his majesty king abdullah ii ibn al-husseinjordan-valley.com/wp-content/uploads/2016/04/...naheel...

His Majesty King Abdullah II Ibn Al-Hussein

His Royal Highness Crown Prince Al-HusseinBin Abdullah II

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نحوو خددمة أأفضلل للمررضى

ألهھھھلل ووأأبناء االعموومة٬، فنلمح ااألبوواابب خلفف أأيیامم االجددااتت٬، كنا نمرر على االعتباتت٬، عتباتت بيیووتت ااتلكك االعتباتت مشررعة٬، كما لوو أأنهھا تقوولل: يیاهھھھال بالضيیفف ضيیفف هللا.. كبررنا ووتفررقنا في ددررووبب االحيیاةة٬، ووما تززاالل هھھھذذهه االعتباتت ووااألبوواابب االمشررعة خلفهھا٬، صووررةة محفووررةة في ووجددااننا٬، تأتي

لشعبيیة: يیا هھھھال بالضيیفف ضيیفف هللا... إإلى مرراافئ االذذااكررةة االمتعبة ووقدد أأحضررتت معهھا ااألهھھھززووجة ااووهھھھا نحنن في االلجانن جميیعهھا٬، االمنظظمة لمؤؤتمررنا االعلمي االعرربي االددوولي نقوولل لكمم جميیعكمم ضيیووفا ووأأصحابب دداارر: يیاهھھھال بكمم٬، نقوولهھا بلسانن أأررددني عرربي إإنساني ووااحدد٬، ثمم وومنن بعدد ووااجبب

ى تأملل محتووااهھھھا االعلمي االتررحيیبب٬، نشدد االررحالل نحوو أأووررااقق عملل االمؤؤتمرر٬، عاقدديینن االعززمم علوواالمعررفي٬، ساعيینن ما ااستططعنا إإلى ذذلكك سبيیال٬، إإلى ااالررتقاء بمهھنتنا٬، ووتحصيینهھا بالعلمم

االمترراافقق مع االعملل٬، ووبالددقة االمصاحبة لألمانة. تشغلل بالل أأبناء مهھنتنا٬، وولكنهھ٬، وومهھما ططررأأ منن مستجددااتت أأوو مهھما ثمة قضايیا مستجددةة دداائما

منن تقددمم فإنن االهھاجسس االذذيي يیشغلل بالل أأبناء مهھنة االتحاليیلل االمخبرريیة نالل االعلمم االمتعلقق بمهھنتنا االططبيیة٬، وويینبغي أأنن يیظظلل يیشغلل بالهھمم هھھھوو كيیفف نووااصلل تقدديیمم أأفضلل االخددماتت للمررضى٬، ووكيیفف نحافظظ على نقاء ددووررةة االعالجج منن أأيي تلووثث أأوو ااضططرراابب٬، إإنهھا االددووررةة االمتعلقة باستقبالل

االمرريیضض وومنن ثمم تشخيیصهھ سرريیرريیا ووصووال إإلى ااختيیارر االعالجج االمناسبب لهھ على ططرريیقق وومخبرريیااالشفاء بإذذنن هللا تعالى.

في مررحلة االتشخيیصص فإنن كثيیرراا منن االعيیوونن تكوونن شاخصة نحوونا٬، معلقة آآمالهھا بعدد هللا بنا٬، منتظظررةة كلمتنا االفصلل٬، فتعالوواا نسعى وونبحثث وونعملل وونررفع شعارر: نحوو خددمة أأفضلل للمررضى.

دد.سلووىى عووددةة عمارريینن ررئيیسة االمؤؤتمرر

نقيیبة أأصحابب االمختبررااتت وواالتحاليیلل االططبيیة

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"سنووااتت االصبرر وواالررضا"

على مددىى أأرربعة عقوودد ماضيیة٬، ووااصلتت االجمعيیة ااألررددنيیة للعلوومم االمخبرريیة االططبيیة عملهھا لمكانتهھا٬، ووتأكيیدداا على حضووررهھھھا االتططووعي االمسكوونن ٬، اانتصارراا للمهھنة٬، ووتكرريیسا بحسس نقابي

ووووجووددهھھھا وومشررووعيیتهھا كووااحددةة منن االمهھنن االططبيیة االحاضررةة في ددووررةة االتشخيیصص وواالعالجج٬، .االمتناثررةة في أأررووقة االمستشفيیاتت وواالعيیاددااتت وواالمستووصفاتت وواالمررااكزز االططبيیة وواالصيیددليیاتت

ررنا ضمنن هھھھذذهه االددووررةة بأمانة وونززااهھھھة وومهھنيیة عاليیة االددقة٬، كنا هھھھناكك٬، نماررسس ددوو نحنن دداائما

سنظظلل هھھھنا في قلبب هھھھذذاا االمعنى االمتعلقق بصحة االناسس مباشررةة ووشووااغلهھمم وونحنن دداائما.ووهھھھموومهھمم

سنووااتت ططوويیلة منن االصبرر وواالررضا عملنا فيیهھا٬، ووتفاعلنا مع محيیططنا االعرربي وومنن بعددهه االددوولي٬،

بمططرر االخيیرر٬، ووأأنررنا ددررووبب االخصبب بالشمع وواالوورروودد٬، تقددمنا كما يیفعلل االسحابب ووااعدديینن دداائما حتى باتت سؤؤاالنا االووجوودديي في هھھھذذهه االلحظظة االفاررقة: نكوونن أأوو ال نكوونن. إإنن جوواابنا بمعوونة هللا ووااألخيیارر منن أأبناء أأمتنا أأننا سنكوونن وونحققق تططلعاتت أأبناء االمهھنة ليیسس في ااألررددنن فحسبب٬،

تحادد االعرربي للبيیوولووجيیا االسرريیرريیة. نعمم سنكوونن٬، وولكنن في االبالدد االعرربيیة االمنضوويیة تحتت لووااء ااالسالحنا سالمة االمجهھرر ووددقة ما ترريینا عددساتهھ االمتططووررةة منن أأحيیاء ووكائناتت ووخاليیا تتدداافع٬، ووسنددنا إإخالصنا للمهھنة ووأأبنائهھا ووللووططنن كلهھ ووااألووططانن جميیعهھا. ووإإنن مووعدد تحقيیقنا غايیاتنا

االصبح: أأليیسس االصبح بقرريیبب؟؟

سعووددعبدد االعززيیزز حسنن م

ررئيیسس االجمعيیة ااألررددنيیة للعلوومم االمخبرريیة االططبيیة

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بسمم هللا االررحمنن االررحيیمم تحقيیقا للنهھج االذذيي خططتهھ االجمعيیة ااألررددنيیة للعلوومم االمخبرريیة االططبيیة بجعلل االمؤؤتمررااتت وواالنددووااتت االعلميیة االددوورريیة

يیة االهھاشميیة٬، أأمم في أأقططارر االووططنن منبرراا للعامليینن في مهھنة االتحاليیلل االططبيیة٬، سووااء أأكانن ذذلكك في االمملكة ااألررددناالعرربي٬، فإننا في االلجنة االعلميیة للمؤؤتمرر٬، قدد عمددنا إإلى تنوويیع مصاددرر االمقاالتت االعلميیة االمططررووحة في االمؤؤتمرر االعلمي ااألررددني االددوولي االرراابع للجمعيیة ااألوولل لنقابة أأصحابب االمختبررااتت وواالتحاليیلل االططبيیة٬، ليیصارر إإلى االتعررفف

لحدديیثة في حقوولل االتشخيیصص االمخبرريي. ووبصفتنا االجهھة االتي تشررفف على االبررنامج عنن كثبب على االتططووررااتت اااالعلمي للمؤؤتمرر٬، فإننا نوودد أأنن نشكرر االعلماء ووااالختصاصيیيینن االذذيینن لبوواا ددعووتنا سووااء منن خاللل ووضع خبررتهھمم

لل بيینن في خددمة االمؤؤتمرر٬، أأوو منن خاللل االمشارركة بأووررااقق علميیة ووددررااساتت محكمة. ووإإذذ نؤؤكدد على أأهھھھميیة االتووااصاالعامليینن وواالباحثيینن في االعلوومم االططبيیة االمخبرريیة في مختلفف أأنحاء االووططنن االعرربي٬، فإننا على ثقة أأكيیددةة أأنن االمؤؤتمرر سووفف يیغني مهھنة االتحاليیلل االمخبرريیة االططبيیة وويیمددهھھھا بكلل ما هھھھوو جدديیدد منن االمووااضيیع االعلميیة. إإنن االلجنة

إإلى مستوويیاتت عالميیة٬، منن خاللل ما قددمتهھ االمنططمة للمؤؤتمرر تبذذلل قصاررىى جهھددهھھھا للووصوولل بالمهھنة محليیاووتووااصلل تقدديیمهھ٬، منن خددمة إإلى االمررضى ووإإلى ااإلنسانيیة جمعاء.

االبررنامج االعلمي للمؤؤتمرر االرراابع للجمعيیة ااألوولل للنقابة٬، يیتضمنن أأرربع جلساتت٬، يیشارركك فيیهھا علماء مجالل االتشخيیصص ووااختصاصيیوونن وومحاضرروونن محليیوونن ووعرربب ووأأجانبب. تتناوولل االجلساتت آآخرر االمستجددااتت في

االمخبرريي في مجاالتت االططبب االتشخيیصي٬، وواالتططبيیقاتت االططبيیة للخاليیا االجذذعيیة٬، وواالتشخيیصص االمبكرر للسررططاناتت االمختلفة٬، وواالتووجهھاتت االحدديیثة في االططبب االمخبرريي٬، ووططبب ااألعشابب٬، ووتشخيیصص أأمررااضض االشيیخووخة ووكبارر

ي وومحليیيینن تقددموواا بأووررااقهھمم االعلميیة كما يیتضمنن االبررنامج االعلمي ستت جلساتت لباحثيینن منن االووططنن االعررب االسنن.ليیضعوواا أأمامم االمؤؤتمرريینن خالصة خبررااتهھمم االبحثيیة في مجاالتت متنووعة ووغنيیة٬، منهھا ااألمررااضض االسررططانيیة

وواالجررثووميیة وواالووررااثيیة ووااأليیضيیة٬، وواالططررقق االمخبرريیة االحدديیثة في االعملل االمخبرريي. ي االمختبررااتت االططبيیة تشملل مختلفف االبررنامج االعلمي يیتضمنن٬، إإلى ذذلكك٬، ووررشة عملل حوولل ضمانن االجووددةة ف

أأساليیبب ضبطط جووددةة االنتائج في االمختبررااتت االططبيیة٬، إإضافة إإلى كيیفيیة االحصوولل على ااالعتمادد االددوولي للمختبررااتت٬، ووكيیفيیة االحصوولل على مززااوولة االمهھنة االعالميیة االتي تمنحهھا االجمعيیة ااألمرريیكيیة للططبب االمخبرريي.

نة االتحاليیلل االططبيیة في ااألررددنن إإلى أأيینن؟" يیتحددثث فيیهھا ممثلوونن هھھھناكك أأيیضا٬، ووأأيیضا٬، نددووةة بعنوواانن "مستقبلل مهھعنن ووززااررةة االصحة٬، وواالجمعيیة ااألررددنيیة للعلوومم االمخبرريیة االططبيیة٬، وونقابة أأصحابب االمختبررااتت وواالتحاليیلل االططبيیة٬، وواالقططاعع االخاصص٬، حيیثث تسعى أأووررااقق االنددووةة إإلى االووقووفف على االتحدديیاتت االتي تووااجهھ االمهھنة في ااألررددنن٬، في ظظلل

ووجوودد نقابة مهھنيیة جامعة مانعة إإلززااميیة ااالنتسابب٬، تمثلل جميیع االعامليینن في االمهھنة٬، ووتنظظمم عملهھا ووتحفظظ عددمم حقووقق االعامليینن فيیهھا٬، ووحقووقق االمررضى االمستفيیدديینن منن خددماتهھا٬، ووتمنع االتجاووززااتت غيیرر االمنضبططة خصووصآ

نضوووواا تحتت رراايیة هھھھيیئة أألفف) منن ددوونن أأنن يی 30في ظظلل تززاايیدد أأعدداادد االعامليینن بالمهھنة (يیززيیدد عددددهھھھمم على ااعتبارريیة ووااحددةة ذذااتت شررعيیة قانوونيیة. يیدديیرر االنددووةة ااألستاذذ االددكتوورر يیووسفف بيیلتوو.

وومتحددثا 45عدددد االمشارركيینن في االبررنامج االعلمي وواالمتحددثيینن في جلساتهھ يیبلغ ( ) خمسة ووأأرربعوونن مشارركا ووعرربيیآ ووأأجنبيیا٬، بمنن فيیهھمم ررئيیسس ااالتحادد االعالمي للططبب االمخبرريي وو بعضض أأعضاء االمكتبب االتنفيیذذيي محليیا

لالتحادد االعالمي٬، ووكذذلكك ررئيیسس ااالتحادد االعرربي لمهھنة االتحاليیلل االططبيیة ووأأعضاء في االمكتبب االتنفيیذذيي لالتحادد االعرربي.

ررئيیسس االلجنة االعلميیة للمؤؤتمرر ااالستاذذ االددكتوورر يیووسفف بيیلتوو

عمانن ااالررددنن –

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رراايیة االعلمم ووااإلعمارر

فإنن االتمسكك بالعلمم خيیارراا ووأأفقق خررووجج منن دديیاجيیرر في لحظظة حررجة منن تارريیخ أأمتنا٬، االظظالمم٬، .يیصبح ووااجبا أأخالقيیا مهھنيیا جووهھھھرريیا

إإنن االمهھنة االتي تجمعنا في أأفيیائهھا هھھھذذهه ااأليیامم بمناسبة إإقامة االمؤؤتمرر االعلمي االرراابع للجمعيیةااألررددنيیة للعلوومم االمخبرريیة االططبيیة٬، ااألوولل لنقابة ااصحابب االمختبررااتت وواالتحاليیلل االططبيیة٬، هھھھي مهھنة االددقة وواااللتززاامم ااألخالقي٬، ووااألمانة االمهھنيیة٬، وواالحساسيیة االتشخيیصيیة االحاسمة في حاالتت

رر٬، ووتبني أأكثرر مما بعيینهھا. ووعليیهھ٬، فإننا أأبناء مهھنة تفعلل أأكثرر مما تقوولل٬، ووتنجزز أأكثرر مما تنظظيیهھددمم االهھاددموونن أأوو يیعبثث االعابثوونن بأووططانن بناهھھھا االمخلصوونن منن أأبناء أأمة ووااحددةة ذذااتت ررسالة

.خالددةة .تعالوواا نتمسكك بالعلمم يیا أأبناء االشمسس وواالحرريیة وواالغايیاتت االعلوويیة االنبيیلة

تعالوواا إإلى كلمة سووااء تووحدد االصفووفف٬، ووتجمع ما فررقتهھ االسيیاسة ووتحصنن ووجووددنا بالعلوومم .امم االمعنوويیةاالتططبيیقيیة ووااألررق

ليیسس بالنوواايیا االصالحة ووحددهھھھا تبنى ااألممم٬، بلل بالعملل االجادد٬، وواالمثابررةة االمخلصة٬، بشررفف االمهھنة ووااالنتصارر ألخالقيیاتهھا االررفيیعة االعاليیة. ووفي االووقتت االذذيي ننتظظرر فيیهھ مآالتت أأحوواالل بالدد شقيیقة

اتت٬، ووال تهھززهه لنا٬، فتعالوواا ال نططيیلل ااالنتظظارر وونباددرر لمساعي عملل مشترركك ال تووقفهھ االعادديی.االنوواائبب

.ووفقنا هللا ووإإيیاكمم لما فيیهھ صالحح ااألررضض ووإإعماررهھھھا كأعظظمم ررسالة أأنيیططتت ببني االبشرر

االددكتوورر كاملل محمدد حسنن

ررئيیسس ااالتحادد االعرربي للبيیوولووجيیا االسرريیرريیة

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Dear Colleagues,

It is my great pleasure to participate to the Conference of the Jordan Society for Medical Laboratory Sciences that will be held in Amman from 7-9 April and to welcome you on behalf of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).

