective of this paper is to evaluate the best sustainable water management options for future agriculture in the lower Jordan Valley (LJV) area of Palestine. LJV is the most important agricultural area in Palestine. Detailed -long term water management scenario analysis up to the year 2025 was conducted using the computer water planning model 'WEAP". Seven potential future water management options were tested including: optimal water use, optimal land use, supplementary water resources including water harvesting and treated wastewater reuse, virtual water trading, food security, political status, and poverty linkage and socioeconomic linkage water management option. Model simulations indicated that one water management scenario or option would not lead to an optimal water management in agriculture in the LJV and a combination of options would better achieve this goal. Accordingly a combination of the first three scenarios (water and land use efficiency and supplementary water resources scenarios) along with stable political solution (scenario number seven) is the best combination to achieve better future water management in Palestinian agriculture in the LJV. The results obtained demonstrate the feasibility and usefulness of simulation analysis using WEAP model.

In Palestine, as in other countries, brucellosis is an endemic disease, even in highly vaccinated zones. Many reports suggest that a decline in vaccine productivity may be due to antigenic shifts in the circulating Brucella melitensis. To address this aspect, the hemagglutinin gene from B. melitensis field isolates was amplified by polymerase chain reaction (PCR), sequenced, digested with the EcoRV and HaeIII, and compared to the Rev.1 strain of the B. melitensis vaccine. From January to December 2008, 80 milk samples were collected from infected flocks, from different West Bank regions of Palestine. From these, 77.5% (62/80) were shown to be positive for specific B. melitensis PCR. However, from the PCR-positive milk samples, only 38 strains could be isolated by culture on Brucella agar plates. The nucleotide alignment and phylogenetic tree for the hemagglutinin gene showed a mismatch between the vaccine strain and field isolates. This is also suggested by the observation of EcoRV and HaeIII digestion profiles for the vaccine strain and field isolates. Although a limited number of isolates and genes encoding immunologically relevant proteins were analyzed, we observed antigenic divergence between the current B. melitensis field isolates and the vaccine strain, in particular with respect to the hemagglutinin gene. Therefore, more research will be necessary to rule out the possibility of reduced efficacy of Brucella whole-cell vaccines.

Objective: To investigate other new species of cercariae encountered in Melanopsis praemorsa (M. praemorsa) snails collected from Palestine. Methods: A total of 1 100 M. praemorsa were collected from Al-Bathan water body, Palestine, from November, 2010 to November, 2011. Cercariae in M. praemorsa were obtained by emerging and crushing methods. Results: Other three new different species of cercariae have been identified from this snail. These species were Xiphidiocercaria (Cercaria melanopsi palestinia IV), Microcercous (Cercaria melanopsi palestinia V) and Longifurcate cercaria (Cercaria melanopsi palestinia VI). The infection rate of M. praemorsa with these three different cercariae was (42.2%). Coinfection with Xiphidiocercariae and Longifurcate cercariae or Xiphidiocercariae and Microcercous cercariae has been noted and coinfection rate was 1.23% among the infected snails. The highest cercarial infection rate was in June (64.3%). No infected snails were found in September. It was also noted that infected snails attained a larger size than uninfected ones and all infected snails had a size between 17-22 mm (average 20 mm). Conclusions: Our studies imply that there are potentially more new species of trematodes in this area than were found until now. Due to the presence of infected M. praemorsa and may be species of other snails, water resources could be contaminated by the emerging new cercariae, consequently attack the local people directly via the skin or are transferred to them by metacercariae ingestion. More surveys are needed to identify the real prevalence of the trematodes both in human and animal hosts, and also to determine the range of snail hosts of the parasite in enzootic areas of the disease, as well as the life cycle and biology of trematodes and its

Objective: To investigate other new species of cercariae encountered in M. praemorsa snails collected from Palestine. Methods: A total of 1100 Melanopsis praemorsa were collected from Al-Bathan water body, Palestine, from November, 2010 to November, 2011. Cercariae in Melanopsis praemorsa were obtained by emerging and crushing methods. Results: Other three new different species of cercariae have been identified from this snail. These species were Xiphidiocercaria (Cercaria melanopsi palestinia IV), Microcercous (Cercaria melanopsi palestinia V) and Longifurcate cercaria (Cercaria melanopsi palestinia VI). The infection rate of M. praemorsa with these three different cercariae was (42.2 %). Coinfection with Xiphidiocercariae and Longifurcate cercariae or Xiphidiocercariae and Microcercous cercariae has been noted and coinfection rate was 1.23% among the infected snails. The highest cercarial infection rate was in June (64.3%). No infected snails were found in September. It was also noted that infected snails attained a larger size than uninfected ones and all infected snails had a size between 17-22 mm (average 20 mm). Conclusions: Our studies imply that there are potentially more new species of trematodes in this area than were found until now. Due to the presence of infected M. praemorsa and may be species of other snails, water resources could be contaminated by the emerging new cercariae, consequently attack the local people directly via the skin or are transferred to them by metacercariae ingestion. More surveys are needed to identify the real prevalence of the trematodes both in human and animal hosts, and also to determine the range of snail hosts of the parasite in enzootic areas of the disease, as well as the life cycle and biology of trematodes and its effects on man should be elucidated.