Hospital Practices and Research

Abstract In this review article, we aim to depict how healthcare facilities may look in the near future from an architectural design point of view. For this purpose, we review newly introduced technology and medical advances in the field of healthcare, such as artificial intelligence (AI), robotic surgery, 3D printing, and information technology (IT), and suggest how those advances may affect the architectural design of future healthcare facilities. In future hospitals, less space will be required; there will be no need for waiting areas. Most care will be given far from the hospital. Every human might have a computer chip attached to his body, with all his medical data ready and monitored by AI. In the future, all processes may be done by robots and AI, from reception to detection (radiology, scans, etc.). Nearly all surgery will be done by robots, so the architectural design of operation departments will need to be changed accordingly. AI is faster and better in disease detection than man; thus, there will be no need for laboratories or detection departments as we know them now. 3D printers are able to print almost everything from medical equipment to parts of the human body; thus, space will be needed for scanning and 3D printing in future hospitals. 3D printers might change the pharmaceutical industries, and drugs will be produced for any human individually.

Abstract Acute coronary syndrome (ACS) results from acute obstruction of a coronary artery which is responsible for a high mortality rate worldwide. The consequences depend on the degree and location of the obstruction and vary from unstable angina to non-ST segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction, and sudden cardiac death. The symptoms are similar in each of these syndromes (except for sudden death), involving chest discomfort with or without dyspnea, nausea, and diaphoresis. The diagnosis is possible; thanks to the electrocardiogram that is essential and the existence or absence of serological markers. In addition to these initial resources, other diagnostic methods are noteworthy, such as stress electrocardiogram, echocardiography, nuclear cardiology, computed tomography angiography, and exercise test. Other necessary measures are the stratification of the identified cases according to the degree of risk, availability of a coronary intensive care unit, and the establishment of the opportune treatment that consists of oxygen therapy, analgesia, sedation, antiplatelet, anticoagulants, nitrates, beta-blockers drugs, reperfusion of emergency with fibrinolytic drugs, percutaneous intervention or, occasionally, myocardial revascularization surgery to provide the recovery and consequently a better quality of life for the patient. This brief review aims to discuss the available diagnostic and therapeutic resources and the appropriate risk stratification for adequate care for the victims of acute coronary heart disease promptly in a hospital setting.

Abstract The Qur’an, the word of God, is the best book that has been revealed to guide human beings contains a complete plan of human life. However, in addition to educational, ethical, and religious issues, it also contains valuable scientific information. Several verses in the Holy Qur’an discuss the importance of breast milk and its proper planning. Qur’an also orders up parents, especially mothers, for getting this goddamn blessing to their children. Qur’an verses as well as Islamic hadiths emphasize that breast milk is an unparalleled and comprehensive food that plays a valuable and unique role in the improvement of mental health, physical development, and desirable development of children. Based on Islamic sources, such as the Holy Qur’an and the traditions of the Prophet (PBUH) and Islamic hadith, there are some interesting and important points about breastfeeding, its benefits and its provisions. The Qur’an verses and Islamic hadiths emphasize the importance of breastfeeding and the importance of continuing it until 24 months. The description of these hadiths and verses is presented in the text. Considering the religious and Qur’an educations regarding the importance of breastfeeding infants, it can be concluded that breastfeeding contains the most complete immune and growth factors in the infant. In addition to physical needs, breastfeeding provides emotional and mental development and also gives countless benefits to the mother.

Abstract Background: Coronavirus disease 2019 (COVID-19) has become a global challenge to the health care system. A novel agent to combat this deadly virus is still a matter of research. Herbal molecules have served humanity since the beginning.
Objectives: This narrative review aims to study the antiviral properties of medicinal plants, which are already effectively used in the past against various viruses. It derives the importance of exploration of such phytochemicals, which can be complementarily used to treat COVID-19.
Methods: Studies related to traditional medicine and treatment for viruses were retrieved from databases including PubMed, Google scholar until December 2020 using the keywords SARS-CoV-2, COVID-19, Immunological, Phyto-chemicals, Traditional Medicine. The resulting publications were analyzed to develop a narrative review on the traditional Indian phytochemicals that have been shown to effectively treat various viral infections and potentially treat or prevent COVID-19.
Results: Many of the researches are showing that Indian herbal compounds have a significant potential against viral diseases. Plants like Azadirachta indica, Withania somnifera, Tinospora cordifolia, Ocimum basilicum, and many more have been shown tremendous antiviral, anti-inflammatory, and immune-modulatory activities.
Conclusion: Phytochemicals obtained from the herbs can be helpful in the treatment and prevention of SARS-CoV-2via various modes such as inhibition of attachment, penetration, uncoating, replication, assembly, and release of respiratory viruses. Further analysis of the potential phytochemicals in treating SARS-CoV-2 in clinical trials is warranted.