Whether you work in a hospital, a university, in private practice or in the diagnostics industry you are here in Amman to share knowledge with many outstanding experts. I am certain the organizing did an outstanding job in delivering a program of high quality and interest containing innovative ideas and of direct relevance to modern laboratory medicine. These are exciting times in the world of laboratory medicine. Therefore, laboratory medicine specialists and the diagnostic industry have a responsibility to work together to convert data into knowledge which can be used to add value to patients health.

Maurizio Ferrari

IFCC President

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Dear colleagues,

On the occasion of the 4th International Jordanian Conference of The Jordan Society for Medical Laboratory Scienses and the 1st for the Association of Laboratory Properties and Medical Analysis from the 7th to 9th of April 2016 – Landmark Hotel – Amman, I would like to express my everlasting thanks and appreciation to my colleagues in Jordan for their efforts to prepare this well organized conference as well as this well prepared scientific program with distinguished speakers. Moreover, I cannot forget to mention the kind invitation and hospitality offered by the Jordanian society.

This conference gathered most colleagues from the Arab Federation of Clinical Biology and our friend guest of honor the president of IFCC-lab Medicine who contributed actively for the success of the conference.

Last but not least, we are very grateful to all colleagues especially Professor Yousef Bilto, Dr. Salwa Amarin, Dr. Abdul Aziz Masoud and Dr. Wahib Ghasib who contributed to the success of the conference Under Patronage of Her Royal Highness Princess Basma Bint Talal.

We all appreciate her support and advice.

Professor Mohamed Shaarawy PhD, FRCPath

Honorary President of AFCB

President of Egyptian Society of Clinical Chemistry and Lab Medicine

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The 4th International Jordanian Conference of the Jordan Society for Medical Laboratory Sciences

The 1st for the Association of Laboratory Proprietors and Medical Analysis

EXECUTIVE ORGANISING COMMITTEE PRESIDENT:

Dr. SALWA ODEH AMARIN(ALPMA)

PRESIDENT:

ABDUL AZIZ HASSAN MASOUD(JSMLS)

Members:

Dr.Bashar Qousous

Dr.Faisal Abu Farsakh

Dr.Falak Qadri

Dr.Hani Ababneh

Dr.Haseeb Sahyoun

Dr.Jamal Abu Farha

Dr.Khaled Abdul Rahman AL Khatib

Dr.Mohammed Abu Zaid

Dr.Mohannad Yacoub

Dr.Muhammad Hassan Hajjar

Dr.Soad Fakhri Shinnara

Dr.Wafiq Farhan Halaseh

George Zuraikat

Mahmoud Zaidan

Maisaa Al-Qaisi

Mohammed Al Ajrami

Muna Elwerr

Naheel Fayad Dajani

Prof. Yousif Bilto

Randa George Naffa

Waleed Alhadidi

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SOCIAL COMMITTEE

Chairperson

Naheel Fayad Dajani

Members:

Amira Mohammed AL-Shinnawi Anas Talal Bahjat AL-Shishani Ayda Yousef Hallis Basima Kamal Ata AL Jaabari Dina Ismael Ibraheem Al Qazaz Duha Mustafa Ali Hassan Dunya Abdul Aziz Abdul Rahman Yasseen Emad Samih Abdellatif Al Sharaia Ghaleb Awad Ghaleb Haifa Haddad Hanan Hamed Amin Haneen Ismail Fuad Abaza Hanin Hijjawe Husam Fakhri Qouzah Maher Anton Altarazi Manar Rafiq AL-Dweik Mohammad Ahmad AL-Khateeb Mouna Abdullatif Alzaeim Neda Issa Mansour Osama Jaber Mustafa Randa George Naffa Rawan Fadel Abu-Zineh Suzan Atalla AL-Bdour Tareq Abdul –Aziz Yousef Srour

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JORDAN SOCIETY FOR MEDICAL LABORATORY SCIENCES

(JSMLS)

Executive Board

Name Position

Abdul Aziz Hassan Masoud President

George Zuraikat Vice-president

Muna ELWerr Secretary

Mahmoud Zaidan Treasurer

Dr. Mohammed Abu Zaid Member

Randa George Naffa Member

Waleed Alhadidi Member

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Association of Laboratory Proprietors and Medical Analysis(ALPMA)

Executive Board

Name Position

Dr. Salwa O. Amarin President

Dr. Haseeb Sahyoun Vice-President

Mohammed Al Ajrami Secretary

Dr. Bashar Qousous Treasurer

Dr. Mohammed Abu Zaid Member

Abdul Aziz Hassan Masoud Member

Waleed Alhadidi Member

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International Federation of Clinical Chemistry and Laboratory

Medicine

Executive Board Name Position Prof. Maurizio Ferrari President

Dr. Graham Beastall Past President

Prof. Sergio Bernardini Secretary

Prof. Tomris Ozben Treasurer

Dr. Rolf Hinzmann Corporate Rep.

Prof. Daniel Mazziotta Member †

Dr. Rosa Sierra-Amor Member

Prof. Vanessa Steenkamp Member

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ARAB FEDERATION OF CLINICAL BIOLOGY (AFCB)

Executive Board

Prof. Mohammad Shaarawy Honorary President Dr. Kamel Hassan President Prof. Abdelrazaq Hedili Vice - President Prof. Chabraoui Layachi Past President Osama Najjar General Secretary Dr. Mohammed Touimi-Benjelloun Treasurer Prof. Yousif Bilto Member Dr. Adnan El-Khatib Member Dr. Christian Haddad Member Dr. Ossama Mansour Member Dr. Abdul Halim Chachou Member Dr. Ayad Aboud Member Dr. Samir Charjabi Member Dr. Salwa O. Amarin: HEAD OF MAIN OFFICE FOR DOCUMENTATION AND PUBLICATIONS FOR ARAB FEDERATION OF CLINICAL BIOLOGY (AFCB). Amman-Jordan

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SCIENTIFIC COMMITTEE

Chairman

Prof. Yousif Belto

Members

Prof. Asem Shehabi

Dr Faisal Abu farsakh

Dr Nashat Dahabreh

Dr. Hani Ababneh

Dr. George Sahyoun

Dr. Issa Abu Dayyeh

Mr.Nael Soudi

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EXHIBITION COMMITTEE

Randa George Naffa

Naheel Fayad Dajani

Neda' Issa Mansour

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FINANCIAL COMMITTEE

Bashar Qousous

Haseeb Sahyoun

Mahmoud Zaidan

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نضع االشعاررااتت ااألرربعة

Under Patronage of Her Royal Highness Princess Basma Bint Talal



Towards a better service of patients نحوو خددمة أأفضلل للمررضى

In collaboration with the International Federation of Clinical Chemistry and Laboratory Medicine

& The Arab Federation of Clinical Biology

Landmark Hotel - Amman April 7-9, 2016 Amman-Jordan

Scientific Program &

Abstract's Book

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The 4th International Jordanian Conference of the Jordan Society for Medical Laboratory Sciences The 1st for the Association of Laboratory Proprietors and Medical Analysis

TIME – TABLE AT- A- GLANCE

THURSDAY April 7, 2016

08.00 – 13.00 *Registration Landmark Hotel-Amman

*WORKSHOP Thursday 7 April, 2016

08:15 – 13.00 Workshop (For Workshop Registered only) Venue: Landmark Hotel-Amman, Rum Hall 1

14:00 – 15.00 * Opening Ceremony

Opening of the Medical Exhibition Followed by Cocktail Reception

*Seminar The Future of Laboratory Medicine in Jordan to Where?

*Poster Sessions

09:00-16:00 Friday 8-4-2016 Saturday 9-4-2016

GALA Dinner 8pm

Friday 8-4-2016

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OPENING CEREMONY PROGRAM (THURSDAY April 7, 2016)

Venue: Landmark Hotel - Amman

“Venue Hall” 14:00 Opening of the Medical Exhibition “Royal Hall” 14:30: *National Anthem

14:35: *Citation from the Holy Qur'an Master of Ceremony Hamad Nejem

14:40: Address of the President of the Conference

Dr. Salwa Amarin Address of the honorary President of the Arab Federation of Clinical Biology Prof. Mohammed Sharawi Address of the President of the Arab Federation of Clinical Biology Dr. Kamil Hassan Address of the President of the International Federation of Clinical Chemistry and Laboratory Medicine. Prof. Maurizio Ferrari Address of the Minister of Health H.E. Dr.Ali Hyasat Address of the Minister of Labor H.E. Prof. Nidal Alkatamine

Conference Patronage Address

Followed by Cocktail Reception

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Seminar

16.00-18.00 The Future of Laboratory Medicine in Jordan to Where?

Coordinator Prof.Yousif Y. Bilto Speakers Dr. Qasem. Rahahleh Representative from the Ministry of Health Dr. Aktham Haddadin Representative from the Ministry of Health Abdul Aziz Masoud President of the Jordan Society for Medical Laboratory Sciences Dr. Salwa Amarin President of the Association of Laboratory Proprietors and Medical Analysis Dr. Haseeb Sahyoun Representative from private Sector

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FRIDAY April 08, 2016

08:00-08:30 REGISTRATION TIME

Rum Hall 1 Session 1: Plenary Lectures: Recent Advances Moderators: Prof. Maurizio Ferrari; Prof. Maher A. Sughayer

08:30-09:10 Circulating Nucleic Acids: a new tool for Laboratory Medicine Prof. Maurizio Ferrari, IFCC President, Italy.

09:10-09:50 Personalized medicine and the role of liquid biopsy. Prof. Maher A. Sughayer, MD, FCAP, King Hussein Cancer Center, Jordan.

09:50-10:30 Clinical Applications of Stem Cells. Prof. Abdalla Abadi. National Center of Cell Therapy, The University of Jordan.

10:30-11:00 Coffee Break TIME

Rum Hall 1 Session 2: Plenary Lectures: Recent Advances Moderators: Prof. M. Sharawi; Prof. Imad Fadl-Elmula

11:00-11:40 From Philadelphia Chromosome to Imatinib Mesylate (anticancer drug); A Story of Success. Prof. Imad Fadl-Elmula, University of Khartoum, Sudan.

11:40-12:20 Serum Biomarker Panel in the Early Diagnosis of Lung Cancer. Prof. M. Sharawi, Cairo University, Egypt.

12:20-12:50 Improved Algorithms for HIV Screening - an example where better is also less expensive. Dr Frank Ryan, UAE.

12:50-14:00 Friday Prayer and Lunch Break

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TIME

Rum Hall 1 Session 3: Oral Presentations: Cancer Session Moderators: Dr. Abdalrazag Hedhili; Dr. Mamoun Ahram.

14:00-14:30 Pesticides, mycotoxins and breast cancer. Dr. Abdalrazag Hedhili, Tunes.

14:30-15:00 Differential Expression and Androgen Regulation of microRNA in Breast Cancer Cells. Dr. Mamoun Ahram, The University of Jordan.

15:00-15:30 The Androgen Receptor Agonist, CL-4AS-1, Possesses Unique Effects on Breast Cancer Cells: A Potential Therapeutic Benefit. Dr. Mamoun Ahram, The University of Jordan.

15:30-16:00 Identification and Characterization of Urinary Micro-peptides as Potential Biomarkers for Early Detection of Ovarian Cancer. Dr. Sulafa S. E. Murgan, University of Khartoum, Sudan.


Rum Hall 1 Session 4: Oral Presentations: Microbiology Session Moderators: Dr. Hani Ababneh; Dr. Ameer M.S. Ali

16:30-17:00 Laboratory Biomarkers of Rheumatoid Arthritis, Multiparametric Approaches. Prof. M. Sharawi, Cairo University, Egypt.

17:00-17:20 Prevalence of Exfoliative Toxins and Toxic Shock Syndrome Toxin-1 Encoding Genes among Coagulase Positive Staphylococcus. Dr. Hala I. Al-Daghistani, Al-Balqa’ University, Jordan.

17:20-17:40 The re-emergence of pertussis in Palestine as revealed by archived samples tested by PCR. Dr. Kamal Dumaidi, Arab American University Jenin, Palestine

17:40-18:00 Latent Tuberculosis Infection (LTBI) Among House Hold Contacts of Patients with Pulmonary Tuberculosis In Kassala State: Revisiting The Tuberculin Skin Test (Mantoux Test). Dr. Brima M. Younis, University of khartoum, Sudan.

18:00-18:20 Diagnostic predictive values of the Hain GenoType MTBDRsl Assay in detecting anti-tuberculous drug resistance among M.tuberculosis Isolates. Muatsim A.M. Adam, Federal Ministry of Health, Khartoum, Sudan.

18:20-18:40 Gastrointestinal infection Etiological Agent and Miss Identification Of Some Pathogenic bacteria like Campylobacter Dr. Nawal S. Faris. Zarka Private University.

Poster Session

09:00-16:00 Friday 8-4-2016

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TIME

Rum Hall 2 Session 3: Oral Presentations: Genetics Moderators: Dr. Christian Haddad; Dr. Belal Azab

14:00-14:30 Clinical Application of Next Generation Sequencing. Mohannad Yacoub, Specialty Hospital, Amman , Jordan.

14:30-15:00 Molecular Diagnosis of Mucopolysaccharidosis, Retinitis Pigmentosa (RP) and Leber Congenital Amaurosis (LCA) using Sanger and Next Generation Sequencing. Dr. Belal Azab. The University of Jordan.

15:00-15:30 Epidermal Growth Factor Receptor Expression and Genetic Variation in Six Types of Cancer in the Arabian Gulf Region. Dr. Raed Hashem Mohieddine Qaddourah, Jordan.

15:30-16:00 Genetic Association of Single Nucleotide polymorphisms with Multiple Sclerosis in Jordan. Dr. Mamoun Ahram. The University of Jordan.


Rum Hall 2 Session 4: Oral Presentations: Clinical Chemistry Moderators: Dr. Faisal Abu Farsakh; Dr. George Sahyoun

16:30-17:00 The impact of bladder monoclonal origin and intraluminal seeding mechanism in management of superficial bladder cancer. Prof. Imad Fadl-Elmula, University of Khartoum, Sudan.

17:00-17:30 Neonatal Screening: Current findings and New Developments Dr. George Sahyoun, MedLabs Consultancy Group.

17:30-17:50 In vitro Enhancement of Pancreatic β cells Proliferation by Gymnema sylvestre: A Regenerative Capacity of an Insulinotropic Medicinal Herb Violet Kasabri, The University of Jordan.

17:50-18:10 Evaluation of fatty liver in hypercholesterolemic patients (one year experience at outpatient clinics). Arwah Al-Homran. King Hussien Medical Center.

18:10-18:30 Pre-analytical Errors Survey in the Major Palestinian Hospitals. Dr. Muayyad Ghoul, Dept. of Medical Laboratory Sciences, Al-Quds University. Palestine.

20:00-23:00 GALA DINNER

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SATURDAY April 09, 2016

08:00-08:30 REGISTRATION TIME

Rum Hall 1 Session 1: Plenary Lectures: Traditional Medicine Moderators: Dr. Kamil Hassan; Prof. Yousif Y. Bilto

08:30-09:10 P4 Medicine: Predictive, Preventive, Personalized and Participatory. A new trend in Laboratory Medicine. Prof. Maurizio Ferrari, IFCC President, Italy.

09:10-09:50 Evidence Based Tradtional Medicine: A Scientific Wish. Prof. Dr. Fatima Afifi. The University of Jordan.

09:50-10:30 Medicinal Herbs: Effects on Clinical Laboratory Results and Antioxidant Markers. Prof. Yousif Y. Bilto, The University of Jordan.


Rum Hall 1 Session 2: Plenary Lectures: Geriatric Medicine Moderators: Dr Bernard GOUGET; Prof. Layachi Chabraoui

11:00-11:40 The Elderly between Reality and Ambition. Haifa Al-Bashir. President & Founder of White Beds Society.

11:40-12:20 When outside the norm is normal; is the Geriatric patient any different? Dr. Lana Halaseh, Jordan University Hospital.

12:20-13:00 Differential Laboratory Diagnosis of Dementias. Prof. Sergio Bernardini, Executive Board Secretary of IFCC, Italy.

