An-Najah Staff

Background:Pap test is widely used both as a screening test in asymptomatic population and in the follow-up of patients with cervical carcinomas.
The objective of the study was to evaluate cervical smear findings in the West Bank and to assess the need for cervical screening program in Palestine.
Methods: This retrospective study was performed at two private laboratories in Nablus and Ramallah, in the West Bank/ Palestine. Cervical smears over a period of 5 years (2003-2007) taken from 239 women referred either for a check-up or with vaginal discharge were reviewed at two Pathology laboratories in the West Bank. All smears were fixed with 96% alcohol, stained with Papanicolaou stain and screened microscopically by a pathologist. Bethesda system definition of morphology was used.
Results: Of the 239 smears, the majority of cases (59%) showed non- specific inflammation while cervical dysplastic changes were uncommon; 11 cases (4.60%) were classified as Atypical Squamous Cells of Undetermined Significance (ASCUS), 1 case (0.42%) was Low-grade Squamous Intraepithelial Lesion (LGSIL), however High-grade Squamous Intraepithelial Lesion (HGSIL) and cervical carcinoma were not found. Conclusion: Our findings are in agreement with Jordanian study which reveals low incidence of cervical precursor lesions, there aggressive screening program is not a priority or recommended in Palestine at this time. We should concentrate on education and awareness of Palestinian women to risk factors for cervical cancer

Background The Fracture Risk Assessment (FRAX) tool has been developed by the World Health Organization (WHO) to calculate 10-year probability hip fracture (HP) or major osteoporotic fracture (MOF). The objective of this study was to assess the 10-year probability of MOF and HF among a selected sample of Palestinian people.
Methods A sample of 100 subjects was studied. Dual energy X-ray absorpitometry was performed to measure bone mineral density (BMD) which was then inserted into FRAX Palestine online WHO tool to calculate the 10-year probability of MOF and HF.
Results The median age of participants was 61.5 years and the majority (79%) were females. The median (interquartile range) of femoral hip BMD was 0.82 (0.76-0.92) g/cm². The mean vertebral and hip T scores were -1.41 ± 0.13 SDs and -0.91 ± 0.10 SDs respectively. About one fifth of the sample (21%) had vertebral osteoporosis and 5% had hip osteoporosis. The median (interquartile range) 10-year probability of MOF and HF based on BMD were 3.7 (2.43-6.18)%, and 0.30 (0.10-0.68)% respectively.
Conclusion Osteoporosis is common among Palestinian people above 50 years old. Bone fracture prevention strategies and research should be a priority in Palestine. Using FRAX might be a helpful screening tool in primary healthcare centres in Palestine.  

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Background: Pneumonia is a serious complication of mechanical ventilation in intensive care units (ICUs’) patients around the world. If it develops 48 hours after the start of ventilation, it’s called ventilator-associated pneumonia (VAP).Objectives: The purpose of this study was to determine the incidence and risk factors of ventilator-associated pneumonia (VAP) in Palestine.Settings: A prospective cohort study was conducted. It involved six intensive care units (ICUs) and one cardiac care unit (CCU) in six hospitals distributed in four cities in Palestine in a period of five months.
Participants: Patients who were ventilated for 48 hours or more.
Results: 134 patients were involved in the study. VAP was present in 29 patients (21.6%). Patients with VAP were more likely to have sepsis, neuromuscular disorders and chronic pulmonary obstructive disease (COPD), (P value: <0.001, 0.009 and 0.01), respectively.Conclusion: VAP represents a common problem in Palestine and should not be neglected. Its epidemiologic profile in terms of incidence, length of stay and clinical course resembles the general pattern described everywhere.

Objectives The objectives of this study were to assess the knowledge and practices associated with pesticide use in an agricultural community in Palestine, and to determine the prevalence of self-reported health symptoms related to pesticide exposure. Methods In this cross-sectional questionnaire study, agricultural farm workers in Nablus district, Palestine, were interviewed on their knowledge and practices of pesticide use. Comparisons of knowledge and practices of pesticide use between various groups were performed using the Mann–Whitney U-test or the Kruskal–Wallis rank test of variance. The program of the Statistical Package for Social Sciences (SPSS) version 15 was used for data analysis. Results The questionnaire was completed by 381 farm workers. The mean age ± SD of the participants was 38.8 ± 11.8 years. The majority (97.9%) of the participants were male. The mean participant scores for knowledge and safety procedures were 2.8 ± 3.2 out of 8 and 9.8 ± 2.4 out of 15, respectively. There was a significant positive correlation (r = 0.323; P < 0.001) between the knowledge and safety procedure scores. Unsafe behaviors were identified as the storage of pesticide products at home, the preparation of pesticides in the kitchen, inadequate disposal of empty pesticide containers, eating and drinking during pesticide application, and using inadequate protective clothing. The most frequent self-reported toxicity symptoms associated with pesticide use were skin rash (37.5%), headache (37%), excessive sweating (24.9%), and diarrhea (21.3%). There was a strong significant negative correlation (r = −0.83; P < 0.001) between self-reported toxicity symptoms and scores for protective measures. Conclusion The results of this study indicate that most farm workers in this district need more educational programs regarding the safety and use of pesticides. Legislation promoting the use of safer pesticides is also needed.


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