Abstract Background: There is a renewed interest in job satisfaction among healthcare workers including nurses in Africa and the West African sub-region due to the perception that global shifts in the internal structures and employment practices are inducing changes in the ties that bind employees to their job. Therefore, it is necessary to examine various studies in order to establish an empirical base and utility for the theory of knowledge.
Objective: This paper reviewed some of the available literatures on factors affecting job satisfaction among nurses around the world with special focus on the African continent.
Methods: Electronic search of Medline, PubMed, Health Internetwork Access to Research Initiative (HINARI), and Google Scholar databases up to 2014 was carried out for studies which analyzed the factors affecting job satisfaction of nurses around the world, Africa and West Africa.
Results: Although regional variations in levels of job satisfaction exist among nurses globally, there is more general trend of dissatisfaction and these are because of various factors related to the work environment. Nigerian nurses are generally more satisfied (as high as 92%) with their jobs when compared with their colleagues in other African countries. Socio-demographic and socioeconomic variables do not affect job satisfaction as much as leadership styles, promotion and other features related to the work environment.
Conclusion: Strong leadership style is a probable reason why nurses in Nigeria are more satisfied with their jobs when compared with their colleagues in other countries even though they may work for longer hours or earn relatively less salaries.

Abstract Most of what we know about the coronavirus disease 2019 (COVID-19) is limited to the severe acute respiratory syndrome, epidemiology, fatality, and acute care. However, infection with COVID-19 may also involve the central nervous system (CNS), which may or may not be due to a multi-organ injury. Our aim in this paper is to briefly summarize the main aspects of the growing literature on neurological manifestations of the COVID-19 infection. As such, after mentioned some general background on the economic and medical pandemic on the populations, the healthcare system, and the society, we summarize some common aspects of the published literature on neurological manifestations of the COVID-19 infection. We also highlight the existing gaps in the literature, which requires additional work. The most common neurological manifestation of COVID-19 infection is the olfactory deficit. However, it is still unknown if it is inflammatory or degenerative in nature. Still, the incidence of neurological involvement, and also mechanisms and their treatments are unknown. This literature is predominantly composed of opinions and reviews rather than original articles, so the patients’ data are not used for a majority of the studies. Multi-center studies that not only conduct chest CT or MRI but also brain CT or MRI are needed. Randomized trials are still required on the management of acute and chronic neurological conditions due to COVID-19 infection. Cohort studies may also determine the natural history of the conditions and factors that are prognostic. Furthermore, while disparities in COVID-19 infections are known, inequalities in neurological manifestations are unknown. Besides, the efficacy of specific treatments on CNS involvement is still unknown. We will discuss the health care needs of patients with chronic neurological conditions. We end the paper with a few recommendations for practice and research.

Abstract Background: Hospitalization due to any reason or medical condition is associated with fear, anxiety, and depression. Psychological and physiological factors have a significant impact on hospitalization outcomes.
Objectives: Given the functional importance of inflammatory cytokines and studies in previous studies on the relationship between inflammatory cytokines and major depressive disorder, we will focus more on studies on the role of interleukin 2 (IL-2) in the pathophysiology of major depressive disorder in hospitalized patients.
Methods: We used PubMed, Scopus, and Elsevier databases to search for articles from 1999 to 2021, emphasizing the studies of the last five years.
Results: In general, there was no consistent pattern in the observed relationships between cytokine concentrations or changes and clinical signs of significant depression. IL-2 and IL, two receptors in the body, play an essential role in the treatment and the pathophysiology of depression and major depression.
Conclusion: Finally, it can be concluded that hospitalization generally exposes the patient to inflammation. Studies show an increased risk of inflammation following hospitalization of patients, and many studies confirm the association of major depression with inflammatory cytokines and, more concentrated, IL-2.