13:00-14:00 Lunch Break

Poster Session 09:00-16:00

Saturday 9-4-2016

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Circulating Nucleic Acids: a new tool for Laboratory Medicine

Prof. Maurizio Ferrari, IFCC President, Italy Circulating Nucleic Acids: a new tool for Laboratory Medicine ABSTRACT

Advanced genetic diagnostics based on circulating molecular markers requires innovative methods for the detection of minority mutant alleles. This is particularly true in the case of mixed samples, where mutations are present at a low concentration among a background of wild-‐type sequences. The presence of fetal DNA in maternal plasma represents a source of genetic material which can be obtained non-‐invasively. To date, the translation of noninvasive prenatal diagnosis from research into clinical practice has been rather fragmented, and despite the advances in improving the analytical sensitivity of methods, distinguishing between fetal and maternal sequences remains very challenging. Thus, the field of noninvasive prenatal diagnosis of genetic diseases has yet to attain a routine application in clinical diagnostics. On the contrary , fetal sex determination in pregnancies at high risk of sex-‐linked disorders, tests for fetal RHD genotyping and non-‐invasive assessment of chromosomal aneuploidies are now available worldwide. Most of the molecular alterations found in cfDNA circulating in plasma reflect the genetic and epigenetic changes found in primary tumors and, thus, the analysis of such tumor cfDNA might be valuable for tumor diagnosis and monitoring. Highly sensitive methods are required to detect those alterations among larger quantities of non-‐altered cfDNA molecules. The clinical value of cfNAs circulating in plasma is already more than a theoretical idea, since the characterization and the quantitation of such nucleic acids (NAs) have been shown to be complementary tools. It is therefore expected that in the coming years, an improved understanding of the relationship between CNAPS and the molecular biology of cancer will lead to better diagnosis, management, and treatment.

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Personalized medicine and the role of liquid biopsy

Maher A. Sughayer MD, FCAP, Chair Dept. of Pathology and Lab. Medicine King Hussein Cancer Center

ABSTRACT Personalized medicine or precision medicine as it is sometimes called involves tailoring

medical decisions of treatment options, medication choices, prognosis, monitoring and

screening according to the individual’s own disease characteristics such as the person’s

cancer genetic profile or according to the individual’s own genetic makeup. To

accomplish this an invasive tissue biopsy especially of cancer is usually performed.

These biopsies may need to be repeated to monitor changes in the tumor profile. The

tissue biopsies are known to be associated with certain risks to the patient as they are

invasive in addition to being painful, costly and may need hospitalization. Tumors on the

other hand can shed cells to the circulation (circulating tumor cells) or cell free DNA.

These can be used to derive not only information about the tumor similar to that

provided by the tissue biopsy but have the advantages of being simpler, noninvasive,

cheaper and able to provide real time information about the tumor and overcome the

limitation of tumor heterogeneity. Cell free DNA assays are being heavily researched

nowadays and increasingly utilized for these reasons and for being simpler than

circulating tumor cells. The applications of cell free DNA include: Characterization of

molecular profiles in lieu of tissue, monitoring response to therapy, minimal residual

disease, tumor evolution with therapy and pharmacodynamics.

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Clinical Applications of Stem Cells

Prof. Abdalla Abadi. National Center of Cell Therapy, The University of Jordan.

ABSTRACT

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From Philadelphia Chromosome to Imatinib Mesylate; A Story of Success

Prof. Imad Fadl-Elmula Faculty of Medical Laboratory Science, Al Neelain University,

President of the Sudanese Society of Clinical Biology, Khartoum, Sudan, E-mail: [email protected]

Website. www.fadl-elmula.com

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Serum Biomarker Panel in the Early Diagnosis of Lung Cancer

Prof. Dr. Mohamed Shaarawy. PhD, FRCPath (UK) Professor of Clinical Biochemistry, Faculty of Medicine, Cairo University, President of Egyptian Society of Clinical Chemistry & Lab Medicine

ABSTRACT We defined a panel of serum tumor markers ( ProGRP,CEA,SCC,and CYFRA21-1 ) to

help the detection of both SCLC and NSCLC with high specificity among subjects with

high risk factors and with high sensitivity among patients with lung cancer. This panel

could provide clinical physicians with diagnostic information concerning lung cancer

when they first evaluate a patient with a high risk factor.

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Pesticides, Mycotoxins and Breast Cancer

A. Hedili1, H. Belhassen1, R. Ghali1, D.Amira1, Jiménez-Díaz2, J.P. Arrebola2, N. Olea2

1Centre d’Assistance medicale Urgente Mahmoud Yacoub Tunisia and Laboratory of Toxicology and Environment (LR12SP07), Tunis, Tunisia

2Instituto de Investigación Biosanitaria ibs.GRANADAl, Granada E-18012, Spain , CIBER Epidemiology and Public Health (CIBERESP), E-18071 Granada, Spain and Radiation Oncology Department. Virgen de las Nieves University Hospital, Granada, Spain

ABSTRACT

Since the 70s, several epidemiological studies have referred to the involvement of

certain pesticides and mycotoxins in several pathologies related to the occupationally

exposed and / or through the consumption of food contaminated with these substances,

particularly cancer pathologies (breast, lung, and liver …cancers).

Our research team of the research laboratory toxicology-environment LR12SP07

Tunisia with the collaboration of the Instituto de Investigación Biosanitaria , the CIBER

Epidemiology and Public Health Center (CIBERESP) and Radiation Oncology

Department. Virgen de las Nieves University Hospital Granada spain , has

conducted a several studies touching the correlation between pesticides (POPs),

mycotoxins (especially zéarolenone) and breast cancer (n = 69 Tunisian women)

Our findings** suggest a potential association between exposure to at least one

organochlorine pesticide, zearalenone (a-ZAL ) and breast cancer risk.. However, our

results should be interpreted with caution, and further research is warranted to confirm

these findings. ** Assessment of estrogenic and anti-androgenic activities of the mycotoxin zearalenone and its metabolites using in vitroreceptor-specific bioassays Jose-Manuel Molina-Molina a,b,c,*, Macarena Real a,c, Inmaculada Jimenez-Diaz a,c, Hidaya Belhassen d, Abderazzak Hedhili d, Pablo Torne e, Mariana F. Fernandez a,b,c, Nicolas Olea a,b,c Food and Chemical Toxicology 74 (2014) 233–239

** Zearalenone and its metabolites in urine and breast cancer risk: A case-control study in Tunisia. H. Belhassen a, I. Jiménez-Díaz b,⇑, J.P. Arrebola b,c,d, R. Ghali a, H. Ghorbel a, N. Olea b,c, A. Hedili. A Chemosphere 128 (2015) 1–6

** Risk of female breast cancer and serumconcentrations of organochlorinepesticides and polychlorinated biphenyls: A case–control studyin Tunisia. Juan P. Arrebolaa,b,�, Hidaya Belhassen c, Francisco Artacho-Cordón b, Ridha Ghali c, Hayet Ghorbel c, Hamouda Boussen d, Francisco M. Perez-Carrascosa a, José Expósitoa, Abderrazek Hedhili c, Nicolás Olea b Science of the Total Environment 520 (2015) 106–113

**Assessment of the exposure to BPA, benzophenones and parabens in Tunisian women: a pilot study. I. Jiménez-Díaz*1,4, F. Artacho-Cordón1,2, F. Vela-Soria1, H. Belhassen3, J.P. Arrebola1,4,5, M.F. Fernández1,2, R.Ghali3, A. Hedili3, N.Olea1,2,4 Soumis au journal " Science of the Total Environment".

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DIFFERENTIAL EXPRESSION AND ANDROGEN REGULATION OF microRNA IN

BREAST CANCER CELLS

Mamoun Ahram, Rand Zaza, Ebtihal Mustafa, Heba Jarrar, Razan Al-Saber, Shatha Abu Hammad, Mariam Hodhod, Randa Bawadi, Salam Abdullah, Malek Zihlif

Department of Physiology and Biochemistry, Faculty of Medicine, The University of Jordan, Amman, Jordan, E-mail: [email protected]

ABSTRACT Background: MicroRNA molecules (miRNAs) have an important impact on cell

behavior and their expression levels can classify tumors according to their type and

prognostic characteristics. Accumulating studies have illustrated alterations in the

expression of microRNAs in association with the expression of the androgen receptor

(AR) or upon treatment of prostate cancer cells with its agonists. AR seems to play an

interesting role in the tumorigenic process of breast cancer where it is associated a

favorable outcome of breast cancer. We hypothesized that AR agonists may control the

behavior of breast cancer cells via modulating the expression of miRNAs.

Methodology: Using PCR arrays, we examined the expression of 84 miRNAs in three

breast cancer cells, the luminal, ER+/PR+/HER2+/AR+ MCF-7 and T47D cells, as well

as the molecular apocrine model, MDA-MB-453, cell line. The same technology was

used to assess potential mRNA targets of miRNAs.

Results: Each cell line had distinct miRNA expression with let-7a and -7b being

markers of the MDA-MB-453 cells, and miR-205 was a marker for the luminal cell lines.

Treatment with the AR agonist, CI-4AS-1, resulted in dissimilar alterations in miRNA

expression among the cell lines. CI-4AS-1 further reduced the expression of miR-205-

5p in the MDA-MB-453 cells. This reduction paralleled a dramatic morphological

alteration where the cells underwent an epithelial-mesenchymal transition (EMT) in

association with up-regulation of expression of ZEB1, an inducer of EMT and a target of

miR-205-5p. The same phenomenon was observed with the metalloprotease-13 (MMP-

13), which is up-regulated upon activation of AR concomitant with the down-regulation

of its translational suppressors, miR-100-5p and miR-125-5p.

Conclusions: Collectively, these data indicate that miRNA molecules can differentiate

breast cancer cells from each other and that AR may control the biological behavior of

breast cancer cells via modulating the expression of miRNAs.

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THE ANDROGEN RECEPTOR AGONIST, CL-4AS-1, POSSESSES UNIQUE EFFECTS ON BREAST CANCER CELLS: A POTENTIAL THERAPEUTIC BENEFIT

Mamoun Ahram, Ebtihal Mustafa, Shatha Abu Hammad, Mariam Hodhod, Malek Zihlif Department of Physiology and Biochemistry, Faculty of Medicine, The University of Jordan, Amman,

Jordan

ABSTRACT Background: The notable expression of the androgen receptor in breast cancer

suggests an important biological role and, hence, a window of utilizing it as a

therapeutic target. Due to the undesirable side effects of androgen receptor agonists,

attempts have been undertaken to develop tissue-selective androgen receptor

modulators (SARMs). One such SARM is known as Cl-4AS-1, which has previously

been shown to act more like the natural AR agonist, dihydrotestosterone (DHT). We

aimed to examine this drug more closely at the molecular and cellular levels.

Materials and methods: Different breast cancer cell lines were utilized, mainly the

luminal, receptor-positive MCF-7 cells, the molecular apocrine ER-/HER2+/AR+ MDA-

MB-453 cells, and the triple negative/AR- MDA-MB-231 cells. Molecular effects were

examined using PCR arrays and RT-PCR, and various cellular techniques were used to

examine the cellular effects. Results: There was high and significant concordance in regulation of gene expression

between DHT and Cl-4AS-1. In addition, both DHT and Cl-4AS-1 caused a similar

morphological change of the MDA-MB-453 cells into a mesenchymal phenotype.

Treatment of cells with testosterone and DHT resulted in induction of proliferation of the

MCF-7 cells, but no effect was observed on the growth of the MDA-MB-453 and MDA-

MB-231 cells. On the other hand, increasing doses of Cl-4AS-1 resulted in an identical

dose-dependent inhibition on the growth of the three cell lines. This inhibition was a

result of induction of apoptosis. Upon analyzing cell cycle progression, Cl-4AS-1, but

not testosterone or DHT, was found to a block in the early stages of the S-phase

followed by DNA degradation.

Conclusion: These results indicate that Cl-4AS-1 has unique properties making it a

possible drug for treatment of breast cancer.

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Identification and Characterization of Urinary Micro-peptides as Potential Biomarkers for Early Detection of Ovarian Cancer

Sulafa Seif Eldin Murgan, Eltahir Awad Gasim Khalil Department of Clinical Pathology & Immunology, Institute of Endemic Diseases, University of Khartoum

ABSTRACT Introduction: Ovarian Cancer is currently the second major lethal gynecologic

malignancy in Sudanese Women. Most cases are discovered late due to the silent signs

of the disease. Moreover, low diagnostic sensitivity and specificity of CA125 antigen as

a biomarker for ovarian cancer make early diagnosis a challenging task. Proteomics

and peptidomics have been used as biomarkers for the diagnosis for many cancers and

diseases. This study aims to test urinary micro-peptides as potential diagnostic

biomarkers for the early diagnosis of ovarian cancer. Materials and methods: This is a longitudinal, analytical and hospital-based study that

was conducted over two years in Greater Khartoum State, Sudan. Following informed

consent, urine, plasma and ascitic fluid samples were collected from 112 women

enrolled in the study (with histologicall proven ovarian cancer) and 200 apparently

healthy female comparators. Follow-up was done every 6 months for a total of two

years after ovarectomy and chemotherapy. SDS-PAGE was used to determined urinary

micro-peptides. Plasma CA125 antigen was measured using ELISA.

Results: The overall mean age of patients 46.5±27.5, while that of the female

comparators was 42.5±22.5. More than forty percent (50/112, 44.6%) of the patients

developed symptoms of abdominal discomfort, pelvic pain and irregular bleeding during

the last 6 months. A tird (38/112, 33.9%) developed symptoms the last year, 5.4%

(6/112) and 14.3% (16/112) developed symptoms within two and three years

respectively. A third (44/112, 39.3%) were single, 40.2% (45/112) were married and had

no children and 20.5% (23/112) were married and had children. A minority (7/112,

6.3%) of the patients had another type of cancer (endometrial, colon, lung, breast and

brain cancers). The ovarian tumors serous adenocarcinoma in the majority (81.1%,

91/112). With stages III & IV in 39.6% and 33% respectively. A quarter (24.1%) was

seen at stage II. A minority (3.3%) was diagnosed early i.e. stage I. The mucinous type

was seen in 11 patients (11/112, 9.8%), with 18.2% at stage II, 45.5% at stage III and

36.45% at stage IV. The endometroid type was seen in 10.7% (6/112) of patients with

3.6% at stage, 1.8% at stage III. A minority was reported as germinoma (1/112, 0.8%),

poor differentiated as 2.7% (3/112).

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Protein bands of sizes 15, 35 and 45 kDa were detected in patients urine samples but

were not detectable in urine of healthy comparators. Protein band size 15kDa was

detected in 37.5% (42/112) of the patients, while the 35 kDa was seen in 21.4%

(24/112). The third protein band (size 45 kDa) was detected in 14.3% (16/112) of the

patients. More than half of the patients (66/112, 58.9%) showed no micro-peptide

urinary bands. The 6 months follow up showed only the 45 kDa protein band in 4.7% of

patients. CA125 antigen was seen in the plasma of 22.5% patients .

Conclusion: Urinary micro-peptides can be sensitive and specific for early detection of

ovarian cancer compared to CA125 plasma. Sequencing and further characterization of

these urinary micro-peptides is underway.

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Laboratory Biomarkers of Rheumatoid Arthritis, Multiparametric Approaches


ABSTRACT Rheumatoid arthritis is a systemic autoimmune disease that is an important socio-

economic health problem. Recent evidence about the immunopathogenesis of this

disorder might open new perspectives for a more appropiate laboratory approach. In

this review, our attention is focused on the clinical relevance and approprateness of

laboratory biomarkers correlated with early diagnosis, prognosis, evolutive aspects of

the disease and tharapeutic efficacy.

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The re-emergence of pertussis in Palestine as revealed by archived samples tested by PCR

Kamal Dumaidi, PhD and Amer Al-Jawabreh, PhD

Assistant Prof. Medical Molecular Virology, Arab American University Jenin, Palestine

ABSTRACT Background: Pertussis caused by Bordetalla pertussis is a vaccine-preventable

disease causing whooping cough in humans of all ages. Around 300,000 deaths occur

worldwide every year. This study reports the re-emergence of pertussis cases in

Palestine.

