Zaher Nazzal

Zaher Nazzal
An-Najah National University · Faculty of Medicine and Health Sciences

Assistant Professor of Community Medicine

About

73
Publications
6,310
Reads
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295
Citations
Additional affiliations
August 2012 - September 2020
An-Najah National University
Position
  • Head of Department

Publications

Publications (73)
Article
Background Digital health interventions have been shown to improve data quality and health services in low- and middle-income countries (LMICs). Nonetheless, in LMICs, systematic assessments of time saved with the use of digital tools are rare. We ran a set of cluster-randomized controlled trials as part of the implementation of a digital maternal...
Article
Full-text available
Background In response to this extraordinary outbreak, many countries and companies rush to develop an effective vaccine, authorize, and deliver it to all people across the world. Despite these extensive efforts, curbing this pandemic relies highly upon vaccination coverage. This study aimed to determine SARS-COV-2 vaccine uptake among Palestinian...
Article
Full-text available
Background In the light of recent years, an increase in the number of life-threatening infections due to various fungi has been observed, especially in tertiary care centres. With Amphotericin B labelled as the first choice in treating these infections, one of its common side effects, nephrotoxicity, along with hypokalemia, were studied to determin...
Preprint
Background: Chronic kidney disease associated-pruritus (CKD-aP) is a common cutaneous complication and an important prognostic factor in patients with chronic kidney disease. The mechanism of Pruritus in those patients is poorly understood. This study aims to assess the burden of CKD-aP among patients receiving dialysis and the role of interleukin...
Conference Paper
Full-text available
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 hypertensio...
Article
Full-text available
Introduction: Despite discovery of effective vaccines, healthy behaviors and good practices remain the cornerstone of the prevention and control of COVID-19 and the mitigation of adverse impacts. This study aimed to assess the Palestinian population's COVID-19 prevention measures and correlate them with their knowledge, attitude, and background ch...
Article
Full-text available
Introduction: Acute kidney injury (AKI) remains a critical issue for cancer patients despite recent treatment improvements. This study aimed to assess the incidence of AKI in cancer patients and its related risk factors. Methods: A Retrospective cohort study was conducted at tertiary hospitals in the period 2016-2018. A data abstraction sheet wa...
Preprint
Full-text available
Background: In the light of recent years, an increase in the number of life-threatening infections due to various fungi has been observed, especially in tertiary care centers. With Amphotericin B labelled as the first choice in treating these infections, one of its common side effects, nephrotoxicity, along with hypokalemia, were studied to determi...
Preprint
Full-text available
Background Females are often more hesitant to get vaccinated than males, even among health care workers (HCWs). The purpose of this study was to assess female HCWs' COVID-19 vaccination coverage and their anti-vaccination attitudes. Methods We conducted a cross-sectional study using an online questionnaire. It included HCWs from various profession...
Article
Full-text available
Background Headache is one of the most disturbing complaints worldwide, negatively impacting social and regular life activities. In the background of stressful life in medical schools, adding to the stressful situation in Palestine, a developing country under occupation, this study investigated the prevalence and clinical characteristics of migrain...
Article
Full-text available
Ocular complications are common in patients with end-stage renal disease treated with hemodialysis. Disability due to visual impairment in these patients represents a global public health problem. The study aimed to estimate the hemodialysis effect on intraocular pressure (IOP) fluctuation and related factors. A cross-sectional study of 60 patients...
Article
Background Uncertainty about vaccination among nurses are major barriers to managing the ongoing COVID-19 pandemic worldwide. Purpose To explore nurseś perceptions about receiving the SARS CoV-2 vaccine to inform the upcoming Palestinian Ministry of Health (MOH) vaccination efforts. Methods Four focus groups were conducted with nurses between Jan...
Preprint
Full-text available
Background: Hypomagnesemia has been shown to have a significant impact on both glycemic control and diabetes complications in type 2 Diabetes Mellitus (T2DM) patients. This study aims to assess the prevalence of hypomagnesemia in T2DM patients and find the association between serum magnesium levels and outcomes relevant to glycemic control and diab...