Abstract Aspirin is an irreversible and non-selective inhibitor of cyclo-oxygenase. It represents the cornerstone of antiplatelet therapy and is used in secondary prevention of cardiovascular disease. Disagreement over the optimal maintenance dosage still exists; in America and Europe the most used doses of aspirin are 81 mg and 100 mg daily, respectively. There is also debate on the formulation and route of administration of the loading dose. The latest studies advise chewable and non-enteric coated aspirin; intravenous administration represents an alternative for unconscious or shocked patients. Aspirin hypersensitivity is characterized by the onset of respiratory, mucocutaneous, and systemic symptoms. It is marginally considered, but its prevalence is significant. International cardiologic guidelines only report the possibility of desensitizing intolerant patients or, alternatively, administering one single antiplatelet agent. Desensitization can induce a temporary tolerance to the drug and consists of the administration of sequential and incremental doses of aspirin. Rapid desensitization protocols have proven to be safe and effective in the vast majority of cases, and they should be included in the management of these patients. New studies are being carried out comparing aspirin with other antiplatelet agents, and the results will be available shortly.

Abstract Background: In 2012, Switzerland changed from retrospective to prospective hospital payment based on diagnosis related groups (DRGs), following the example of the United States, Australia, and Germany. As in these countries, the objective of this transition was to motivate hospitals to improve efficiency by making them bear financial risk to some extent.
Objective: This contribution seeks to find out whether SwissDRG, the Swiss version of DRG payment, indeed provides hospitals with appropriate incentives, thus creating a level playing field enabling workable competition between them.
Methods: Three conditions for creating a level playing are stated, of which the first is tested using data on some 757 000 patient cases treated by 93 hospitals in the year 2012.
Results: The evidence suggests that hospital payment as currently devised by SwissDRG fails to create a level playing field. Differences in margins over cost of treatment can be traced to a hospital’s portfolio of specialties and mix of patients, both of which are largely beyond their control. The findings of this paper are subject to several limitations. The true DRG-specific cost distributions (and hence expected values) are not known; moreover, emphasis has been on variable cost, neglecting fixed (capital user) cost. Finally, hospitals with a high amount of capital user cost may well benefit from modern technology contributing to their efficiency in terms of variable cost.
Conclusion: The finding that current hospital financing by SwissDRG fails to create a level playing field is likely to be robust, calling for an expeditious adjustment be-cause hospitals are exposed to financial risk to a greatly differing degree. It may be appropriate for them to purchase insurance against their financial risk, which is largely driven by influences beyond their control.

Abstract Background: Primary hyperhidrosis (PH) refers to excessive sweating, beyond normal physiological levels, in specific sites of the body for unknown reasons. It is usually bilateral and is most prominent in the palms, axillae, feet, and face. PH prevalence is estimated to be 0%-6.1% in different populations. It usually begins in childhood and is more frequent in women. In 57% of cases, there is a positive family history. It is an autosomal dominant disorder with variable penetration in chromosomes 5, 14, or both.
Objective: The aim of this study was to illustrate current treatments of PH while focusing on surgical therapies through a narrative review.
Methods: A complete search of online articles from 2007 to 2014 in PubMed, Scopus, and the Cochrane Library was performed. A free search and a search in the MeSH database for the study’s keywords were also done. More than 600 relevant articles were found, of which 51 were chosen for this study. This article is based on those articles.
Results: Surgery is the best and more permanent therapy for PH. The most common consequences of surgery are compensatory sweating and gustatory sweating. There is controversy concerning whether lowering the level and limiting the number of ganglia on which surgery is performed reduces compensatory sweating.
Conclusion: It seems that ramicotomy (selective division of the sympathetic postganglionic fibers) reduces compensatory sweating, but this theory should be confirmed with more studies.

Abstract Incidence and prognostic relevance of supraventricular arrhythmias were evaluated in nine studies. These studies investigated patients with different forms of pulmonary hypertension. Supraventricular arrhythmias were more often found in patients with group two pulmonary hypertension. Common findings in these patients were elevated right atrial pressure and diameters and reduced tricuspid annular plane systolic excursion (TAPSE). Elevations in other parameters like systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance (PVR) were inconsistent. Most of the patients with arrhythmias suffered symptoms and improved after sinus rhythm (SR) was restored. The prognostic relevance of non-sustained ventricular tachycardia was evaluated in only one study. Non-sustained ventricular tachycardia does not seem to be prognostically relevant. Extending Holter electrocardiogram (ECG) monitoring over 24 hours up to 72 hours raises the detection rate of arrhythmias. Ablation of arrhythmias, especially atrial flutter and atrioventricular node reentry tachycardia, is feasible and safe in these patients.

