An-Najah Staff

Background: This retrospective study was performed at the Family Practice clinic, Nablus, in the West Bank/Palestine. The objective of the study was to determine pattern and factors influencing pap smear test, and involved 201 women visiting the clinic for different gynecologic problems during the year 2002. Methods: We analyzed the records of all patients who had pap smear done during this period, categorizing their age, occupation, level of education, their obstetric history including number of deliveries, methods of contraception, and menstrual period regularity. Results: About 12% of the study sample had abnormal (precursors of cervical cancer) results and the majority (88%) had normal and benign changes. There was no statistically

Breast cancer is the most common cancer in women, which can be early detected by mammogram test (an x ray of the breast). Screening mammography is one of the best techniques that can find majority of breast cancer cases in women over 50. The main objective of this study is to illustrate the different socio-demographic patterns of use and their relationship to mammography test results in Nablus district. Methods: This is a cross sectional study that included all women from Nablus area who underwent mammography test in the Palestinian Family Planning & Protection Association center (PFPPA) during 2007. Socio-demographic data (age, marital status, parity, residence, breastfeeding, education level and source of referral) from 556 files of women were collected, in addition to the mammography test result whether malignant or not. Data then were analyzed applying descriptive studies, and chi square test. Results: most of the study sample were of age interval (35-47) years old, married, breastfed, with parity interval 3-5, highly educated, inhabiting the city, and were self-referred. There was a significant statistical association between age, parity and mammography test results (p<0.05), however there was no significant statistical relationship for all other variables. Profile of self-referred women was of no big difference when compared to all study sample variables. Conclusion: Awareness towards doing mammography in Nablus/Palestine seems to be good; however the most vulnerable group is still not doing it frequently. Older women, less educated, single, and women from refugee camps need to be reached out to increase their awareness to go for screening mammography.

Background Radon gas is considered as a main risk factor for lung cancer and found naturally in rock, soil, and water. The objective of this study was to determine the radon level in the drinking water sources in Nablus city in order to set up a sound policy on water management in Palestine.
Methods This was a descriptive study carried out in two phases with a random sampling technique in the second phase. Primarily, samples were taken from 4 wells and 5 springs that supplied Nablus city residents. For each source, 3 samples were taken and each was analyzed in 4 cycles by RAD 7 device manufactured by Durridge Company. Secondly, from the seven regions of the Nablus city, three samples were taken from the residential tap water of each region. Regarding the old city, ten samples were taken. Finally, the mean radon concentration value for each source was calculated.
Results The mean (range) concentration of radon in the main sources were 6.9 (1.5-23.4) Becquerel/liter (Bq/L). Separately, springs and wells' means were 4.6 Bq/L and 9.5 Bq/L; respectively. For the residential tap water in the 7 regions, the results of the mean (range) concentration values were found to be 1.0 (0.9-1.3) Bq/L. For the old city, the mean (range) concentration values were 2.3 (0.9-3.9) Bq/L.
Conclusions Except for Al-Badan well, radon concentrations in the wells and springs were below the United State Environmental Protection Agency maximum contaminated level (U.S EPA MCL). The level was much lower for tap water. Although the concentration of radon in the tap water of old city were below the MCL, it was higher than other regions in the city. Preventive measures and population awareness on radon's exposure are recommended.

Background: Several studies in Palestine, including some performed in refugee camps, showed that breastfeeding is a common practice, however, exclusive breastfeeding was practiced less frequently. The social and cultural patterns in relation to different types of infant feeding were not studied.
Objectives: This study aimed to evaluate the association between mothers’ and infants’ sociodemographic factors and breastfeeding patterns during the first 6 months of infant life.
Methods: This cross-sectional study evaluated data of 690 clinic files from 3 refugee camps in Nablus, Palestine in 2007. Maternal age, age at marriage, parity, mother’s and father’s education, type of delivery and infant’s gender were studied in relation to 3 types of breastfeeding: exclusive breastfeeding, partial breastfeeding, and exclusive formula feeding in the first 6 months of life. Bivariate analysis and logistic regression were applied for data analysis.
Results: A total of 69.7% of infants aged 0–6 months were exclusively breastfed and only 14.3% were exclusively formula fed. Older mothers at marriage (risk ratio [RR], 0.13; 95% confidence interval [CI], 0.06–0.28), and cesarean birth (RR, 0.59; 95% CI, 0.41–0.81) were negatively associated with EBF.
Conclusion: Breastfeeding educational and health promotion program and policy for EBF implemented by UNRWA (United Nations Relief and Works Agency for Palestine Refugees in the Near East) should continue with special attention to older mothers at marriage, and to babies born by cesarean section.