Methods: Archived nasopharyngeal DNA samples were collected from 268

clinicallyconfirmed cases between the years 2004 and 2008. Laboratory diagnosis was

done on all DNA samples using polymerase chain reaction (PCR).

Results: Approximately 49% (130/268) were confirmed by PCR. A pertussis peak was

shown to occur in 2008 with 77% (100/130) of PCR-confirmed cases isolated in that

year. A second peak was reported in 2014. Pertussis existed in all Palestinian districts

with highest incidence in Ramallah, Bethlehem, Jenin and Al-Khalil. Over half of the

PCR-confirmed cases (68/120) were less 2 months old. The infection rate among the

study group who had three vaccine doses (at 2, 4 and 6 months) was 38% and 50%

after the fourth dose at the 12th month.

Conclusion: Pertussis in Palestine peaked two times since the year 2000, once in 2008

and again in 2012. Prevalence in Palestine is one of the highest in the region. High

efficacy whole-cell vaccine or acellular vaccine is recommended. Additionally, pertussis

vaccination policy for Palestine should be reconsidered.

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Latent Tuberculosis Infection (LTBI) Among House Hold Contacts of Patients with Pulmonary Tuberculosis In Kassala State: Revisiting The

Tuberculin Skin Test (Mantoux Test). Samia Abdalrhman Osman1, Alaa Hassan Ahmed Yousif2, Fath Elrahman Mohamed Idris3, Abd

Elgadir Ali Bashir4, Brima Musa Younis5, Ahmed Mudawi Musa5, Eltahir Awad Gasim Khalil5

Tuberculosis Research Group/Sudan 1Omdurman Islamic University, Omdurman, Sudan 2Department of Medicine, Faculty of Medicine, University of Khartoum 3Chest Hospital, Khartoum North Teaching Hospital, Khartoum North, Sudan 4Khartoum State, Ministry of Health, Khartoum, Sudan 5Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan ABSTRACT Background: One third of the world’s population is believed to be latently infected with

TB. Household contacts (HHCs) of patients with active pulmonary TB are at a greater

risk of developing TB. Early investigation and identification of LTBI individuals may

reduce progression to active TB and increase the detection rate for TB. Objectives: This study aimed to determine LTBI point prevalence among HHCs and

CCs of active TB patients using the Tuberculin Skin Test (TST; Mantoux test) and whole

blood IFN-γ release assay using PPD as stimulant. The study also aimed to present TST

(Mantoux test) as an accurate, simple and not costy diagnostic tool for LTBI.

Study design and Setting: This was a prospective, longitudinal and community-based

study with 614 days duration that was carried out in Greater Kassala area in Kassala

State, Eastern Sudan. The study represents the East Leg of the LTBI study of the

Tuberculosis Research Group/Sudan that was started in 2009 in River Nile State. Index

pulmonary TB cases were identified from the records at the TB treatment Centres at

Kassala Teaching Hospitals and then consented with their HHCs and Community

contacts (CCs) at their homes.

Materials & Methods: Total coverage of house-hold contacts (HHCs) of registered and

consented smear positive pulmonary TB patients (index cases) in Tuberculosis

Treatment Centers in Kassala Teaching Hospital, Kassala State during June 2012 to

March 2014. Consenting Community contacts (CCs) from the same neighborhood with

no family history or contact with pulmonary TB cases were randomly selected and

enrolled. This was done following public enlightenment meetings. Five and a half mls of

EDTA+heparin blood were collected ESR and IFN-γ release assays using Purified

Protein Derivative (PPD) as stimulant. Tuberculin skin testing was performed by injecting

5 tuberculin units (TU) and read after 72 hours using the ball-point pen technique. A

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reaction of ≥10 mm was considered as reactive for LTBI. Three tubes with one ml in

each was taken for whole blood stimulation.

Results & Discussion: A total of 768 consented volunteers were recruited in the study,

245 were HHCs and 523 were CCs with an overall mean age of 35.2±16.1 years and a

male: female ratio of 1:2. The mean ages of HHCs and the CCs were 35.6 ± 15.7 years

and 30.6 ± 11.7 years respectively (p=0.99). The male: female ratio for HHCs and CCs

was 1:2. TST was performed two times 614 days follow up.The overall mean TST

induration at screening [Day 0] was 4.7±5 mm, while the screening TST mean

induration for the HHCs and CCs was 4.6±5.5 mm and 2.8±3 mm respectively

(p=0.000). The follow up mean TST induration increased significantly to 9.1±7.2 mm and

4.4±3.2 mm for HHCs & CCs respectively (p=0.001). The overall mean IFN-γ production

level was 0.09±0.7 IU/ml. The screening and follow up mean of IFN-γ levels were

significantly different for the HHCs [0.655 ± 0.17 IU/ml; 0.570± 0.152 IU/ml] compared to

the CCs [0.055 ± 0.036 IU/ml; 0.019± 0.021 IU/ml] (p=0.000). Using TST induration of ≥

10 mm as a tool for LTBI diagnsosis, 26.7% (205/768) were reported as having LTBI in

the study volunteers. More than 40% of these were seen among HHCs (113/245;

46.1%), while more than a third (36.7%; 192/523) among CCs tested positive (p=0.03).

The overall point prevalence among the study population was reported as 267/1000

individuals. LTBI point prevalence among HHCs was 461/1000 individuals, while that

among CCs was 367/1000 (p=0.008). Using IFN-γ production level of ≥ 0.35 IU/ml as a

cutoff level, the LTBI overall point prevalence was 279/1000 individuals (214/768). The

point prevalence among HHCs was 440/1000 individuals (108/245), while that among

CCs was 203/1000 individuals (106/523) (p= 0.07).

Eleven individuals [HHCs=9; CCs=2] who developed pulmonary TB had strongly

reactive TST [induration≥ 15 mm] and mean IFN-γ levels below the cut-off point of 0.35

IU/ml.

Conclusion: LTBI is prevalent in Kassala State, Eastern Sudan. TST is a simple, cheap

and efficient tool for diagnosis of LTBI and triaging individuals for LTBI treatment. IFN-γ

release assay gave a marginally higher LTBI point prevalence, but failed to identify

individual who progressed to overt disease.

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Diagnostic predictive values of the Hain GenoType MTBDRsl Assay in detecting anti-tuberculous drug resistance among M.tuberculosis Isolates.

Muatsim Ahmed Mohammed Adam1, Hamdan Mustafa Hamdan2, Eltahir Awad Gasim Khalil3 1. National Reference Tuberculosis Laboratory, Public Health Laboratory, Federal Ministry of

Health, Khartoum, Sudan. 2. National Tuberculosis control Program, Sudan. 3. Tuberculosis Research Group/Institute of Endemic Diseases, University of Khartoum, Khartoum,

Sudan.

ABSTRACT Background: Hain GenoType MTBDRsl Assay is nucleic acid amplification (NAA)

assay based on reverse hybridization with specific oligonucleotide probes on

nitrocellulose strips. The Hain GenoType MTBDRsl assay identifies M. tuberculosis

complex and detects resistance to fluoroquinolone, second line injectable drugs and

ethambutol evident as mutations of gyrA, rrs and embB genes respectively.

Objectives: This study aimed to evaluate the sensitivity, specificity, positive and

negative predictive values of the Hain GenoType MTBDRsl Assay using 1% proportion

method on LJ medium as gold standard. Materials and Methods: A total of 50 MDR strains were tested for second line anti-TB

drugs sensitivity by 1% proportion method on LJ medium and by Hain GenoType

MTBDRsl Assay.

Results: Five of the MDR isolates (5/50; 10%) showed resistance to at least one

second line anti-TB drug and one isolate (1/50; 2%) was XDR. The XDR strain was

concordantly detected by the two methods. One of two Kanamycin-resistant isolates

showed discordant result between the two techniques. Ofloxacin showed one false

positive and one false negative result in the Hain Genotype assay. Most discrepancies

were detected with Ethambutol. The sensitivity, specificity, positive and negative

predictive values [PPV and NPV] of the Hain Genotype assay for the study drugs were

respectively as follows: Ethambutol [90.4%, 60%, 63.3% and 90%]: for Kanamycin

[67%, 100%, 100% and 97.9%]: for Amikacin and Capreomycin [100%, 100%, 100%

and 100%]: for Ofloxacin [75%, 97.5%, 75% and 97.8%]. For XDR isolate the values

were 100%, 100%, 100% and 100% respectively.

Conclusion: Hain GenoType MTBDRsl Assay showed high specificity and negative

predictive values making it an acceptable, simple and time-saving technique for early

presumptive detection of resistance to second-line anti-TB drugs. Keywords: GenoType MTBDRsl Assay, TB, MDR, XDR-T , anti-TB drugs, Sudan.

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Gastrointestinal infection Etiological Agent and Miss Identification Of Some Pathogenic bacteria like Campylobacter

Dr. Nawal S Faris

Department of Allied medical sciences, Zarqa University. ABSTRACT Pathogenic bacteria can enter and infect the digestive tract when someone eats food or

drinks water that is contaminated. Examples of contaminated sources include raw or

undercooked eggs, poultry or beef, unpasteurized milk, and untreated water from lakes,

streams, and (occasionally) from community water supplies. The aims of our study are

strengthening of surveys of the cases of the gastrointestinal tract infection , more

knowledge of the causes leading to the gastrointestinal tract, also knowing the risk

factors which caused in Miss Identification of some pathogenic bacteria (mainly

Campylobacter and Yersinia, enterocolitica , then evaluate the number of persons who

have negative result and the reason for this lack of screening for all pathogenic bacteria

and search for Salmonella and Shigella only, Attach previous studies in the world on the

importance of isolating bacteria and number of Campylobacter positive samples and the

importance of taking the subject into account, finally culture characterization and

epidemiology of the isolated pathogenic bacteria in order to reach those goals we

carried out a survey of 484stool samples in the Department of Microbiology at Central

Laboratory of the Ministry of Health in Amman the capital of Jordan between January

2012 to December 2013 using of stool culture and biochemical test and antisera against

salmonella and shigella. Atotal of 484 stool samples were tested for 49 salmonella and

50 shigella , a total 99 stool samples were gave positive results for salmonella , and

shigella of with an overall prevalence of 20.5 %. The high number of negative results

due to misidentification of many pathogenic bacteria like Campylobacter and a wide

variety of other bacteria may sometimes cause diarrhea. These may include:

Aeromonas species, Staphylococcus aureus, Yersinia enterocolitica, Vibrio cholerae

and other Vibrio species.

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Clinical Application of Next Generation Sequencing

Mohannad Yacoub, Specialty Hospital, Amman , Jordan

ABSTRACT Next-generation sequencing (NGS) has significantly contributed to the transformation of

genomic research by providing access to the genome for analysis, by significantly

decreasing the sequencing costs and increasing the throughput. The next goal is to

exploit this powerful technology in the clinic, namely for diagnostics and therapeutics.

NGS provides a lot of possible clinical applications, the potential of some of the current

NGS systems to transition to the clinic, the identification of causative mutations for rare

genetic disorders through whole-genome or targeted genome resequencing, the

application of NGS for family genomics, and NGS data analysis tools. Here, I will

discuss the clinical applications of NGS and the obstacles that must be overcome prior

to widespread use in clinical decision making.

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Molecular Diagnosis of Mucopolysaccharidosis, Retinitis Pigmentosa (RP) and Leber Congenital Amaurosis (LCA) using Sanger and Nest Generation

Sequencing Dr. Belal Azab

The University of Jordan, Dept. of Clin. Lab. Sciences

ABSTRACT Mucopolysaccharidosis type I (MPS I) is an autosomal recessive storage disorder that

result as a consequence of a deficiency in the lysosomal hydrolase, α-L-iduronidase

enzyme encoded by IDUA gene. This enzyme’s function is the degradation of heparan

and dermatan sulphates. More than hundred mutations in IDUA gene have been

reported resulting in a wide variation in MPS I phenotypes. The aim of this study was

the detection of IDUA mutation in a couple who had two children affected with lethal

MPS I. The IDUA gene was analyzed by PCR and bidirectional sanger sequencing of

the coding region and exon-intron splice junctions in order to test for MPS I. Sequencing

revealed a novel new c.657delA mutation in exon six, in addition to nonpathogenic

polymorphisms. Identification of this mutation should facilitate the risk assessment and

prenatal diagnosis and genetic counseling for MPS I in incoming pregnancies for

families where the couple are both heterozygous for this mutation.

Around 100 Jordanian patients with nonsyndromic RP/ LCA are recruited and evaluated

at The University of Jordan Hospital Ophthalmology clinic. The ophthalmological

examination included best-corrected visual acuity (BCVA) using Snellen chart, slit-lamp

biomicroscopy, dilated fundus examination, optical coherence tomography (OCT, when

available), full-field electroretinogram (ERG), and visual evoked potential (VEP).

Patients age will be between 5 to 69 years. Exome sequencing for a custom made

panel of 94 genes is being performed using the Applied Biosystems Next Generation

sequencer at the CTC center at The University of Jordan. To discriminate between

pathogenic and nonpathogenic variants, the annotated sequencing data will be filtered

and prioritized based on the following criteria: (1) variant located in coding sequence;

(2) nonsynonymous variant; (3) nonsense variant; (4) short insertion or deletion variant

(indel) in coding sequence; (5) variant located at splice donor or acceptor site, and (6)

variant reported in flagged SNPs but not in common or multiple-location mapped SNPs

of the dbSNP137 database.

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GENETIC ASSOCIATION OF SINGLE NUCLEOTIDE POLYMORPHISMS WITH MULTIPLE SCLEROSIS IN JORDAN

Mamoun Ahram, Rand Zaza, Leena Ibayyan, Baha'a-Al den Mustapha, Said Dahbour, YacoubBahou,

Ammar El-Omar, Mohammad El-Khateeb, SalimAbderrahman Department of Physiology and Biochemistry, Faculty of Medicine, The University of Jordan, Amman,

Jordan, E-mail: [email protected]

ABSTRACT Multiple Sclerosis (MS) is a chronic inflammatory autoimmune disease of the human central

nervous system. Both genetic and environmental factors play a role in disease development

with unique distribution according to latitude and association of a number of genetic factors.

When we examined the willingness of MS patients to participate in long-term biomedical

studies, they had an actual participation of over 95% and 100% approval of re-contact, a

considerable positive view when compared to public participation. Approximately 85% of

patients preferred open consent with 37% of them preferring to renew their consent. We also

conducted a number of genetic studies to investigate the association of single nucleotide

polymorphisms (SNPs) within a number of genes with this disease. SNP genotyping was

performed using mainly two PCR-based techniques: restriction fragment length polymorphism

followed by PCR (RFLP-PCR) and Amplification Refractory Mutation System polymorphism

(PCR-ARMS).The analyzed genes included: Interleukin 7 receptor alpha (IL7Rα), the interleukin

2 receptor α chain (IL7Rα), the MER tyrosine kinase (MERTK), the tyrosine kinase 2 (TYK2),

and the intercellular adhesion molecule-1 (ICAM-1). Genetic analysis revealed variable

association of polymorphisms with MS not only among the genes, but also within the same

gene. For example, no significant association was found between MS and the IL-7R SNPs,

rs6897932 or the IL-2R rs3118470; however, a significant difference was found with regards to

the IL-7R rs11567685. The latter SNP is located within the promoter region of the gene,

whereas the former results in the formation of alternatively spliced mRNA and a soluble protein.

Within the MERTK gene, only rs687311 shows significant association with disease incidence,

but not other two SNPs. No conclusions could be made about association of rs34536443 within

TYK2 to MS susceptibility because of the low minor allele frequency (0.02) and small study

population size. In regards to two SNPs within the ICA gene that could potentially influence its

interaction with its ligands, the frequency of exon 6 homozygote E469K was significantly higher

in MS patients than in controls, but not the G241R allele and genotype distribution did not show

any significant difference between patient and control groups. Not only that these results offer a

glimpse towards genetic variations associated with MS, but also necessitate the need to

formulate strategies to perform Genome Wide Association Studies on the genetics of this

disease in Jordan.