Article
Full-text available
Background University students are at a higher risk of using cognitive enhancers and psychoactive substances. Depression is associated with a noticeable decline in academic performance and can increase the risk of substance use. Due to sociopolitical issues, the use of cognitive enhancers and psychoactive substances among Palestinians has spread in...
Preprint
BACKGROUND Digital health interventions have been shown to improve data quality and health services in low- and middle-income countries (LMICs). Nonetheless, in LMICs, systematic assessments of time saved with the use of digital tools are rare. We ran a set of cluster-randomized controlled trials as part of the implementation of a digital maternal...
Article
Full-text available
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 hypertensio...
Article
Full-text available
Background Breast cancer affects women's lives worldwide, yet early detection is an effective strategy for reducing mortality. The participation of women in mammography screening is linked to their knowledge, attitudes and perceived barriers. Objectives Our study aims to assess mammography screening uptake and barriers among women attending primar...
Article
Full-text available
This study aimed to assess the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) total antibodies in the north, middle, and south regions of West Bank and the prevalence of SARS-CoV-2 specific antibodies (IgA, IgM, and IgG) in the Palestinian population. This was a cross-sectional study. The serological and epidemiological...
Article
Full-text available
Introduction: Due to their stressful lives, Palestinian refugees are prone to use cognitive enhancers (CE) and psychostimulant substances (PS). Recognising health problems associated with CE/PS use can indicate how preventive programs should be directed towards adolescents. Unfortunately, research has not thoroughly investigated the health problem...
Article
Full-text available
Introduction: About 14% of COVID-19 patients experience severe symptoms and require hospitalization. Managing these patients could be challenging for limited-resource countries, such as Palestine. This study aimed to evaluate hospitalized severe COVID-19 patients' treatment outcomes managed with supportive care and steroids. Methodology: This wa...
Article
Full-text available
Background Due to the long waiting time for kidney transplantation, most End-Stage renal disease patients are commenced on either hemodialysis or peritoneal dialysis. Reusable fistulas have the lowest risk for death, cardiovascular events, and infections among all vascular accesses. This study aims to report the outcomes of the arteriovenous fistul...
Preprint
Full-text available
Background Headache is one of the most disturbing complaints worldwide, negatively impacting social and regular life activities.In the background of stressful life in medical schools, adding to the stressful situation in Palestine, a developing country under occupation, this study investigated the prevalence and clinical characteristics of migraine...
Article
Full-text available
Background Retinitis pigmentosa (RP) is a heterogeneous group of inherited ocular diseases that result in progressive retinal degeneration. This study aims to describe different Swept-source Optical Coherence Tomographic (SS-OCT) changes in Palestinian RP patients and to explore possible correlations with Visual Acuity (VA). Methods A cross-sectio...
Article
Full-text available
Mental morbidities have been widely investigated at Primary Health Care (PHC) worldwide, but no data available in Palestine have discussed these diseases’ burden. This study aimed to assess the prevalence of psychological morbidity among primary health care attendees and related factors. A cross-sectional design was adopted in this research. We col...
Article
Full-text available
Background: Diabetes is one of the most common chronic illnesses worldwide, and it is increasing in prevalence. Urinary incontinence is another worldwide health problem, with a reported prevalence that ranges from 9% to 67%. It decreases quality of life for men and women and has been associated with many poor outcomes, such as longer hospital stay...
Article
Full-text available
Background Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors....
Article
Full-text available
AimThis study aimed to assess weight control behaviors and their relationship with body weight and image perceptions among female university students.Subject and methodsA cross-sectional study was conducted among female students. The study included 420 female students aged 17–27 years using a convenient sample. Students were invited from all facult...
Article
Full-text available
Background: University students, who are at risk of eating disorders (ED), are more liable to use cognitive enhancers and psychostimulants to improve their cognitive functions and lose weight. ED in Palestinian male students is a neglected health issue. We aimed to investigate the prevalence and the association between ED and cognitive enhancers,...