Background
Polycystic Ovary Syndrome (PCOS) is the most common gynecological endocrinopathy in women of reproductive age. Despite its heavy burden on female reproduction and general health, there is no study regarding PCOS prevalence in Palestine. This study aims to establish prevalence of PCOS among female university students at An-Najah National University-Palestine and to explore its possible risk factors.
Methods
A cross sectional study was conducted on 137 female students using convenience sampling method for age group (18–24) years. PCOS cases were identified according to the National Institute of health (NIH) criteria through clinical interview and assessment for participants at the University clinics. Menstrual irregularities regarding cycle and flow were identified and clinical hyperandrogenism was assessed as the self-reported degree of hirsutism using the modified Ferriman Gallwey (mF-G) scoring method of more than 8 score. Biochemical hyperandrogenism for girls with menstrual irregularities was assessed by measuring free testosterone level. Data were analyzed using SPSS version 17 applying descriptive methods; different risk factor relationships were estimated using bivariate analysis and multivariate logistic regression.
Results :
The estimated prevalence of PCOS was 7.3% , acne was the only studied risk factor among others to be statistically significantly related to PCOS patients (OR=8.430, P-value=0.015). Clinical Hirsutism was found in 27% of participants, 70% of whom had idiopathic hirsutism.
Conclusions
Prevalence of PCOS in Palestine seems to be relatively high but similar to other Mediterranean statistics. We recommend further studies using wider age group and larger sample for all parts of Palestine in order to generalize results.

A pot experiment was conducted to evaluate the performance of a gradual multi-stage vertical flow hydroponic system as an option for decentralized wastewater treatment and reuse. The low cost of such option and the ease of its application make it feasible for rural areas where low cost decentralized options of wastewater treatment and reuse have a great potential in improving environmental and economic conditions in these areas. To evaluate the performance of such option, a five-stage vertical flow gradual hydroponic pot experiment was conducted in a greenhouse in the new campus of An-Najah National University. The experiment included five types of plants: two types of corn, barely, alfalfa, and sunflowers. Wastewater flow was applied through a drip system for the five types of plants. Wastewater was drained by gravity from one pot to the next through a gradual vertical flow hydroponic system. Quality of wastewater entering the first pot and leaving the last pot for each set of plants was monitored throughout the growing season. Results showed an over 90% removal efficiency of soluble organics and suspended solids, and about 60% removal efficiency of nitrogen through the system. The proposed gradual hydroponic treatment system was proved to be a successful alternative method to treat and reuse wastewater. Thus, gradual hydroponic systems could be successfully used as small decentralized wastewater treatment systems. This system could be used in producing crops with economic returns in Palestinian rural areas, where agriculture has a significant contribution in the income and employment of communities.

The reuse of treated wastewater offers opportunities to reduce the demand for scarce potable water resources. Importantly, social acceptance poses a barrier to the effective use of this resource should the concept not be comprehensively presented. This research highlights the potential for reuse of wastewater, identifies the areas of concern and examines the most important factors that affect wastewater reuse in the West Bank, Palestine. The most important factors considered are social, religious, economic, health, political, freshwater scarcity and institutional framework. It is found that traditions have negative effect on the acceptance of wastewater reuse. The psychological factor is negatively affecting the opinion of the community. Public awareness is weak and the information provided is not sufficient. The research will contribute to the improvement of the environment and sustainable development of the West Bank and proposes guidelines for a strategic plan for wastewater reuse.

A pot experiment was conducted to evaluate the performance of a gradual multi-stage vertical flow hydroponic system as an option for decentralized wastewater treatment and reuse. The low cost of such option and the ease of its application make it feasible for rural areas where low cost decentralized options of wastewater treatment and reuse have a great potential in improving environmental and economic conditions in these areas. To evaluate the performance of such option, a five-stage vertical flow gradual hydroponic pot experiment was conducted in a greenhouse in the new campus of An-Najah National University. The experiment included five types of plants: two types of corn, barely, alfalfa, and sunflowers. Wastewater flow was applied through a drip system for the five types of plants. Wastewater was drained by gravity from one pot to the next through a gradual vertical flow hydroponic system. Quality of wastewater entering the first pot and leaving the last pot for each set of plants was monitored throughout the growing season. Results showed an over 90% removal efficiency of soluble organics and suspended solids, and about 60% removal efficiency of nitrogen through the system. The proposed gradual hydroponic treatment system was proved to be a successful alternative method to treat and reuse wastewater. Thus, gradual hydroponic systems could be successfully used as small decentralized wastewater treatment systems. This system could be used in producing crops with economic returns in Palestinian rural areas, where agriculture has a significant contribution in the income and employment of communities.