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Epidermal Growth Factor Receptor Expression and Genetic Variation in Six Types of Cancer in the Arabian Gulf Region

Dr. Raed Hashem Mohieddine Qaddourah

Abstract As the understanding of cancer molecular pathology has progressed, novel therapies

targeting specific molecular entities shown to be involved in tumor progression have

emerged. Epidermal growth factor receptor (EGFR) is one of the first validated targets

for cancer therapy and has high diagnosis and prognosis potential. EGFR or HER1

(Human Epidermal Receptor 1) is a member of the HER family of cell surface growth

factors tyrosine kinase receptors. In this work we report data on the EGFR cell surface

expression and genetic variability in a total of 104 Arab cancer patients distributed into 6

groups of carcinoma types. We used automated IHC and a scoring method that

matches College of American Pathologist (CAP) criteria for measuring Her2neu (human

epidermal growth factor receptor 2) expression. We analyzed the genetic variation of

three markers in the EGFR gene; two SNPs: rs712829, (-216 G/T), located in a sp1

recognition site, rs712830 (-191 C/A) and intron 1 embedded CA repeat (SSR1), known

to impact EGFR cell surface expression level. The study also included an ethnically

matched control group. Our data show that EGFR expression varied according to

cancer types with the highest expression rate observed in lung cancer patients (95%)

and the lowest in patients with breast cancer (10%). EGFR expression level was

correlated with high grade tumors in Lung and Bladder urothelial carcinomas. Single

marker genetic analysis showed that the SSR1 marker Long (number CA repeat >35)

alleles as well as variant A of SNP rs712830 (-191 C/A) are associated with lung

adenocarcinoma with a (p <0.05 and odd ratio = 4.265). Furthermore analysis of the

three markers as a mini haplotype using Haploview and the SHEsis software platform,

identified two haplotypes that are significantly associated with lung (SSR1L/-216G/-

191A, p < 0.021, Odd Ratio = 5.364) and bladder (SSR1L/-216G/-191C, p < 0.033, Odd

Ratio = 2.322) cancers. Our data provide valuable insights into the genetic of EGFR in

Arab cancer patients and highlight the discrepancies in EGFR expression and genetic

variability between different studies and ethnic groups and point toward an

individualized EGFR characterization for each cancer patient to determine the most

adapted anti EGFR therapy.

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The impact of bladder monoclonal origin and intraluminal seeding mechanism in management of superficial bladder cancer

Prof. Imad Fadl-Elmula Faculty of Medical Laboratory Science, Al Neelain University,

President of the Sudanese Society of Clinical Biology, Khartoum, Sudan, E-mail: [email protected]

Website. www.fadl-elmula.com

ABSTRACT Bladder cancer is a common disease, worldwide it is ranking as the fourth and the

seventh most frequent cancer in men and women respectively. Based on the

histopathology (grading, and staging), bladder cancer can be classified in superficial

and muscle-invasive disease. In contrast to the muscle invasive ones, superficial

bladder cancer has a distinct natural history characterized by multiplicity, high recurrent

rate, and heterogeneous natural history. According to many investigators the multifocal

nature of superficial uroepithelial cancer, together with a propensity for recurrence

(polychronotopicity) is the results of intraluminal seeding of viable detached malignant

cells that results in genetically monoclonal multiple tumors. Thus the intraluminal

shedding and implantation of viable tumor cells have been proposed as the

mechanisms responsible for both synchronous and metachronous multifocal bladder

tumors. This is of considerable relevance for therapeutic strategies, suggesting that

complete endoscope removal of the primary tumor is often not enough to treat even

superficial bladder cancer because by, or during, the time of initial treatment several

micro satellite tumors are already implanted in the bladder. Therefore, additional

measures should be directed toward preventing tumor cell seeding and growth of the

already implanted ones. The intraluminal seeding mechanism implies more emphasis

on intravesical adjuvant therapy in superficial bladder cancer, including the use of

intravesical chemo- or immunotherapy and long interval follow-up for those patients.

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Neonatal Screening: Current findings and New Developments

George Sahyoun, Chief R&D Officer, MedLabs Consultancy Group Amman-Jordan, Email: [email protected]

ABSTRACT Neonatal Screening began in the 1960s when Dr. Guthrie was able to develop a method

for the screening of PKU in large numbers. Since then, many countries have

established screening programs for newborns in an attempt to detect inborn errors of

metabolism at an early enough stage to benefit the child, helping to avert serious health

complications, mental retardation and even death. The number of tests screened for by

different countries varies from 1 to over 40 disorders.

This presentation will give a brief introduction to neonatal screening. The presentation

will shed light on the neonatal experience at MedLabs, where over 60,000 babies have

been screened over the last 5 years, all of which were born in the Middle East. The

presentation will also talk about what is currently available in terms of different

screening panels offered by both the private and public sector and the techniques used

to detect the mentioned disorders.

The presentation will stress the importance of increasing awareness about the tests, the

benefits they bring to the patient, the family and society as a whole. The presentation

will end with where we need to go from here in the future in terms of neonatal

screening, the importance of cooperation between the private and public sectors and

that currently, more than 1:200 babies born in the Middle East, is born with one of the

45 metabolic disorders screened for by MedLabs.

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In vitro Enhancement of Pancreatic β cells Proliferation by Gymnema sylvestre: A Regenerative Capacity of an Insulinotropic Medicinal Herb

Violet Kasabri 1*, Fatma U. Afifi1, Yasser Bustanji1, Sundus Mashallah1,

Randa Naffa2 and Hala S. Mehdi2

1. Faculty of Pharmacy, The University of Jordan 2. Faculty of Medicine, The University of Jordan

*Presenting author: [email protected]

ABSTRACT Aim: To show that Gymnema sylvestre (Roxb.) Asclepiadaceae not only has

antidiabetic propensities, but it most likely works by regeneration of pancreatic β cells

which is imperative in anti-obesity-diabetes therapeutic applications of medicinal plants. Study Design: The present study design investigated the effects of G. sylvestre leaves

crude aqueous extracts (AEs) on the pancreatic β-cell MIN6 proliferation and insulin

secretion and extrapancreatic dietary carbohydrate and lipid digestion

Results: Comparable to GLP-1 (500 nM) pancreatic proliferative capacity; G. sylvestre

AE concentrations (0.01 and 0.1 mg/mL) induced MIN6 monolayers expansion by

respective 130.3% and 127.4% (P<0.001 vs. spontaneous control). Like L-alanine (10

mM) insulinotropic efficacy and without exerting cytotoxicity, glucose-stimulated insulin

secretion was potentiated by G. sylvestre AEs (5, 10 and 25 mg/mL) (711.0%, 843.0%

and 906.5%, respectively, P<0.001 vs. basal control). The potent plants’ insulin

secretory bioactivities were abolished in the depleted Ca2+ conditions (P<0.001). Similar

to orlistat antilipolytic efficacy, pancreatic lipase IC50 value for G. sylvestre AEs was

106.3±7.2 µg/mL. Unlike acarbose (100 µg/mL) dual inhibition of α-amylase/α-

glucosidase, G. sylvestre AE was inactive at used doses. Dissimilar to guar gum (50

mg/mL) diffusional hindrance in a simple dialysis model, G. sylvestre AEs (10, 25 and

50 mg/mL) proved inactive. This in vitro ineffectiveness was mirrored in respective in

vivo oral carbohydrate tolerance tests in overnight fasting normoglycemic rats.

Conclusions: This evaluation has revealed that G. sylvestre leaves AEs augmented β-

cell expansion and potentiated glucose-evoked Ca2+-regulated insulin secretion;

combined with impressive antilipolytic activity. Future directives may assess G.

sylvestre as a new alternative for anti-obesity-diabetes pharmacotherapy and

prevention if its bioactive water soluble phyto-principles intact absorption in vivo.

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Evaluation of fatty liver in hypercholesterolemic patients (one year experience at

outpatient clinics)

Arwa Al Homran, Banan Al-Turman, khawla Al-Abbadi, Alanood Al-Azaydeh, Sofia Al-Abbadi

King Hussien Medical Center

ABSTRACT Objective: To evaluate of liver enzymes in fat steatosis hypercholesterolemia patients. Introduction: Liver is the second largest organ in the body that’s function is to alter any

harmful waste substance in the blood. Fatty liver or steatosis is a term that describes

the build up of fat in the liver. The two liver enzymes that are the most formal test to

evaluate the (AST) function are aspartate aminotranferase (AST), and alanine

aminotransferase (ALT). Cholesterol is type of fat found in your body and produced in

the body and comes from the food you eat (animal products). Material and methods: One hundred adult male (20-60 years) samples were collected

and received at outpatient clinics. They were (steatosis) diagnosed as fatty liver in

internal medicine clinic, the fat on liver shown up as awhile area on the ultrasound

image. All patients were diagnosed as hypercholesterolemia; enzymes AST, ALT were

tested in a round in blood test performance on dimension RxL-Max (Siemens).Higher

liver enzymes are one of the frequent find in the routine doctor visit .The two liver

enzymes that are most formal test to evaluate the liver function are (AST) Aspartate

aminotransferase,and alanine aminotransferase (ALT). Results: All patients were hypercholesterolemia with high level of cholesterol

ranging(200-300) mg/dl,they were exanimate fatty liver on ultrasound image, around

60% of diagnosed patients have a high level of liver enzymes AST 58+- 8 IU/ml,and

ALT 70+- 6 IU/ml. Conclusion: High liver enzymes are one of the frequent finding at steatosis

hypercholesterolemia patients with fatty liver. Recommendation: It is important to maintain a healthy lifestyle ,by attention to risk

factors you can control includes diet, weight, exercise, smoking. Patients with

hypercholesterolemia should be tested for liver enzymes and also for abdominal

ultrasound average six months to check the liver.

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Pre-analytical Errors Survey in the Major Palestinian Hospitals (During 2005-2013)

Muayyad Ghoul1,2, Lubna Al-Zeir1, Nehaya Awwad1, Aqsa J. Bader1, Nour Abdo1, Rania Abu Seir1 1. Medical Laboratory Sciences, Al-Quds University

2. Al-Makassed Islamic Charitable Hospital, Jerusalem.

ABSTRACT Background: Health care systems are increasingly relying on efficient and reliable

clinical laboratory services. These services as a part of health care processes are not

free from errors. Pre-analytical errors contribute to the largest proportion of laboratory

identified errors that have an impact on the patient care, comfort or even potentially

affect the laboratory results and lead to a serious patient misdiagnosis.

Objectives: to assess the frequencies and types of pre-analytical errors in three major

Arab hospitals in Jerusalem to enable the education of sample collectors; consequently,

to share awareness of error management and prevention in the pre-analytical phase.

Methods: All reported pre-analytical errors during the period of 2005-2013 in three

major Arab hospitals in Jerusalem were analyzed. Data were obtained from hard file

records filled by laboratory personnel reporting causes of rejection, wards, date and

time of rejection. Frequencies and types of these mistakes were evaluated.

Results: Among 11550000 tested samples. A total of 4587 pre-analytical errors were

encountered in the three studied hospitals. Errors involving sample collection

contributed to the majority of the pre-analytical errors 67.7%, followed by handling

errors 13.1% and then identification errors 9%. Clotted blood samples were the most

common collection errors 27.8%, while those attributable to hemolyzed samples

accounted for 23.9% followed by insufficient sample quantity 22%. Most of the errors

were implemented during the morning shifts (7:30am- 9:30am).

Conclusions: Apparently, application of quality management concepts to laboratory

testing should be implemented in the pre-analytical phases to reduce or, ideally,

eliminate all defects within the process itself. In addition, hospitals and universities

should take on the educational responsibility to improve the quality of the health care

workers in Palestine.

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P4 Medicine: Predictive, Preventive, Personalized and Participatory. A new trend

in Laboratory Medicine. Prof. Maurizio Ferrari, IFCC President, Italy.

ABSTRACT

Personalized medicine, which simply means selection of treatment best suited for an individual,

involves integration and translation of several new technologies in clinical care of patients. The

scope is much broader than indicated by the term genomic medicine because many non-

genomic factors are taken into consideration in developing personalized medicine.

The wide and public availability of the human genome sequence and the other tools spawned

by the Human Genome Project have helped to create an unparalleled era of biomedical

discovery.

Researchers have discovered hundreds of genes that harbour variations contributing to human

illness, identified genetic variability in patients' responses to dozens of treatments, and begun to

target the molecular causes of some diseases. In addition, scientists are developing and using

diagnostic tests based on genetics or other molecular mechanisms to better predict patients'

responses to targeted therapy. Since the completion of the mapping of the human genome, we

have seen whole new areas of research evolve such as genomics, proteomics, and

metabalomics.

Advances in DNA analysis to develop methods, which are increasingly specific, sensitive, fast,

simple, automatable, and cost-effective, are considered paramount. These demands are

currently driving the rapid evolution of a diverse range of newer technologies.

Although the potential diagnostic applications are unlimited, most important current applications

are foreseen in the areas of biomarker research, cancer diagnosis and detection of infectious

microorganisms.

There has been an explosion in the number of validated markers but relatively little independent

analysis of the validity of the tests used to identify them in biologic specimens. The success of

personalized medicine depends on having accurate diagnostic tests that identify patients who

can benefit from targeted therapies.

Another important step will be expanding efforts to develop tissue banks containing specimens

along with information linking them to clinical outcomes.

In this arena Laboratory Medicine should play a major role.

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Evidence-Based Tradtional Medicine: A Scientific Wish

Prof. Dr. Fatma Afifi The University of Jordan, Faculty of Pharmacy

ABSTRACT Plants are used in developed and in developing countries as home remedies, collected

by local inhabitants, purchased upon recommendation of herbalists and also in final

dosage form as OTC drugs and food supplements. Some plant constituents are

available as prescription products. Natural products played a critical and distinctive role

in drug discovery and are an integral aspect of drug discovery programs in the

pharmaceutical industry.

The use of medicinal plants is seen as the most common form of traditional medicine in

Jordan in the treatment of common mild conditions as well as in the treatment of

chronic and “difficult-to-cure” diseases. This wide-spread use of herbal treatments can

put the consumers/patients at risk for plant/drug- or supplement/drug- interactions.

Possibilities and limits, safety and efficacy of medicinal plants, despite tested for

generations, should be evidenced.

The ethnopharmacological shortcomings in the treatment with plants, results of our

surveys in the plant-based treatment of chronic diseases as well as appraised

pharmacological evidence for some indigenous medicinal plants will be briefly

discussed.

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Medicinal Herbs: Effects on Clinical Laboratory Results and Antioxidant Markers

Prof. Dr. Yousif Y. Bilto Dept. Clinical Laboratory Sciences, The University of Jordan, Amman, Jordan, [email protected]

ABSTRACT Background: The use of herbal medicine is widespread and growing. In developing

countries, as much as 80% of the indigenous populations depend on a local traditional

system of medicine. The majority of people who use herbal medicines do not inform

their physicians nor the laboratories about their use. Herbal medicines may cause

abnormal test results and confusion in diagnosis. Herbal medicines may alter test

results by direct interference with certain assays. Drug-herb interactions may result in

unexpected concentrations of therapeutic drug results. Herbal medicines may alter

physiology, and these changes can be reflected in abnormal test results. Surprisingly

only few clinical studies are available on testing the effects of herbs on patients, with no

studies exist on testing the effects of herbs on normal healthy humans.

Objectives: As many patients may go to the clinical laboratory for analysis after

drinking herbal extracts that have become a common habit in public, we studied as part

of a major research the in vivo effects of commonly used medicinal herbs in Jordan, on

normal human volunteers after oral administration of aqueous extracts for several days,

to see whether a given medicinal herb affects laboratory analysis, and to see whether

the in vitro chemical antioxidant activity of a given herb replicates in vivo or not.

Methods: The following biochemical parameters were tested: serum Na, K, BUN,

CREA, UA, ALB, TP, LDH, ALT, AST, ALP, CPK and AMYL, and the following

antioxidant parameters were employed: total antioxidant capacity (TAC), reducing

power, scavenging activity of DPPH, scavenging activity of OH·, iron chelating ability,

serum total antioxidant status (TAS), erythrocyte malonyldialdehyde (MDA), protein

carbonyl (PC), reduced glutathione (GSH) and superoxide dismutase (SOD).

