Background: Breast cancer (BC) is the most common cancer among women. Studies have shown that cancer patients can develop depression impacting their quality of life, treatment outcomes, and survival rates. This study aimed to determine the risk factors, severity and prevalence of depression among females diagnosed with BC in multiple hospitals across Palestine. Methods: A cross-sectional study was conducted at different cancer treatment centers in Palestine using a previously developed questionnaire consisting of 23 questions to assess the severity of major depressive disorder among females diagnosed with breast cancer. The Patient Health Questionnaire-9 (PHQ-9) was included in the questionnaire. Results: Out of 223 respondents, 79 (35.4%) have developed moderate to severe depression. Chi-square results revealed that the risk of developing moderate to severe depression was higher among females who suffer from side-effects related to BC treatment (P < 0.011), females who knew the BC stage at the diagnosis step (P < 0.031), and negative implications on BC patients in Palestine (P < 0.009). Conclusion: Breast cancer patients have an increased risk of developing major depressive disorder. Patient assessment and treatment for depression at the time of BC diagnosis, during the treatment journey, and monitoring after treatment completion is essential for patient quality of life and BC treatment outcomes.

Introduction and importance: Drug-induced pancreatitis is an important health issue that makes a minority of causes of acute pancreatitis. Tigecycline-induced pancreatitis is a rare condition with poorly understood mechanism and has a small incident compared to other causes of pancreatitis Case presentation: The authors present a case of a 39-year-old female patient with acute pancreatitis. Tigecycline was the suspected culprit by exclusion. The patient was managed by keeping her nill per os, rehydration, pain management and discontinuation of the drug. The patient improved gradually. Clinical discussion: Tigecycline-induced acute pancreatitis is a rare but known complication that is mostly seen in patients with chronic renal insufficiency combined with high dose of administration. Onset is usually within 14 days of initiation. Discontinuation of the drug is the most effective intervention in addition to supportive management. Conclusion: Acute pancreatitis should be suspected in any patient presenting with vomiting, abdominal pain and acidosis while on tigecycline. Monitoring of amylase and lipase can be beneficial especially in those with chronic renal insufficiency or those receiving a high dose.

Vancomycin-Resistant Enterococcus (VRE) is one of the key antibiotic-resistant pathogens that challenges the health system with its threat to human health. Most VRE infections occur in hospital settings as these pathogens are known to colonize hospital environments and maintain their viability for long periods. Without good infection control measures, these pathogens can spread in the hospital setting and cause hospital-acquired infections including bacteremia. In this study, we report the isolation of VRE from patient samples hospitalized in four Palestinian hospitals. The American Society for Microbiology proceedings were utilized to culture and identify VRE. During the 5-year study period between December 2020 and March 2024, 736 VRE isolates were detected, and 30 (4.76%) patients with bacteremia were reported. Excellent infection control measures including active surveillance swabs, contact precaution and following strict isolation protocols were important to limit the spread of these pathogens, as well as limiting the consumption of antibiotics, especially Vancomycin. In this research article, we discuss the detection of VRE in the different hospitals located in West Bank and East Jerusalem. We also analyze the prevalence of VRE in other body sites including anal surveillance swab, urine, wound and stool cultures that may be associated with developing VRE bacteremia. The cumulative average of VRE causing bacteremia was of urinary origin, followed by wound and stool positive cultures, respectively. Hospital number 2 had the highest risk of developing bacteremia in patients with other VRE positive culture or swab with a percentage of 11.3%.

Background: We report 2 cases of recurrent right-sided endocarditis in 2 young patients known to be intravenous (i.v.) drug users. We highlight the importance of early diagnosis and management, especially in recurrent infection, which has a higher mortality rate and poor prognostic outcome despite antibiotic treatment.Case Reports: A 30-year-old woman with a medical history of active i.v. drug use and tricuspid valve replacement owing to Serratia marcescens endocarditis 2 months prior to presentation was admitted to the Intensive Care Unit for septic shock. The patient did not respond to i.v. fluids and required vasopressors. Blood cultures returned positive for S. marcescens again. The antibiotic regimen consisted of meropenem and vancomycin. The patient underwent redo sternotomy, explant of old tricuspid valve bioprosthesis, debridement of tricuspid valve annulus, and bioprosthetic valve replacement. She continued antibiotic treatment during hospital admission for 6 weeks. In another similar case, a 30-year-old woman, also an i.v. drug user, was admitted to the hospital for tricuspid bioprosthetic valve S. marcescens endocarditis after tricuspid valve replacement 5 months prior to her presentation with S. marcescens endocarditis. Her antibiotic regimen consisted of meropenem and vancomycin. She was eventually transferred to a tertiary cardiovascular surgery center for further case management. Conclusions: In the setting of recurrent bioprosthetic valve S. marcescens endocarditis, it is suggested that treatment should be more focused on source control, including cessation of i.v. drug abuse and providing appropriate antibiotic treatment to prevent recurrence because, in the case of recurrence, morbidity and mortality risk can increase significantly.

Background: Breast cancer (BC) is the most common cancer among women. Studies have shown that cancer patients can develop depression impacting their quality of life, treatment outcomes, and survival rates. This study aimed to determine the risk factors, severity and prevalence of depression among females diagnosed with BC in multiple hospitals across Palestine.Methods: a cross-sectional study was conducted at different cancer treatment centers in Palestine using a previously developed questionnaire consisting of 23 questions to assess the severity of major depressive disorder among females diagnosed with breast cancer. The Patient Health Questionnaire-9 (PHQ-9) was included in the questionnaire. Results: Out of 223 respondents, 79 (35.4%) have developed moderate to severe depression. Chi-square results revealed that the risk of developing moderate to severe depression was higher among females who suffer from side-effects related to BC treatment (P<0.011), females who knew the BC stage at the diagnosis step (P<0.031), and negative implications on BC patients in Palestine (P<0.009).Conclusion: Breast cancer patients have an increased risk of developing major depressive disorder. Patient assessment and treatment for depression at the time of BC diagnosis, during the treatment journey, and monitoring after treatment completion is essential for patient quality of life and BC treatment outcomes.

On the 11^th of March 2020, the world faced a new global pandemic, COVID-19 which is a disease caused by the novel coronavirus, it had multiple devastating outcomes on multiple sectors along with significant rates of mortality. These challenges encouraged the development of multiple testing methods, as well as anti-viral medications such as Molnupiravir, as well as evaluating the efficacy of available medications against it, like; Azithromycin, Ritonavir and Hydroxychloroquine. Vaccination against COVID-19 forged into a significant challenge, few months ensuing the first case of SARS-CoV-2, which was diagnosed in December 2019, in Wuhan-China, thus, multiple vaccines were approved for use around the world to combat this pandemic. Our study includes a sample of 556 oncology patients at Augusta Victoria Hospital in Jerusalem, all patients were tested using Panbio rapid antigen test and Allplex PCR Assay. The main objective was to study the sensitivity and specificity of Rapid antigen test, which contributes to a faster isolation call and management of infected patients, thus decreasing the risk on spread to other patients and health care. Patients were categorized based on two factors: Ct range and age group and studying their possible effect on false-negative results. Patients with Ct value less than 20, had the highest detection rate which is consistent with other studies in the literature. The sensitivity and specificity of Panbio Rapid Antigen testing were of 69.9% and 100%, respectively. A correlation between age group and false negative results could not be made, but a correlation between Ct value and false negative result was noticed, Ct value was directly related to false negative results. P-value of 0.007 indicated that results were statistically significant where PCR test is considered more sensitive compared to rapid antigen test.