On 17 th Nov 2010, an outbreak of acute gastroenteritis occurred among labourers at the Rass Laffan Industrial City. The aim of this study was to identify the agent and the source of the outbreak in order to stop it, develop control measures and prevent future outbreaks. A case-control study was conducted to study this outbreak. A total of 85 cases were randomly selected as well as 85 controls. Both groups completed a structured questionnaire. In addition, stool culture from patients and food handlers as well as food samples were investigated to determine the pathogen and the possible source of infection.About 300 labourers developed the disease; attack rate is 28.5%. Diarrhoea and abdominal cramps were the most common symptoms. The median incubation period was 15 hours. Cases were more likely than controls to have eaten macaroni salad 97.6% and 27.3% respectively with OR 109.3 (CI: 25-484). Stool culture of 6 patients and 3 food handlers were positive for Salmonella group D and none of the food item showed microbial growth. The findings of this study indicate that the causative agent of this outbreak is Salmonella group D and the possible source of infection is macaroni salad, which was mixed with raw eggs.

Introduction: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the principal causes of maternal morbidity and mortality. The maternal morbidity and mortality burden for Palestinian women is relatively high, suggesting a substandard quality of care. Therefore, an early diagnosis of GDM and gestational hypertension (GH) can improve prenatal care for pregnant women and improve pregnancy outcomes. Previous studies demonstrated that elevated Hb levels in the first trimester indicate possible pregnancy complications and should not only be considered as good iron status. However, ethnic differences could play a role in determining the magnitude of the association. We hypothesized that high Hb levels (≥12.5 g/dl) in the first trimester (6-13 gestational weeks, GW) are associated with increased risk of fasting blood sugar (FBS) ≥126 mg/dl, systolic blood pressure (SBP) ≥140 mmHg, and diastolic blood pressure (DBP) ≥90 mmHg among pregnant Palestinian women visiting prenatal clinics in Palestine.Methods: Medical records (N=5263) were reviewed for singleton pregnancies who had their first maternity care clinic visit (6-13 GW) at primary healthcare centers of the Palestinian Ministry of Health in the north of the West Bank in 2018 and 2019. Women were excluded if they had FBS ≥92 mg/dl, SBP ≥140 mmHg, DBP ≥90 mmHg, ultrasound-based gestational age >13 weeks, or who were previously diagnosed with diabetes mellites, GDM, hypertension, GH, taking drugs for these conditions, or were smoking during pregnancy. Hb levels in g/dl were divided to low (<11.0), normal (11-12.49), and high (≥12.5). The associations between high hemoglobin levels and pregnancy complications in pregnant women were assessed by calculating the odds ratios (OR) and their 95% confidence intervals (CIs) using logistic regression. P-values of <0.05 were considered significant.Results: The final number of eligible records was 2565. Pregnant women with high Hb levels in the first trimester were at higher risk of high FBS (≥126 mg/dl; OR=2.99, 95%CI, [1. 675-5.368]) and high systolic blood pressure (≥140 mmHg; OR=3.048, 95%CI,) at 24 GW. Gravidity was significantly associated with decreased risk of high FBS (OR=0.838, 95%CI [0.704-0.991]). Conclusion: Our findings suggest that Hb level at registration could be utilized in predicting the risk of GDM and HP among Palestinian women who never had a previous history of these conditions. The results of this study could have important clinical implications for early screening, which could improve preventive and curative health services to promote the health of pregnant women and children.

Background: The objective of this study is to assess the frequency of anatomic variations of the biliary system in the Palestinian population in patients undergoing MRCPs.Methods: For a period of 3 years, from March 2016 to January 2019, a total of 401 MRCPS were performed in different Palestinian Medical Centers for different indications. 346 Images were included in the study. Images were evaluated independently by two expert radiologists for the presence of variations in the anatomy of gallbladder, cystic duct, common bile duct, pancreatic duct, pancreas and intrahepatic ducts.Results: About 78% of the images had normal anatomy of Intra-hepatic ducts. Right posterior duct joining the right anterior duct by its lateral side was observed in 12.6% of images and triple confluence in 8.5% of images. About 12% of the gallbladder images have anatomical variation; multi-septate in 4.1% of images and ectopic in 3.7% images. For the cystic duct, it was abnormally low in 9.6% of images and high in 5.3% of images. The cystic duct was found parallel in 2.3% of images. Variations of the pancreatic duct were evident in 3.9% of the images.Conclusions: anatomical variations of the pancreatico-biliary system are common and they are worth the attention to prevent major complications during hepatobiliary surgeries.

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