Results: The tested herbs showed a decreasing order of their in vivo antioxidant

strength in plasma (measured as antioxidant status) and erythrocytes (measured as

induction of reduced glutathione) as follows: Zingiber officinale > Rosmarinus officinalis

> Verbena triphylla > Saliva triloba > Nigella sativum > Origanum syriacum. Also

showed a decreasing order of their in vivo anti-lipid-peroxidant activity measured as

erythrocyte MDA as follows: Zingiber officinale > Verbena triphylla > Rosmarinus

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officinalis, whereas Saliva triloba, Origanum syriacum and Nigella sativum had no effect

on erythrocyte MDA. Also showed a decreasing order of their in vivo induction of the

antioxidant enzyme superoxide dismutase in human erythrocyte as follows: Zingiber

officinale > Rosmarinus officinalis > Saliva triloba, whereas Verbena triphylla, Nigella

sativum & Origanum syriacum had no effect on this enzyme. The tested herbs showed

different effects on serum biochemical tests. Rosmarinus officinalis had no significant

effect on the levels of serum biochemical tests. However, serum Na, AST & ALT were

not affected by any of tested plants.

Conclusions: Although all tested herbs improved in vivo plasma and erythrocyte

antioxidant status and some herbs failed to improve erythrocyte lipid-peroxidation or

superoxide dismutase, in overall, medicinal herbs can improve the base line of the

defense mechanisms against possible oxidative stress at various degrees and possibly

inhibit pathological conditions related to oxidative stress. Medicinal herbs can cause

abnormal test results in patients and confusion in diagnosis. The results also lead us to

highlight the importance of asking patients about herbal medicine use and to check for

any possible interactions with their medications and laboratory test results.

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The Elderly Between Reality and Ambition

Haifa Al-Bashir. President & Founder of White Beds Society.

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When outside the norm is normal; is the Geriatric patient any different?

Lana Halaseh, MD, JBFM, MCFP, AGS, CGS, MEAMA. Assistant Professor, Faculty of Medicine, University Of Jordan

Consultant family medicine, Jordan University Hospital.

I will be talking about the following aspects:

1. Definition of "elderly" 2. a bit of demographic details about Jordanian elderly (2015 statistics) 3. the main physiologic changes in the elderly 4. definition of "Geriatric syndromes" 5. A literature review of interpretation of lab values in the elderly

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Differential Laboratory Diagnosis of Dementia

Prof. Sergio Bernardini, Executive Board Secretary of IFCC, Italy

ABSTRACT Dementia is tremendous challenge for the future. A human and social challenge and a

challenge for sustainability on the part of the health system. It is an extremely complex

world. The main form of Dementia is the Alzheimer’s Disease, but others diseases can

lead to cognitive impairment (Fronto Temporal Dementia, Vascular Dementia and

Synucleinpathies).

Often the clinical symptoms of these disorders are the arrival of a long way and it is

necessary to advance the diagnosis as early as possible to slow the progression of the

disease. Sometimes the clinical, neuroimaging and pathologic phenotype may be

heterogeneous, and the coexistence of other pathologies, can complicate the differential

diagnosis.

Recently the IWG2 Criteria for the diagnosis of Dementia have been published and the

meaning of the Dementias is changed from a clinocopathological to clinico-biological

entity. From the laboratory point of view it should be pointed out that to date the overall

variability of available biomarkers (both diagnostic and progression markers) remains

too high to allow assignement of universal biomarkers cutoff values for a specific

intended use. Moreover the new approaches in biomarkers discovery (proteomics,

mirromics, metabolomics) often showed conflicting results because of different

analytical platforms, different matrices, different panel of metabolites studied, different

clinical cohorts, and preanalytical confounding factors. The Harmonization and

standardization between different methods are absolutely needed including the

creation of certified reference materials. At the same time the Integration of the data

from the Routine Laboratory with other laboratory techniques (Proteomics, Genomics,

Flow Cytometry) and diagnostic tools (Radiology, Pathology) is desiderable. Moreover

other roles of biomarkers have to be considered in clinical trials: for diagnostic accuracy,

stratification of patients, to characterize the mechanism of action and the biochemical

effects of drugs, to monitor disease progression, and assess the response to

treatment. It is really a big challange!

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Distinction between Central Diabetes Insipidus and Nephrogenic Diabetes Insipidus; The role of Mutations in the Genes for AVP, AVPR2 Receptor and

Aquaporin 2 Water Channel (AQP2).


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Prevalence and characterization of Streptococcus pneumoniae isolated from carrier children from Northern Jordan

Samer Fuad Swedan*, Wail Ahmad Hayajneh†, George Nikola Bshara‡.

* Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology. PhD. E-mail: [email protected] Tel: 00962-2-7201000 Ext. 26929; Fax: 00962-2-7201087

† Department of Pediatrics, Faculty of Medicine, Jordan University of Science and Technology. MD. E-mail: [email protected]

‡ Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of

Science and Technology. MSc. E-mail: [email protected]

ABSTRACT Aims: Streptococcus pneumoniae is an opportunistic pathogen that may be carried

asymptomatically, especially in children. The aims of this study were to determine the

prevalence of asymptomatic nasopharyngeal carriage of S. pneumoniae in children 5 years or

younger, the serotypes of the of isolates, the susceptibility of the isolates to macrolides and

other antimicrobial agents, and the genotypes responsible for macrolide resistance.

Methods: For the isolation of S. pneumoniae, a single nasopharyngeal swab was collected from

the left and right nasopharynx from 157 children attending the pediatrics clinic of KAUH for

routine checkup. Recovered isolates were serotyped using multiplex PCR. Isolates’

antimicrobial susceptibility was assessed using the disk diffusion test and the E-test. Macrolide

resistance genes erm(B) and mef(E) were identified among the isolates using multiplex PCR.

Results: S. pneumoniae was isolated from 53 (33.8%) subjects. The highest carriage rate (i.e.,

50%) occurred in age groups 7-12 months and 49-60 months. The most frequently encountered

serotypes were 19F (17.0%), 6A/B (11.3%), 11A (7.5%), 19A (7.5%), 14 (5.7%), and 15B/C

(5.7%). Serotypes 9V, 15A, 23F, 8F, 16F, 18, 22F, 33F, and 35B were encountered less

frequently. 60.4%, 62.3%, and 60.4% of isolates had resistance to erythromycin, azithromycin,

and clarithromycin, respectively. All isolates were susceptible to chloramphenicol, levofloxacin,

and vancomycin. 90.6%, 54.7%, 32% of isolates were resistant to oxacillin,

trimethoprim/sulfamethoxazole, and clindamycin, respectively. Erm(B) and mef(E) were

encountered at a frequency of 39.6% and 37.7%, respectively. Presence of the erm(B) was

associated with a very high level of resistance to macrolide drugs (MIC >256 µg/mL). Presence

of the mef(E) was associated with a moderate-to-high level of resistance to macrolide drugs

(MIC 3-24 µg/mL).

Conclusions: One third of children under 5 years harbored multi-drug resistant S. pneumoniae.

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BACTERIAL STRAINS IN URINE CULTURES AND THEIR ANTIBIOTIC RESISTANCE IN JORDAN

AbuGhosh, Z.1, Alsadi, M.1, Ayoub, F.1, Alhakim, M.1, Alnawaji, T1. 1.Electronic Health Solutions, Department of Health Analytics, Amman, Jordan.

ABSTRACT OBJECTIVE: Using data contained in Jordan’s national electronic health record system

‘Hakeem’ to assess the most common bacterial strains in urine cultures in Jordan and

their resistance to common antibiotics. MATERIALS AND METHODS: IRB approval was obtained from Jordan’s Ministry of

Health. Data collection was performed retrospectively and centrally using the national

electronic health record system ‘Hakeem’ (Electronic Health Solutions®, Jordan).

Positive urine culture results and their resistance to antibiotics were obtained from four

Jordanian public hospitals (totaling 795 beds) between January 1st 2011 and April 30th

2015. Urine culture and antibiotic sensitivity testing was performed using Jordan’s

Ministry of Health standard microbiology laboratory protocol. RESULTS: Out of a total of 29410 urine cultures recorded at the participating study

sites, 16.8% (4940) were considered positive and grew bacterial isolates at >105 colony

forming units/mL. The most commonly identified bacterial strain was E. coli in 64.1%

(3164) followed by Klebsiella species in 16.8% (832) and Enterococcus in 3.7% (182).

E. coli was most resistant to ampicillin in 90.3% of cases, followed by cephalothin

(83.7%), nalidixic acid (70.6%), trimethoprim/sulfamethoxazole (69.8%), cephalexin

(53.7%), norfloxacin (53.5%), cefuroxime (52.7%) and levofloxacin (46.5%). E. coli was

least resistant to meropenem in 0% of cases, followed by imipenem (2%), ertapenem

(2.4%), amikacin (8.5%), nitrofurantoin (10.6%), cefoxitin (15.5%), ciprofloxacin (22.2%)

and gentamicin (25.7%). CONCLUSIONS: E. coli was the most commonly isolated bacterial strain in urine

cultures in Jordan. E. coli exhibited surprisingly high resistance to usual empirical

treatment options for uncomplicated UTIs such as trimethoprim/sulfamethoxazole and

flouroquinolones. Data obtained centrally through Jordan’s electronic health record

system ‘Hakeem’ offers an important resource for local health authorities. Our study

demonstrates that data obtained from ‘Hakeem’ can help to formulate local guidelines

for the empirical antibiotic treatment of UTIs and to prevent increasing microbial

resistance in Jordan.

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Etiological agents and patterns of antibiotic resistance in urinary isolates Doua Saad1 , Sara Gameel 2, Salma Ahmed3, Esraa Basha 4 , Mudather 5 , Eltahir Khalil 6

1, 2 ,3,4,6 Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan 5 Elzhrawi laboratory , Khartoum ,Sudan

ABSTRACT Introduction: Knowledge of longitudinal trends in antimicrobial susceptibility patterns helps

both clinicians and infection control practitioners. Unlike many developed countries, Sudan does

not have a nationwide antimicrobial resistance monitoring program and therefore long term

longitudinal single center studies can give important information regarding resistance patterns.

Among the most common infectious diseases, urinary tract infections (UTIs) are a commonly

encountered diseases by clinicians in developing countries with an estimated 7 million visits to

outpatient clinics, 1 million visits to emergency departments, and 100,000 hospitalizations

annually .

Material and methods: This is a retrospective facility based study was conducted in the

microbiology section of Elzhrawi laboratory in Khartoum-Sudan throughout seven years

periods(2009-2015). Elzahrawi is a referral laboratory that receives cases from outside and

within Khartoum state. Gram staining of suspected colonies was Performed and confirmatory

identification was done as described in the guidelines (Monica Cheesbrough 2000, 2006)

.Susceptibility test was performed by standard disc diffusion method . Data was analyzed using

Epi info software .

Results: A total of 372 urine samples were collected , significant bacteruria was detected in 303

(81.5%) of them. Females represent 65.89 % of UTI cases. The most common five organisms

are E.coli (32.43 % ) S.aureus (30.74 % ) Klebsiella spp. (12.16 % )Pseudomonas spp. (11.15

%) Coagulase -ve Staphylococcus (6.09% ) C.albicans (4.39 % ) . More than 70 % of isolates of

each of the five commonest organisms were resistant to both Amoxicillin clavulinic acid and

cotrimoxazoles. 62.35% of E.coli is resistant to ciprofloxacin. On the other hand very low levels

of resistance were detected to antibiotics such as ceftriaxone, levofloxacin and gentamycin

.Pattern of resistance of ciprofloxacin and cotrimoxazole is generally increasing with time

whereas gentamycin resistance is increasing till the last two years when it dropped down.

Conclusion: The presence of bacterial isolates with very high resistance to the commonly

prescribed drugs that in turn leaves the clinicians with very few alternative options of drugs for

the treatment of UTIs. As drug resistance among bacterial pathogens is an evolving process,

routine surveillance and monitoring studies should be conducted to provide physicians

knowledge on the updated and most effective empirical treatment of UTIs.

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Evaluation of MDR Klebsiella spp. Resistance pattern in Khartoum, Sudan

Dr. Sara Siddig, Khartoum, Sudan

ABSTRACT Background: Bacterial resistance to antimicrobial drugs have reached an alarming

levels. Multidrug-resistant Klebsiella spp.(MDR Klebsiella spp.) has become a major

public health concern in Sudan and many countries, causing failure in treatment with

consequent huge health burden.

Objectives: To determine the prevalence and susceptibility of MDR Klebsiella spp.

Among different clinical isolates .

Methods: A total of 349 Klebsiella spp. Strains were isolated between June 2009 and

October 2015. Different clinical specimens mainly swab culture isolates, urinary tract

isolates and respiratory tract isolates were identified, and tested for their antimicrobial

susceptibility.

Results: Of the 349 Klebsiella spp. Isolated MDR Klebsiella spp. was present in 264

(76 %) Of the specimens, the resistance rates were recorded to: Ampicillin- sulbactam

(95%), Ceftotaxime (93%), Tetracycline (82%),Tazobactam- piperacillin (59%),

Chloramphenicol (51%), Ciprofloxacin (45%), Gentamycin (23%), and  Amikacin (9%).

Conclusions: Klebsiella spp . showed high resistance against ampicillin-sulbacatm

and Cefotaxime (95 % and 93% respectively). Amikacin was the most effective drug

among the antibiotics tested (91 % of the strains were susceptible). This study showed

that Klebsiella spp. presents high level of resistance. This issue needs to be addressed

in national guidelines. Antimicrobial resistance surveillance and epidemiological

analysis of patient data is need to be conducted periodically, and can be informative for

appropriate management of antimicrobial resistance.

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Second Line Drug Resistant Mycobacterium tuberculosis Isolates Among

Retreated pulmonary TB Patients In Sudan

Muatsim Ahmed Mohammed Adam1, Hamdan Mustafa Hamdan3, Eltahir Awad Gasim Khalil2 1. National Reference Tuberculosis Laboratory, Public Health Laboratory, Federal Ministry of

Health, Khartoum, Sudan. 2. Tuberculosis Research Group/Institute of Endemic Diseases, University of Khartoum, Khartoum,

Sudan. 3. National Tuberculosis control Program, Sudan.

ABSTRACT Background: Prescription of second line anti-TB drugs for MDR-TB patients was

started in 2008 in Sudan. The program was run based on suspicion and managed

cases empirically. In 2010, Sudan signed the Green Light Committee (GLC) Initiative

Document to combat MDR-TB by improving access to affordable second-line anti-TB

drugs.

Objectives: This study aimed to determine resistance patterns to second line anti-TB

drugs (SLDs), and to determine the frequency of extensively drug resistant (XDR)

Mycobacterium tuberculosis isolates.

Materials and Methods: A total of 239 sputum specimens were collected from smear

positive TB retreatment patients during the period from July 2009 to July 2010.

Specimens were pre-treated according to Petroff method. The recovered isolates were

tested for sensitivity to first line anti-TB drugs by the 1% proportion method on LJ

medium; MDR strains were tested for second line anti-TB drugs sensitivity by 1%

proportion method on LJ medium and by Hain GenoType MTBDRsl Assay.

Results: One hundred and forty three mycobacterial isolates were successfully

recovered from a total of 239 samples (143/239; 59.8%). Two strains (2/143; 1.4%)

were identified as RIF/INH-resistant MOTT, the majority (141/143; 98.6%) were

Mycobacterium tuberculosis complex strains. Fifty four strains (54/141; 38.3%) were

MDR isolates. Four (4/54; 7.4%) isolates perished during subsequent subculture. Five

of the MDR isolates (5/50; 10%) showed resistance to at least one second line drug and

one isolate (1/50; 2%) was XDR. The XDR strain was concordantly detected by the two

methods.

Conclusion: Resistance to second line anti-TB drugs among MDR-TB patients is at

10% levels, while XDR-TB is prevalent at low levels (2%).

Keywords: GenoType MTBDRsl Assay, TB, MDR, XDR-TB, Sudan.

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Etiological trends and patterns of antimicrobial resistance in respiratory infections

Salma Mohamed Alzain, Intern at Soba university hospital - khartoum - Sudan

ABSTRACT Background: Respiratory Infections are among the most common causes of morbidity

and mortality arising from infectious diseases both in the developed and developing

nations. The emergence of resistance to antimicrobial agents is a global public health

problem which is well pronounced in developing countries. Prompt clinical and

laboratory diagnosis along with appropriate treatment strategies would be helpful in the

management of both community and nosocomially acquired Respiratory Infections.

