An-Najah Staff

Objectives: Staphylococcus aureus is an important pathogen associated with diseases in a variety of hosts including humans. It produces several toxins and virulence factors that contribute to its pathogenic potential such as staphylococcal enterotoxins (SEs). This study was conducted to determine enterotoxigenicity of S. aureus associated with chronic urogenital tract infection by detectingenterotoxin genes.
Setting: This study was done in The Microbiology laboratory, An-Najah N. University, Palestine.
Methodology: A total of 90 S. aureus isolates recovered from clinical samples from patients suffering from chronic urogenital tract infection in the North of Palestine were used to detect the presence of staphylococcal enterotoxin genes sea, seb, sec, sed and see by polymerase chain reaction (PCR) assay.
Results: Out of 90 S. aureus isolates tested, it was found that 57 (63.3%) of these isolates harboured one or more enterotoxin genes. Up to 78.9% of the enterotoxigenic isolates possessed one SE gene. The majority of these enterotoxigenic strains (61.4%) isolated from both semen and urine samples harbored sec gene either alone or in combination with other genes. Also the prevalence of genes in combination was significantly more common in S. aureus isolates derived from urine 9/33 (27.3%), as compared to those derived from semen 3/24 (12.5%).
Conclusions: The role of enterotoxin genes in the pathogenesis of urogenital tract infection is still unknown. However, it is evident that urogenital infection can be caused by S. aureus strains which lack these genes. Other newly detected genes may play a role in pathogenesis.

Objective To evaluate the possible in vitro interaction between ethanolic extracts of Rhus coriaria (R. coriaria) (seed), Sacropoterium spinosum (S. spinosum) (seed), Rosa damascena (R. damascene) (flower) and certain known antimicrobial drugs including oxytetracycline HCl, penicillin G, cephalexin, sulfadimethoxine as sodium, and enrofloxacin. This synergy study was carried out against 3 clinical strains of multidrug-resistant Pseudomonas aeruginosa (P. aeruginosa).
Methods Evaluation of synergy interaction between plant extracts and antimicrobial agents was carried out using microdilution method.
Results The results of this study showed that there is a decrease in the MIC in case of combination of ethanolic plant extracts and test antimicrobial agents. The most interesting result was that the combination between R. coriaria and these antibiotics, showed a high decrease in minimum inhibitory concentration (MIC), and a strong bactericidal activity against these strains.
Conclusions These results may indicate that combinations between R. coriaria extract and these antibiotics could be useful in fighting emerging drug-resistance P. aeruginosa, which may due to that R. coriaria extract contain natural inhibitors working by different mechanisms or inhibiting efflux pumps. Now we have experiments underway leading to the identification of the active molecules present in R. coriaria. Further, in vivo experiments are needed to confirm pseudomonal protection.

A total of twenty-three Echinococcus granulosus hydatid cysts were collected from infected sheep slaughtered in Nablus abattoir, Nablus – Palestine. Protoscoleces or germinal membranes were used for DNA extraction followed by PCR amplification. Amplified products were analyzed the presence of a fragment of 444 bp of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene followed by nucleotide sequencing. Overall, 21 hydatid cysts were positive compared to a negative control. The partial sequences of cox1 gene of E. granulosus strains indicated that the sheep in Palestine were infected with genotype 1 (G1), genotype 2 (G2) and genotype 3 (G3). The prevalence of these genotypes was (14/21) 66.7%, (4/21) 19.0% and (3/21) 14.3% for G1, G2 and G3, respectively. Our results showed that twelve strains of G1 belonged to the common haplotype EG01 which is the major haplotype in all the geographic populations. Phylogenetic analysis also showed that two sequences of G1 genotype which have GenBank accession No. KC109657 and KC109659 were corresponding to G1.4 micro-variants. Only the sequence of GenBank accession No. KC109652 identified in our study as G2 was found to have complete identity to the original sequence described for the cox1 gene (GenBank accession No. M84662). It is concluded that G1 genotype is the predominant genotype in sheep in Palestine. Therefore, these findings should be taken into consideration in developing prevention strategies and control programs for hydatidosis in Palestine.

This study sought to describe type, frequency, purpose and patterns of herbal medicine used by a sample of patients with cancer in Palestine. A cross-sectional survey of patients attending the outpatient cancer departments at the Governmental Hospitals was undertaken using semi-structured questionnaires.
Results A total of 1260 patients with cancer were interviewed. Of the participants, 60.9% (n = 767) reported using herbs primarily bought from Palestine (92.3%) frequently employed in the form of decoctions (43%). The most common herbal product was Arum palaestinum (22.5%). Most Complementary and Alternative (CAM) users were more than 40 years of age, predominantly female, and living in rural areas of Palestine. Family member’s recommendation was cited as the main factor prompting participants to use CAM (43.5%).
Conclusion This study revealed that there is an appreciable prevalence of herbal use among patients with cancer in Palestine.  