Abstract Health technology assessment (HTA) is an evaluative process used to inform technology-related policymaking in healthcare. Interest in involving patients in the HTA process is increasing. Patients can provide additional perspectives to those of other groups that are concerned with health technology. Information on patients’ perspectives is preferably obtained through reviews of published studies. Primary research approaches can be used if good quality, published evidence is unavailable. There are good examples of input from patients influencing the scope or preparation of HTA reports and subsequent consideration of these reports by decision-makers. One challenge to achieving effective patient involvement is finding suitable resources for patient organizations and HTA agencies. There is also a need for the further development of methods, for example, for use in rapid evidence reviews. HTA programs and the decision-makers they inform have to make choices about when patient input is appropriate. Such choices will include considering which questions or aspects of a technology requires such input and the expected time lines for assessment.

Abstract The coronavirus SARS-CoV-2 disease (COVID-19) is the most current life-threating disease that affect health and economic sectors in the world. This pandemic raises weighty and urgent ethical issues that affected patients, health care provider and health care systems. Based on medical ethics textbooks, there are four fundamental ethical principles: The principle of respect for autonomy, the principle of beneficence, the principle of non-maleficence, and the principle of justice. Medical ethics scientists have well explained these principles before with full accuracy and detail. In this review article, we discussed the ethical issues raised during the COVID-19 pandemic. Health inequity and inequality, health care rationing/triage, contact tracing technologies and data privacy, movement restriction and exit strategies, and finally COVID-19 research ethics especially clinical trials and vaccine studies could cause ethical problems during Covid-19 pandemic. In this review article, we discuss about these issues and provide some ethical solutions to these issues

Abstract Background: Cucurbitacins are important compounds in the Cucurbitaceae family. They are known for their potential in cancer treatment. Cucurbitacins have a complex structure with over 200 variants, each exhibiting different biological activities. Ongoing research aims to enhance their effectiveness in medicine
Objectives: The study aimed to identify compounds with the potential to be used in chemotherapy by examining the structure of Cucurbitacins found in plants of the Cucurbitaceae family.
Methods: In this review study, we analyzed the biological and anticancer activities of plant compounds known as Cucurbitacins. We searched for keywords such as "Cucurbitacins", "Cucurbitaceae family", "Antioxidants", and "Anticancer" in databases including Google Scholar, PubMed, and Scopus. We gathered information about Cucurbitacins from PubChem, searched for Cucurbitacin, and refined results using advanced options.
Results: The anticancer potential of Cucurbitacins has been extensively researched. Specific Cucurbitacins, such as D, E, I, and IIa, have been found to induce cell death and autophagy in cancer cells, inhibit their migration and invasion, arrest the cell cycle, and impede their proliferation and survival. These compounds also inhibit the JAK2/STAT3 pathway, which is implicated in various cancers, including breast, pancreatic, colon, ovarian, and osteosarcoma. Recent interest in Cucurbitacins has surged for their potential in cancer prevention and treatment. Some studies suggest that consuming fruits and vegetables rich in Cucurbitacins may reduce the risk of certain cancers. Furthermore, they hold promise as chemotherapeutic agents in combination with conventional treatments.
Conclusion: The ability of Cucurbitacins to inhibit cell proliferation, induce apoptosis and autophagy, inhibit cell migration and invasion, and block the JAK/STAT3 signaling pathway make them potential candidates for cancer prevention and treatment.

Abstract Background: Management of cardiovascular disease (CVD), the leading cause of death in the world, is often associated with a variety of treatments and lifestyle modifications.
Objectives: In this review, the authors sought to identify and summarize self-care related behaviors in persons with CVD based on Orem’s self-care theory. By applying this theory, healthcare professionals can involve patients in their own care in a holistic way that can improve health outcomes.
Methods: A comprehensive review was conducted using the Web of Science, PubMed, Magiran, SIDS, Scopus, CINAHL, and Google Scholar databases. The results were organized into themes based on the Orem’s Self-care model for patients with CVD.
Results: A total of 1153 articles identified through databases. After excluding duplicated, unavailable or unqualified articles a total of 12 articles met all inclusion criteria and were included in this review and categorized into five major themes based on Orem’s self-care model for patients with cardiovascular diseases: basic conditioning factors and self-care agency, initiating and adhering to self-care activities, symptom recognition, and supportive nursing interventions and culture. The model suggests the patients should take responsibility for self-care behaviors; and nurses, peers, families and health systems can have a great impact on the level of self-care in these people with considering cultural factors.
Conclusion: Improving the well-being in people with cardiovascular diseases and reducing the related healthcare costs are achievable by promoting self-care behaviors based on culture, educational interventions, and monitoring the self-care over time as suggested by the model.