Objectives: This retrospective study was conducted to elucidate the bacterial aetiology

of Respiratory Infections in Sudan, as well as update the clinicians in the various

antimicrobial alternatives available in the treatment.

Methods: Isolates identified by morphological and biochemical characteristics were

tested for antibiotic susceptibility.

Results: Out of 1481 specimens examined, 377 samples were culture positive,

pathogens were more commonly recovered from sputum (225 cases; 59.7%) than

bronchio-alveolar lavage (94 cases; 24.9%) and Pleural fluid (58 cases; 15.4%).

Male to female ratio was 3:2, the most common isolated organisms were klebsiella ssp.

(25.20%) & mycobacterium tuberculosis (25.20%), followed by Staphylococcus

aureus(19.89%) and pseudomonas areginosa(8.49%). High rate of resistance of

bacterial isolates was observed to Co-trimoxazole (BA), Ampicillin sulbactum (AS),

Cefotaxime (CF) and Tetracycline (TE): 80%, 72.3%, 68.8% and 66.9% respectively,

while very low resistance rate found to Amikacin (AK) and Levofloxacin (LE), 4.6% and

8.5% respectively.

Conclusion: Guided prescription of antimicrobial agents must be implemented and

controlled to limit further spread of antimicrobial resistance.

Keywords: Respiratory infections, sputum, BAL, Pleural fluid, antibiotic susceptibility.

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Clinical application of chromatography in medical lab Dr.Faisal Abu Farsakh,Ph.D. Al-KhalidiMedicalCenter

ABSTRACT: Chromatographic techniques are very useful tool in medical laboratories. HPLC is very

useful technique in analysis of drugs that are not analyzed by routine procedure such as

lamtrogen, sirolimus, amiodaron. Imuran, prozac and topamax. In addition, it can be

used for vitamins assay such as B1, B2, B6, A, E, K and B-carotene. Furthermore,

hormones such as adrenaline, noradrenaline and L-dopamine and 5HIAA and VMA

metabolite are analysed by HPLC. Quantitative measurement of amino acids in plasma,

urine and CSF is carried out by this technique. Actually, differential diagnosis of

porphyrias is carried out by HPLC, the following compounds can be analysed into:

uroporphyrin, coproporphyin, heptacarboxylporphyrins, hexacarboxylporphyrins,

pentacarboxylporphyrins, porphbilinogen, protoporphyrin and delta aminolevulenic acid.

In stone formers, citrate and oxalate can be measured accurately by HPLC. Carnitine in

semen, 24hr urine & serum are also analysed by this technique. Finally, HPLC is used

in most of our laboratories in Hb variant (instead of Hb electrophoresis) & in HbA1c

measurement. HPLC when linked to MS is very powerful technique and can

tremendously be used in analysis of many analytes and it is the reference method of the

above tests. GC/MS is used in diagnosis of organic acidemia in neonates such as

:methylmalionicacidemia, propionic acidemia, fatty acid oxidation defects,3

methylglutaconicaciduria,HMG CoA lyasedeficiency,pyruvate carboxylase deficiency,

glutamicaciduria,isovalyricacedemia. In addition fatty acid profile(C22-C26)is used in

investigation of patient with possible paroxysmal disorders including X-linked

adenoleukodestrophy and refsum disease. Fatty acid profile,mitochondrial(C8-

C16)which is used for biochemical diagnosis of inborn error of mitochondria fatty acid

oxidation, including deficiency of medium-chain-acyl-CoA dehydrogenase, long chain

23-hydroxy acyl Co A dehydrogenase ,very long chain acyl CoA dehydrogenase and

glutaricacedemiatypII. Furthermore carnitine and acyl carnitine can be analysed by

GC/MS and it is used in inborn error of metabolism,specially organic acedemia and fatty

acid oxidation disorders including primary carnitine deficiency and in monitoring

carnitine treatment. Finally GC/MS can be widely used in drugs analysis which helps in

drug monitoring.and in toxic screening in Suicide cases. In Tandem-MS, more than 40

genetic diseases can be analyzed by only a dried blood spot on a filter paper. In

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addition, LC and LC-MS can be used for quantitation of glycosylated hemoglobin,

Vitamins assay (A, E , K , B2 , B1 ,B6, Biotin , D) , drug monitoring (Lamotrogine,

sirolimus , Immuran , Amidirone …) , fractionated catecholamines(adrenalin, nor-

adrenalin, and L-dopamine), fractionated porphyrins&carnitine& acyl carnitine. Gel

electrophoresis is widely used in medical laboratories, serum Immunofixation , serum

protein electrophoresis , serum lipo protein electrophoresis, hemoglobin electrophoresis

, alkaline phosphatazeisoenzym electrophoresis, CPK isoenzyme electrophoresis are

very useful in diagnosis and monitoring of many diseases. Finally, isoelectric focusing

has been used to confirm oligoclonal bands in multiple sclerosis & for LDL & HDL

subtypes.

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The Introduction of LC-MS/MS Tandem Mass Spectrometry for the Detection of Vitamin D Level in Serum.

George Sahyoun, Chief R&D Officer, MedLabs Consultancy Group, Amman-Jordan, Email: [email protected]

ABSTRACT Over the last decade, the role of Vitamin D within the body became more apparent with

the discovery that most tissues and cells have a vitamin D receptor. Several tissues and

cells also possess the enzymatic machinery to convert the primary circulating form of

vitamin D, 25-hydroxyvitamin D, to the active form, 1,25-dihydroxyvitamin D.

Vitamin D has been shown to play a major role in decreasing the risk of many chronic

illnesses, including common cancers, autoimmune diseases, infectious diseases and

cardiovascular disease, not to mention osteoporosis and other more commonly

described diseases.

As a result, the detection of Vitamin D levels in serum has become one of the most

popular clinical laboratory tests in the field of laboratory medicine. Of all the platforms

used within diagnostic laboratories, the “Gold Standard” has always been the use of LC-

MS/MS Tandem Mass Spectrometry for the detection of Vitamin D levels in serum and

more importantly, its ability to distinguish between Vitamin D2 and Vitamin D3.

Comparisons of automated immunoassays against LC-MS/MS Tandem Mass

Spectrometry results demonstrated variable performance and not all tests meet the

minimum performance goals. It is important that laboratories be aware of the limitations

of their assay.

This presentation aims to highlight the benefits of LC-MS/MS technology as a diagnostic

platform as well as the advantages and disadvantages of introducing such a test.

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Application of a Novel light-based non-invasive technology in bilirubin measurement of neonates, a Biolab experience

Dr. Issa Abu Dayyeh, biolab

ABSTRACT Neonatal jaundice is usually a transient phenomenon that occurs without any major

complications. However, if not properly monitored and treated, it could result in rare but serious

complications such as: Kernicterus, cerebral palsy, and deafness. Early hospital discharges,

increased prevalence of breast-feeding, and lack of adherence to prompt-post discharge follow-

up testing for newborns are all contributing factors to the increased number of uncontrolled

cases.

In Jordan, neonatal bilirubin is measured through a heel prick, whereby blood is collected into a

capillary tube, plasma separated, and optical density measured to evaluate the amount of

bilirubin present based on colour intensity. Although the technique is accurate, it has several

disadvantages: The process is stressful to patients, is time consuming, technician-dependent,

and above all invasive. Heel pricking causes blood loss and by breaking the baby’s skin barrier,

the neonate is subjected to an additional risk for infection and even osteomyelitis.

Recently, cutting-edge non-invasive transcutaneous bilimeters were developed. These devices

utilizes safe xenon light pointed to a baby’s forehead or sternum to measure bilirubin levels. In

an effort to enhance the quality of its medical services, Biolab employed a transcutaneous

bilimiter approved and recommended by the American Academy for Pediatrics (AAP) to

measure bilirubin in neonates. The device has been previously validated in several clinical

studies in hospitals and doctors’ clinics. Nevertheless, we performed our own validation study

where sternum transcutaneous bilirubin (TcB) was measured alongside total serum bilirubin

(TSB) in outpatient babies presenting to our 5th circle branches from the period between June

2014 to December 2015. Inclusion criteria was any baby born > 35 weeks gestation, between 1-

30 days old, who has not undergone transfusion or phototherapy treatment.

Results indicated a strong linear correlation between both techniques, suggesting that TcB

measurement is a suitable non-invasive, quick, and accurate method to screen neonates for

high elevations in bilirubin that could cause major health issues. More significantly, TcB

measurement represents an ideal method for follow-up especially with patients that require

multiple/frequent testing. The adoption and generalization of this experience in Jordan will help

uncover more “at risk” cases and thus increase the efficacy of the health sector in quickly and

effectively diagnosing and handling jaundice cases that could cause major health issues if left

undiagnosed.

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Immune Evasion in Colo-rectal Cancer in Sudanese patients: possible roles for MHC antigens

Mohammed Mustafa Mohammed Dafalla1; Kamal Elzaki Elssidig2; Elsagad Eltayeb Ahmed Mohamed3;

Mohamed Elhassan Mohamed Osman Elsafi4; Hatim Abdalla Ahmed Mohamed1; Brima Musa Younis1,

Chantal van Niekerk5; Vanessa Steenkamp6; Ahmed Mudawi Musa1; Eltahir Awad Gasim Khalil1; 1Institute of Endemic Diseases, University of Khartoum, Sudan 2Department of Surgery, Faculty of Medicine, University, University of Khartoum 3Ibn Sina Specialized Hospital, Khartoum, Sudan 4 Department of Pathology, Faculty of Medicine, National Ribat University

5Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria/NHLS. 6Department of Pharmacology, Faculty of Health Sciences, University of Pretoria

ABSTRACT

Background: Colorectal cancer (CRC) is ranked as the third highest cancer world-wide. Sixty

percent of cases are found in the developed world and 0.5 million deaths are recorded annually.

This prospective, cross-sectional, hospital-based study aimed to determine the frequencies of

HLA, DRB1 and DRB3 alleles in colorectal tumors and to correlate sHLA-G serum levels to

CRC histopathology types as well as degree of spread.

Materials and Methods: Following informed consent, 33 patients with confirmed CRC were

recruited. Demographic, clinical and laboratory data were collected in a specially designed case

record form (CRF) and IBM-SPSS statistics version 20 was used for data entry and analysis.

Tumor tissue, “normal” colon tissue and 5 mL of EDTA blood were collected. Molecular typing

for HLA, DRB1 (DR1, 7& 17) and DRB3 was carried out using PCR-based Sequence-Specific

Primers (PCR-SSP). sHLA –G was measured in the serum using an indirect ELISA technique.

Results: Forty per cent of the patients were younger than 50 years of age. The male to female

ratio was 2.5:1. Rectal bleeding was the most common symptom on presentation. Moderately

differentiated adenocarcinoma was the dominant histological type. Duke's stages B and C were

reported in 54.6% and 42.4% of patients, respectively. No Duke’s stages A or D were seen.

HLA and DRB3 were the most frequent alleles detected followed by DRB4, DR17, DR7 and

DR1. The highest frequency of the DRB3 allele was found in the peripheral blood. HLA, DRB3

and DR7 allele frequencies correlated with Duke's stages A and B, but not with age, sex or

degree of differentiation. The mean level for sHLA-G in the serum was 10.2± 13 U/mL [Range

0.8 U/mL - 57.4 U/mL]. sHLA-G did not correlate with Duke's stage or the degree of

differentiation.

Conclusion: CRC was more common in younger patients (<50) with predominance of poorly

differentiated adenocarcinoma and higher DR17 allele frequencies in peripheral blood

compared to tumors and apparently normal colonic tissue. Tumor tissue and apparently normal

colon mucosa showed similar DR17, DRB3 allele expression.

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Colorectal Cancer in Sudanese Patients: The Role of Tumour Genomic Aberrations in Tumour Aggressiveness

Hatim Abdalla Ahmed Mohamed1; Kamal Elzaki Elssidig2; Mohamed Elhassan Mohamed Osman Elsafi3;

Elsagad Eltayeb Ahmed Mohamed4; Mohammed Mustafa Mohammed Dafalla1; Brima Musa Younis1;

Chantal van Niekerk5; Ahmed Mudawi Musa1; Vanessa Steenkamp6; Eltahir Awad Gasim Khalil1

1Institute of Endemic Diseases, University of Khartoum 2Department of Surgery, Faculty of Medicine, University of Khartoum 3Department of Pathology, Faculty of Medicine, National Ribat University 4Ibn Sina Specialized Hospital, Khartoum, Sudan 5Department of Chemical Pathology, Faculty of Health Sciences, University of Pretoria/NHLS 6Department of Pharmacology, Faculty of Health Sciences, University of Pretoria

ABSTRACT Background: Colorectal cancer (CRC) is a leading cause of death in western countries.

This cancer is common in young Sudanese patients whom mostly present at an

advanced stage with lymph node/hepatic metastasis, ascites and intestinal obstruction.

Functional polymorphisms of the Methylene-tetrahydrofolate reductase (MTHFR) gene

and vitamin D receptor (VDR) gene at FokI, BsmI and Bpu10I sites modulate the

tumour’s behaviour. This study aimed to correlate polymorphisms of the MTHFR and

VDR genes to the aggressiveness of colorectal cancer in Sudanese patients.

Materials and Methods: Following informed consent, 34 patients undergoing surgical

excision of primary colorectal tumour at Khartoum and Ibn Sina Teaching Hospitals

were recruited into this study. Demographic, clinical and laboratory data were collected

in specially designed case record forms. Five milliliters of blood and biopsies of the

tumour and distant “normal” tissue were collected for genotyping of MTHFR and VDR

variants by means of PCR-RFLP technique. Results and Discussion: Colorectal cancer was more common in males than females

(2.5:1). The disease was more prevalent in patients aged younger than 50 years and

with a predominance of poorly differentiated adenocarcinoma. All patients studied were

diagnosed with Dukes’ stages B or C. Stages A or D were not found despite the short

duration of symptoms which probably points to the aggressive nature of the tumour.

MTHFR polymorphisms were not found in tumours, “normal” tissues or blood samples.

FokI, BsmI and Bpu10I VDR variants were similar in the tumour and “normal” tissue

biopsies, which probably indicates the absence of normal tissue per se. A significantly

decreased frequency of FokI Ff, BsmI BB and Bpu10I wild genotypes was observed in

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tumour samples (14.7%, 26.5% and 16.1%, respectively) compared to blood samples

(35.3%, 41.9% and 37.5%, respectively) with p-values of 0.03, 0.04 and 0.04,

respectively. The FokI FF, BsmI Bb and Bpu10I AA variants were higher in tumour

samples compared to peripheral blood and “normal” tissue although these were not

statistically significant.

Conclusion: FokI FF, BsmI Bb and Bpu10I AA VDR gene variants could be promising

biomarkers of CRC pathogenesis in Sudanese patients. The similarity of these variants

in tumour and apparently normal colon mucosa probably indicates that there is no

normal tissue per se in CRC patients. Larger prospective studies are needed to

elucidate the exact roles of VDR gene polymorphisms in CRC pathogenesis/prognosis.

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Prevalence and Antimicrobial Resistance among Pseudomonas aeruginosa isolates from Jordanian Patients with Respiratory Tract Lung Infection.

Heba Yousef Al Dawodyah MSc. 1, Dr. Nathir Obeidat2 and Dr. Asem Shehabi1 1Department of Pathology-Microbiology, Faculty of Medicine, 2Jordan University Hospital, The Jordan

University, Amman, Jordan

ABSTRACT Background: Pseudomonas aeruginosa is a leading cause of respiratory and

nosocomial infections, particularly life-threatening infections in immunocompromised

persons, and in cystic fibrosis patients. Infections caused by multidrug-resistant (MDR)

P. aeruginosa are difficult to treat.

Aim of the study: This study intended to investigate the occurrence of ESBLs and

MBLs enzymes in association with important specific virulence factors alg D ,las B and

tox A, and to investigate the phenotyping and genotyping variation of those P.

aeruginosa isolates from respiratory tract of Jordanian patients using RAPD -PCR .