Article
With the planned COVID-19 vaccine, vaccine hesitation is a great challenge, particularly for healthcare professionals. In this study, we examined the acceptance of the COVID-19 vaccine by health care workers, their concerns about it, and the reasons that might prevent them from getting vaccinated. We conducted a cross-sectional study using an anony...
Article
Full-text available
Background: The eRegCom cluster randomized controlled trial assesses the effectiveness of targeted client communication (TCC) via short message service (SMS) to pregnant women, from a digital maternal and child health registry (eRegistry) in Palestine, on improving attendance and quality of care. In this paper, we assess whether this TCC intervent...
Article
Full-text available
Objective: To measure COVID-19 vaccine acceptance and related factors to undercover nurses' concerns and fears. Design: A cross-sectional study. Sample: The study included 639 nurses; 83% were women and 80% under 50 years. Measurement: A self-administered questionnaire was used. It included demographic characteristics, COVID-19-related fears...
Article
Full-text available
Introduction: The level of vitamin D status and its relationship to kidney function and liver function among patients with and without type 2 diabetes were not studied among Palestinian hemodialysis patients before. The aim of this study was to assess the status of vitamin D in hemodialysis patients with and without type 2 diabetes and its determi...
Article
Full-text available
Background: Smoking cessation counseling is not well established in Middle East countries including Palestine. This study assesses the practice of smoking cessation counseling among primary healthcare (PHC) physicians in Palestine and its determinants. Methods: Over the period from April to September 2019, general practitioners, family medicine...
Article
Full-text available
Background This trial evaluates interventions that utilize data entered at point-of-care in the Palestinian maternal and child eRegistry to generate Quality Improvement Dashboards (QID) for healthcare providers and Targeted Client Communication (TCC) via short message service (SMS) to clients. The aim is to assess the effectiveness of the automated...
Article
Full-text available
Background: The high potential risks involved in working in a healthcare setting during a pandemic and the associated fear that may affect health care workers' (HCWs') willingness to work are important to understand to eliminate potential barriers to working. This study aimed to assess Palestinian HCWs' willingness to work and the related factors a...
Preprint
Full-text available
Background: Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors....
Article
Full-text available
Objectives: Healthcare systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians' compliance and attitude towards smoking cessation cou...
Article
Full-text available
Background Chronic kidney disease (CKD) is a global public health concern and diabetes is one of the main risk factors for its occurrence and progression. The aim of this research is to determine the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes in primary health centers in North West Bank. M...
Preprint
Full-text available
Background: Retinitis pigmentosa (RP) is a heterogeneous group of inherited ocular diseases that result in progressive retinal degeneration. This study aims to describe different Swept-source Optical Coherence Tomographic (SS-OCT) changes in Palestinian RP patients and to explore possible correlations with Visual Acuity (VA) Methods: A cross-sectio...
Article
Full-text available
Background: Sepsis syndrome is an emerging healthcare problem, especially in critically ill patients, regardless whether it\'s community- or hospital-acquired sepsis. This study evaluates the characteristics of these patients, in addition to the type, source, and outcome of sepsis and septic shock, in a university tertiary hospital in Palestine. It...
Article
Full-text available
Background COVID-19 is thought to be the most significant public health threat the modern world has encountered. Health care workers (HCWs) face enormous pressure due to work overload, negative emotions, exhaustion, lack of contact with their families, and risk of catching the infection and death. Aim This study aims to assess the level of stress...
Article
Full-text available
Background: Sepsis syndrome is an emerging healthcare problem, especially in critically ill patients, regardless whether it's community- or hospital-acquired sepsis. This study evaluates the characteristics of these patients, in addition to the type, source, and outcome of sepsis and septic shock, in a university tertiary hospital in Palestine. It...
Article
Full-text available
PurposeDiabetic Retinopathy (DR) screening among Palestinian diabetic patients is limited. To improve the care of our patients, we explored the barriers to DR screening with a qualitative study.Methods Three focus groups were conducted in the northern West Bank. Patients noncompliant with DR screening were recruited from Primary Health Care clinics...