Objectives To measure the frequency of herbal medicine use among patients with diabetes mellitus in Palestine; to determine demographic characteristics that may increase the likelihood of Complementary and Alternative Medicine (CAM) use and to find out how benefits, if any, were perceived by patients.
Method Cross-sectional survey of patients attending the outpatient diabetes departments at 7 Governmental Hospitals. The method was based on semi-structured questionnaires.
Results A total of 1883 patients with diabetes were interviewed. Of the participants, 51.9% (n = 977) reported taking herbs primarily bought from Palestine (98%) and used in crude form mainly as decoctions (44.1%). The five most common herbal products used were: Trigonella berythea (Fabaceae) (n = 191, 19.6%), Rosmarinus officinalis (Lamiaceae) (n = 132, 13.5%), Olea europaea (Oleaceae) (n = 131, 13.4%), Teucrium capitatum (Lamiaceae) (n = 111, 11.4%), and Cinnamomum zeylanicum (Lauraceae) (n = 105, 10.8%). Most CAM users were above 40 years old 79.6% (n = 778), predominantly female (53.2%) and residents of refugee camps and rural areas (59.3, and 53.5, respectively). The recommendations of a family member or friend was the main factor prompting the use of CAM (40.2 and 37.1%). Most CAM users (71.7%) were satisfied with the perceived effects. Interestingly, 68% of patients recruited in the study did not disclose CAM use to their physicians or pharmacists.
Conclusion Use of herbal therapies in diabetes is highly prevalent in Palestine. More than 70% of those using CAM (977, 51.9%) reported positive benefits including a feeling of slowing down disease progression, symptom relief, disease resolution or a reduction in the side effects of allopathic medication. Use of CAM should be explored with patients before clinical decisions are made. There is a need for health education relating to herbal use in conjunction with conventional medicines in diabetes.  

Purpose To explore the frequency of CAM use among hypertensive patients in Palestine, determine demographic characteristics that may increase the likelihood of CAM use and to find out how benefits were perceived by patients.
Methods Across-sectional survey of patients attending outpatient hypertension clinics. The method was based on a semi-structured questionnaire.
Results Of the 4575 hypertensive patients interviewed, 85.7% respondents used at least one type of CAM. Of the 3921 CAM users, 62.13% reported taking herbs. Most of these users were >50 years old, of low educational level, and had a family history of HTN, 62.9% claimed to have obtained the desired effect from taking these herbs; however, 68.1% did not disclose this fact to their health care providers, 83 plant taxa were reported by these patients, Allium sativum was the most commonly used herb.
Conclusions The use of CAM, particularly herbal therapies for hypertension treatment, is highly prevalent in Palestine.

The objectives of this study were the assessment of healthcare waste management and the characterization of healthcare waste material generated in the hospitals in Nablus city, Palestine, and furthermore, to estimate the prevalence of hepatitis B among the cleaning personnel working in these hospitals. The medical waste generation rate in kg per bed per day was between 0.59 and 0.93 kg bed^{— 1} day^—1. The waste generation rate in the healthcare facilities of Nablus city hospitals was similar to some other developing countries; however, the percentage of medical wastes in the total waste stream was comparatively high. The density of medical waste at the four hospitals studied ranged between 144.9 and 188.4 kg m^{— 3} with a mean value of 166.7 kg m^—3. The waste segregation and handling practices were very poor. Other alternatives for waste treatment rather than incineration such as a locally made autoclave integrated with a shredder should be evaluated and implemented. The system of healthcare waste management in Nablus city is in need of immediate improvement and attention. Formulating rules and guidelines for medical waste and developing strategies for overcoming the obstacles related to waste management should be considered as an urgent matter.

The objective of this study was to investigate the presence of anti-T. gondii in goats raised on farms in the Jenin and Tulkarm districts in the north of Palestine. The investigation was conducted on 14 herds comprising of 280 goats. Blood samples were collected via the jugular veins of 151 goats during the period from January to December 2011. The indirect ELISA test was used for the detection of anti-T. gondiiantibodies. Results showed that an anti-T.gondii IgG antibody was detected in 13.4 % of the samples. The presence of the anti-T. gondii antibody was influenced by the location of the goat herds. The highest incidence was in Jenin district (17.44 %) while it was 7.69 % in Tulkarm district. These results indicated the possible contamination of meat and milk of the goats with this parasite, which in turn negatively affects human health.

This study was undertaken to determine aetiology and prevalence of subclinical mastitis in manually and mechanically milked animals in the north of Palestine. Milk samples from animals with bacterial infection of the mammary gland showed significantly higher somatic cell count (SCC) than did the corresponding milk from healthy animals, which (1,420±100 X103 cells/ml; vs. 330±35 X103 cells/ml; 1650±155 X103 cells/ml vs. 490±40 X103 cells/ml; 520±50 X103 cells/ml vs. 140±25 X103 cells/ml) for ewes, goats and cows, respectively. The prevalence of bacterial isolation of the milk from goats (n = 25), sheep (n = 40) and cows (n=220) from several major herds was determined. Culturing for bacteria revealed that 52 %, 72.5% and 59.1% of tested goats, sheep and cows had subclinical mastitis, respectively. Most pathogens (90.6%) isolated from milk samples were Gram positive bacteria. Staphylococci (68.3%) were the predominant cause of subclinical mastitis. Coagulase-negative staphylococci and coagulase-positive staphylococci accounted for 35.6% and 32.7% of the total bacteria isolated, respectively. Other mastitis pathogens isolated include Micrococcus spp (18.3%), Proteous mirabilis (9.4%) and Bacillus spp (4.0%). Early diagnosis of subclinical mastitis in dairy animals may be important in reducing production losses and enhancing prospects of recovery herds in order to avoid the development of clinical mastitis.