Methods: A total of 284respiratory tract samples obtained from adult patients admitted

to Pulmonary Clinic at the Jordan University Hospital (JUH), over the period from

November 2014 to June 2015. Samples were cultured for P.aeruginosa and their growth

was identified and tested using microbiological culture and antibiotic susceptibility

methods. Virulence factors, antimicrobial resistance genes and genotypes were

detected using polymerase chain reaction (PCR) and random amplified polymerase

DNA (RAPD).

Results: A total of 61out of 284 (21.5%) of P.aeruginosa isolates were detected. The

percentage of the virulence factors in 61 isolates algD, lasB and toxA were 98.3%,

98.3% and 80.3%, respectively. Out of these isolates (73.7%) were resistant to

ertapenem, and (44.3%) to cefotaxime, whereas isolates were susceptible to colistin,

followed by ceftazidime, cefepime, imipenem and piperacillin-tazobactam. The

percentage of MDR P.aeruginosa was 32 (52.5%).By PCR amplification blaCTX-M,

blaVEB, blaTEM, blaGES and blaSHV genes were detected in 22(68.9), 6(18.9),

6(18.9), 5(15.6) and 4(12.5), respectively.Constructed dendrogram using RAPD results

revealed highdiversity of isolates as judged by thepresence of 14 genotype groups.

Conclusions: The present study demonstrates common occurrence of ESBL, and

CTX-M in MDR P.aeruginosa isolates. Few isolates were positive for MBLs and the

majority carried algD, lasB and toxA genes and produce pyocyanin. Both phenotyping

and genotyping revealed no significant genetic relationship between the isolates among

investigated patients.

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THE SPECTRUM OF MEFV MUTATIONS IN AN ARABIC COHORT

Rowaida Taha, Dina Ahram, Abdulghani Kohilan,Suhail Ayesh, Hatem El-Shanti QBRI-Medical Genetics Centre,Hamad Ben Khalifa University,Doha-Qata

ABSTRACT Autoinflammatory diseases are a group of disorders characterized by seemingly

unprovoked inflammation in the absence of high-titer autoantibodies or antigen-specific

T cells. Familial Mediterranean fever (FMF) is an autosomal recessive disorder and is

the archetypal autoinflammatory disease. It is characterized by recurrent self-limiting

episodes of fever and painful polyserositis. FMF is prevalent in specific ethnic groups—

namely, non-Ashkenazi Jews, Armenians, Turks, and Arabs. The gene responsible for

FMF—MEFV—has been identified in 1997. There seems to be a distinctive clinical

picture in Arab patients with FMF, and the range and distribution of MEFV mutations is

different from that noted in other commonly affected ethnic groups. The aim of this study

is to delineate the spectrum and distribution of MEFV mutations amongst an Arabic

FMF patient cohort and to assist the genotype-phenotype correlation in these patients.

We have collected DNA samples from 188 FMF patients (from Qatar, Jordan and

Palestine) who have been clinically diagnosed with FMF, according to international and

validated diagnostic criteria. We have designed primers to cover the entire genomic

region of MEFV. As a first tier, mutation detection is done by resequencing the entire

coding sequence and splice sites; as a second tier the rest of the genomic region

including the promoter are resequenced. In the first tier, we have identified 191 out of

376 mutant alleles (50%) by resequencing the entire coding region and splice sites of

MEFV. In addition, resequencing of the entire genomic region of 100 patients who had

only one identifiable allele was carried resulting in the identification of specific

haplotypes and we are currently investigating the phenotypic significance of these

haplotypes. The spectrum of MEFV mutations in Arabs seems different from other

ethnic groups commonly affected by FMF. The fraction of the identifiable disease

causing alleles is the lowest amongst the commonly affected ethnic groups. The results

of the genomic resequencing of MEFV may provide some insight into the role of non-

coding sequences and may explain the molecular pathology of FMF. Thereby, we are

currently working on the development of a low cost and high throughput technique to

facilitate the resequencing of the entire genomic sequence of MEFV using the Next

Generation sequencing technology.

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Prevalence of Exfoliative Toxins and Toxic Shock Syndrome Toxin -1 Encoding Genes among Coagulase Positive Staphylococcus Isolated from Human and

Animal Sources

Hala I. Al-Daghistani, Dhia S. Hassawi, Aseel A. Hasan, Saeid Abu-Romman, and Azmi D. Hawari Al Balqa Applied University, College of Sciences, Department of Medical Laboratory Sciences

ABSTRACT This study was undertaken to determine the prevalence of coagulase positive

Staphylococcus (CPS) in Jordan and to investigate the presence of genes encoding

exfoliative toxins (eta, etb), and toxic shock syndrome toxin-1 (tst). Seven hundred and

fifty three samples were used including 273 obtained from human sources and 480 from

animals (sheep, cows, and goats). One hundred and sixty seven isolates were identified

as CPS and appeared as gram positive cocci, non-motile, produced coagulase,

catalase, reduce tellurite, were resistant to acriflavin, unable to produce oxidase and

amylase. The prevalence of CPS colonizing human was 115(42.1%) with 26.0% in

nasal and 16.0% in nails. Livestock-associated CPS was detected in 52(10.8%) of the

samples. PCR amplification revealed eta to be the most common toxin gene detected in

36.5% and 28.8%, followed by tst in 25.2% and 5.76% of human and animal isolates,

respectively. The possession of various gene combinations was found in 15(8.98%) of

the isolates including eta plus tst in 14(12.2%) and eta plus etb in 1(0.86%) of human

isolates. PCR-RFLP assay was performed for all CPS by using TaqI restriction; the

pattern revealed that 163(97.6%) were S. aureus and were identified phenotypically and

confirmed genotypically by amplification of kat gene, and 4(2.40%) identified as S.

pseudintermedius. Phylogenetic analysis indicated that clones characterized in this

study were S. aureus subsp. aureus and S. pseudintermedius. Toxins genes are mostly

prevalent among S. aureus subsp. aureus strains.

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Laboratory Accreditation: From The Drawing Board To Reality And All The Challenges In Between

Nael M. Soudi, MS, CT(ASCP)(MIAC), CPHQ. Chief Quality Officer, MedLabs Consultancy Group,

Amman-Jordan, Email: [email protected]

ABSTRACT In recent years, the quest for accreditation became a great ambition to health care

institutions as it provides systems and processes that if followed it will offer better

quality services focused on patient safety.

The aim of this presentation is to discuss the most common challenges that we face as

healthcare professionals in this part of the world not only when we embark on a project

such as Laboratory Accreditation but the ability to sustain it to guarantee service

excellence.

The Accreditation process (irrespective of its type) has many challenges, some of which

include leadership commitment, limited financial resources, lack of trained staff who are

well oriented in building the accreditation process, write policies and procedures and

ensure implementation.

Accreditation is a long term pledge, the institution and its staff must look at this change

as everlasting and ensure the culture of quality and safety are embedded in each

employee at all levels. Their contribution to this continuous process must be clarified

based on their role and job description.

Real life examples (JCI and CAP accreditation for the Laboratory) will be shared with

the audience in order to shed more light on the challenges that may face any

organization pursuing accreditation. Understanding these challenges with a realistic

outlook and planning ahead is the recipe of success.

The presentation is directed to all levels of staff working in various capacities and

services in health care institutions.

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Lean Thinking

Wafa Al-Ahmed, MSc, PgD, BSc, MLS(ASCP)cm Senior Quailty Assurance Officer, Arab Medical Center,

Email: [email protected], [email protected]

ABSTRACT

Quality problems and patient safety are the main reasons that forced healthcare leaders

to redesign healthcare delivery. Lean thinking was adopted by healthcare sector to

improve quality, enhance safety and eliminate waste. Therefore, I introduced lean

thinking in the Arab Medical Center Organization, in order to minimize the patient

waiting time in the laboratory reception area. I believe that lean thinking has the

potential to improve health care delivery. In my presentation, I will discuss the following:

1. Lean principles

2. Define types of waste

3. Identify the problem, i.e. prolonged patient waiting time

4. The solution for the problem through implementing lean

5. Continuous improvement cycle

6. 5S

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GENERAL INFORMATION HOTEL ACCOMMODATION Main venue of the conference Landmark Amman Hotel & Conference Center (5 Stars) Standard Room

Single Double JD95 JD105

• All prices are in JD, subject to 10% service charge & 16% sales tax, and inclusive of Buffet Breakfast.

• Free Parking Available at Hotel (Conference Badge Requested)

REGISTRATION FEES International Participants USD 250

Jordan Society for Medical Laboratory Sciences Members JD 100

Association of Laboratory Proprietors and Medical Analysis Members JD 100

Non Members JD 120

Medical Students

(attend Scientific Sessions, Program & Certificate)

Free

(Pre-Registration Required) The Registration fees include: Access to the opening ceremony, the scientific sessions, exhibition, lunches, coffee breaks, and conference bag which includes a certificate of attendance, and abstract book with final program. *(Except and medical students).

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Currency: One Jordanian Dinar is equivalent to 1.4 US Dollar. Foreign currency may be exchanged freely at any bank or money exchanger. Credit cards are accepted in most hotels, restaurants and shopping malls.

Insurance Liability: - It is suggested that participants obtain travel and health insurance before they depart from their countries. - The Congress will not be liable for any accident, injury or illness that may occur.

Visa Requirements and Passports You must possess a valid passport at least for 6 months. Nationals of most countries including British Nationals can obtain a visa at Queen Alia International Airport upon arrival. However participants requiring a visa should apply to Jordan Embassies or Diplomatic Missions in their countries.

Electrical Current: 220 V. When using 110V, you need an adapter.

Language: The official language of the congress is English.

Weather: Temperature in April is expected to be around 18-20C

Time Zone Jordan is three hours ahead of Greenwich Mean Time (GMT).

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Touristic Localities Sightseeing Tour in Amman (Half-day Tour) Amman is the modern and ancient capital of Jordan, known in history as Philadelphia & Rabbath-Ammon in the Roman-Greco period. Originally spread over seven hills like Rome, Amman now covers twenty hills. The city is crowned by the Citadel, a hill with the ruins of the Temple of Hercules, and a museum with artifacts dating back to the earliest settlement in the region, some 7,000 years ago. At the foot of the citadel lies the 5,000 - seat Roman Amphitheater; while there visit the museum of Popular Tradition and the Folklore museum, one flanks either side of the Amphitheater.

Tour to Jerash (Half-Day Tour) An easy 25 minutes drive from Amman is the Roman City of Jerash, known in the past as Gerasa or Pompeii of the East. It is considered the best preserved and most complete city of the Decapolis, a confederation of ten Roman cities dating back to first century B.C. Within the city you will see the great oval Forum, approached by what is termed the Street of Columns. This forum was once the center of social activity. There are two public baths, three theaters, and a hippodrome. There is also a nymphaeum, which is a complex of fountains and sculptures. You may walk under the triumphal arch built in honor of Emperor Hadrian, and let your mind return to the dream of time in the Temple of Artemis. One of Jordan’s most highly anticipated culture / fun events is the annual Jerash Festival held for two weeks each summer. During the remainder of the year there is an impressive and unique sound-and-light show given within the walls of the ancient city.

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Religious Tour to Ma’daba, Mount Nebo, Baptism Site & Dead Sea (Full-Day Tour) Ma’daba: Thirty minutes drive south from Amman, along the 5,000 – years old King’s Highway is the city of Madaba (Madaba of the Bible). Madaba’s chief attraction is the contemporary Greek Orthodox Church of St. George. The church contains the earliest surviving original mosaic map of the Holy Land dating back to the sixth century.

Mount Nebo: Ten minutes to the west is the most revered site in Jordan: Mount Nebo, the memorial of Moses, the presumed site of the prophet’s death and burial place. The Byzantines built a small church whose floor is still covered with marvelous mosaics.

Baptism Site: Ten minutes drive from Mount Nebo, Some 2000 years ago, John the Baptist lived and baptized in a settlement called “Bethany Beyond the Jordan” (John 1:28). This important site of early Christianity, which Jesus also visited, has been rediscovered in Jordan, about 1500 meters east of the Jordan River. It has been carefully excavated by international archeologists, receiving pilgrims and visitors.

Dead Sea Ten minutes drive from Baptism Site, at 1,306 feet (400meters) below sea level, this is the lowest spot on Earth. As the name suggests, the sea is devoid of life due to an extremely high content of salts and minerals, giving the waters their curative powers, recognized since the days of Herod the Great, more than 2500 years ago. Take a swim where it is impossible to sink, and bath in the water that have flowed from the river Jordan and from the hills of Moab and Gilead.

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Historical Tour to Petra (Full-Day Tour) Three hours driver south from Amman is the most famous attraction in the Kingdom. In July 2007, Petra was ranked second among the New Seven Wonders of the World. Three hours drive south from Amman is the most famous attraction in the kingdom, Petra fortress city. Literally carved out of craggy rocks, by the Nabataeans 800 B.C..

Fortified behind a narrow deep siq (gorge) that slowly winds through a massive rock wall. It is a wading, one kilometer long fissure between the overhanging clefts that seem to meet 300 feet overhead. Within Petra you will see soaring temples, royal tombs, Roman theatre, water channels, arched gates and others.

Petra was discovered when a Swiss explorer disguised as ab Arab, fell on it in 1812.

2 days Petra, Wadi Rum & Aqaba (2 day tour) Stunning in its natural beauty, Wadi Rum epitomizes the romance of the desert. With its "moonscape" of ancient valleys and towering sandstone mountains. Climbers are especially attracted to Wadi Rum because of its sheer granite and sandstone cliffs, while hikers enjoy its vast empty spaces. Wadi Rum is best known because of its connection with the British officer T.E. Lawrence. You can rent out a four-wheel-drive jeep with a Bedouin driver. Also available are camels, which you can hire. For those with the sense of adventure, the best way to see Wadi Rum is by hiking and camping in it. In Aqaba, King Solomon built a fleet that sailed to Ophir (Somalia) and returned with 420 talents of gold. The Aqaba fort was rebuilt in 1587 AD. In one of the most exciting discoveries in recent times, archaeologists in Aqaba have unearthed what they believe to be the world’s oldest church, from the late 3rd Century AD. Surrounded by rugged purplish mountains, Aqaba enjoys formidable weather throughout the year. The Gulf of Aqaba is a world known diving area. Aqaba itself offers eager divers the chance to experience virgin coral reefs, rare marine life forms, and encounters with friendly sea animals like turtles and dolphins.

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ACKNOWLEDGEMENT

SPONSORS Platinum Sponsor

Gold Sponsors

Bronze Sponsor

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ACKNOWLEDGEMENT

The organizing Committee would like to express its gratitude to all the following governmental and private agencies, companies and donors for their most valuable aid, contribution and assistance to ALPMA & JSMLS

Special Thanks to:

• Ministry of Health

• Jordan Medical Services

• Amman Chamber of Commerce

• Medlabs Consultancy Group

• Husam Nimer Drug Store

• Roche Diagnostics Middle East-F.Hoffmann-La Roche Ltd/Jordan P.S.C.

• Al-Sami Technical Suppliers Co.

• Arab Medical & Scientific Alliance

• Diab Medical & Lab. Supplies

• Agencies Med. Lab Trading Co.

• Burgan Drug Store

• Jerial Est. for Medical Consumables

• Unity Medical Supplies Est.

• Specialty Hospital

• Al-Wafi Group

• Biolab

• Mega Labs

• Al-Yamama Co. for Health & Environmental Projects

• Al-Sadaqa for Lab & Scientific Equipments

• Al-Amer Medical Supplier

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Medical Exhibition:

• Medlabs Consultancy Group

• Husam Nimer Drug Store

• Roche Diagnostics Middle East - F. Hoffmann-La Roche Ltd / Jordan P.S.C.

• Al-Sami Technical Suppliers Co.

• Arab Medical & Scientific Alliance

• Diab Medical & Lab. Supplies

• Agencies Med. Lab Trading Co.

• Burgan Drug Store

• Jerial Est. for Medical Consumables

• Unity Medical Supplies Est.

• Specialty Hospital

• Al-Wafi Group

• Biolab

• Al-Yamama Co. for Health & Environmental Projects

• Jordan Society for Medical Laboratory Sciences

• Association of Laboratory Proprietors and Medical Analysis

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