Article
Full-text available
Background: Waterpipe smoking in young individuals is increasing with limited studies addressing its respiratory health effects. The aim of the study was to determine the effect of waterpipe smoking on young adults' lung functions. Spirometric parameters were compared between waterpipe smokers and nonsmokers. Methods: A comparative cross-section...
Preprint
Full-text available
Background This trial evaluates interventions that utilize data entered at point-of-care in the Palestinian maternal and child eRegistry to generate Quality Improvement Dashboards (QID) for healthcare providers and Targeted Client Communication (TCC) via short message service (SMS) to clients. The aim is to assess the effectiveness of the automated...
Article
Full-text available
Introduction: The kidney affects the thyroid gland causing various derangements in its function whenever the kidney is impaired, even with a minor imperfection in its job, and this makes dialysis patients more prone to thyroid disorders with subsequent increase in mortality and morbidity. This study aims to assess the prevalence of thyroid disease...
Preprint
Full-text available
Background: This trial evaluates interventions that utilize data entered at point-of-care in the Palestinian maternal and child eRegistry to generate Quality Improvement Dashboards (QID) for healthcare providers and Targeted Client Communication (TCC) via short message service (SMS) to clients. The aim is to assess the effectiveness of the automate...
Preprint
Full-text available
Background Chronic kidney disease (CKD) is a worldwide public health problem and diabetes is one of major risk factor for its development and progression. The aim of this study is to assess the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes treated in primary health care centers in North West B...
Preprint
Full-text available
Background: Chronic kidney disease (CKD) is a global public health concern and diabetes is one of the main risk factors for its occurrence and progression. The aim of this research is to determine the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes in primary health centers in North West Bank. M...
Preprint
Full-text available
Background: Health-care systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that provision of smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians' compliance and attitude towards smoking...
Preprint
Full-text available
Background: Eating behaviors and body image perceptions is an increasingly relevant and important topic in public health; due to its ultimate impact on health and human well-being in general. Objectives: This study aims to assess weight control behaviors and their relationship with body weight and image perceptions among university female students....
Article
Full-text available
Objective: To determine the prevalence of urinary incontinence (UI) in women with type 2 diabetes mellitus (T2DM) in the North West Bank, Palestine, and to assess the role of potential risk factors including age and DM control. Patients and methods: Adult women with DM attending governmental primary healthcare centres in the North West Bank were in...
Article
Full-text available
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 Imag...
Article
Background Social media has become popular and changed social interaction between people. The Middle East is an important and expanding market, particularly the occupied Palestinian territory, where restrictions related to cultural and geopolitical realities create an environment of isolation for young adults. Dependence on social media is suggeste...
Article
Background Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at p...
Article
Full-text available
Background: Mortality data are essential for many aspects of everyday public health practices at both national and international levels. Despite the current developments in various aspects of the medical field, the apparent inability of physicians to complete death notification forms (DNF) accurately is still worldwide concern. The aim of this stu...
Article
Full-text available
PurposeThe aim of this study is to evaluate the role of the non-fusion instrumented procedure with compression adjunct to lengthening by distraction in facilitating spinal modulation of the wedged peak vertebra, in patients with congenital thoracolumbar kyphosis/kyphoscoliosis according to the Hueter–Volkmann law. The authors seek to address the pr...
Article
Full-text available
Background The death notification forms (DNFs) are important documents. Thus, inability to fill it properly by physicians will affect the national mortality report and, consequently, the evidence-based decision making. The errors in filling DNFs are common all over the world and are different in types and causes. We aimed to evaluate the quality of...
Article
Background: Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impa...
Article
Full-text available
Background Premenstrual syndrome (PMS) is a cyclic occurring disorder that affects young and middle-aged women mainly. It characterized by group of physical, cognitive, emotional and behavioral symptoms that interfere with daily living activities. PMS is common worldwide, but there is no published research about it in Palestine. The aim of this stu...