Abstract Osteoarthritis (OA) is the most common form of arthritis, causing pain and progressive disability in millions of people worldwide. The commonly prescribed medications for OA, including non-steroidal anti-inflammatory drugs, have many side effects which has led the scientists to consider safer drugs as an alternative. Therapeutic effects of Curcumin on OA are increasingly declared, and its various aspects in suppressing inflammation and reducing the disease progression are examined more thoroughly. This study aims to discuss curcumin and OA to help scientists working in these fields. In this brief review, we took a look at OA pathogenesis, the role of the immune system, and the biomarkers involved in the onset and progression of the disease. We focused on available data on the anti-inflammatory effect and mechanism of treatment by curcumin on OA.

Abstract The African continent is a known malaria-endemic region. Amid the COVID-19 pandemic, COVID-19/malaria co-infection is of critical importance in Africa due to the similarities in the manifestation of their symptoms. To avert compromising the health status of individuals on the African continent during the COVID-19 pandemic, this commentary sought to examine the link between COVID-19 and malaria, outlining strategies for improving the diagnosis and prevention of COVID-19 and malaria in Africa. A scale-up of malaria-focused care should be considered to ensure adequate reporting of COVID-19 cases in Africa. Likewise, individuals who present for malarial testing should be linked to COVID-19 testing and treatment care in Africa. Also, surveillance activities should be scaled up to ensure accurate COVID-19 case reporting and improved case notification. Regular refresher trainings should be organized for healthcare workers to promote healthcare service delivery.

Abstract The countries located in west Asia and other parts of Asia are positioned in important and strategic areas due to specific political and geopolitical conditions. These countries have faced various military and political threats, and it is crucial for them to strengthen their ability to foresee, prevent, and prepare for any biological threats. Meanwhile, with the progress made in science and technology, particularly in the field of biology, new biological threats and wars have surfaced. These threats and wars are self-replicating and can significantly expand the contaminated area, requiring advanced equipment and resources in the community in order to combat them effectively. The field of threat detection, cleanup, and contamination has been identified as an area of concern. Additionally, the hidden use of these factors in peacetime poses a potential danger, as does the possibility of deliberate casualties and damages, along with the incidence of intense fear and panic in the target population. Given the recent outbreak of the avian influenza virus in some countries, there is a concern that avian influenza virus outbreaks could be a precursor to a more widespread and severe biological attack, such as the Ebola virus, which presents with widespread biological and clinical symptoms.

Abstract Some neutrophils are shown to be able to release structures consisting of DNA strands associated with histones, decorated with about 20 proteins. These structures are called Neutrophil Extracellular Traps (NETs). NETosis is the process by which the formation of neutrophil extracellular traps eventually leads to cell death. Indeed, NETosis is a cell death process that is unique from other common types of cell death. Two kinds of NETosis have been identified, vital NETosis and suicidal NETosis. Vital NETosis, unlike suicidal NETosis, occurs a few minutes after neutrophil stimulation. Suicidal NETosis can be dependent on or independent of NADPH oxidase. NADPH-independent NETosis can be induced by calcium ionophores. As long as NETs are set up properly, they play an important role in fighting infections. However, if not properly adjusted, tissue damage and inflammation increase. Furthermore, NETs are involved in some autoimmune diseases.

Abstract Background: Alcohol-based antiseptics are widely used in clinical settings for skin disinfection prior to procedures, with efficacy dependent on both concentration and adequate wet contact time. Despite recommendations to allow antiseptics to air dry naturally, practices such as fanning or blowing are commonly used to hasten drying. The impact of such practices on antiseptic efficacy and safety remains unclear.
Objectives: To systematically map the existing literature on the effects of accelerated drying, particularly through fanning, blowing, or forced evaporation, on the antimicrobial efficacy of alcohol-based antiseptics used for skin disinfection.
Methods: A scoping review was conducted following the Arksey and O’Malley framework and the PRISMA-ScR guidelines. Five databases (PubMed, Embase, Scopus, CINAHL, and Web of Science) and grey literature sources were searched from inception to July 2025. Eligible studies examined alcohol-based antiseptics and assessed drying methods or contact time in relation to antimicrobial efficacy. Data were synthesized thematically.
Results: Eighteen publications met inclusion criteria, comprising experimental studies, clinical guidelines, technical protocols, and reviews. Four key themes emerged: (1) Sufficient wet contact time is essential for antimicrobial efficacy; (2) Fanning or accelerated evaporation reduces microbial kill rates, particularly for Staphylococcus aureus; (3) Surgical and clinical guidelines emphasize complete natural drying due to infection and fire risk; and (4) There is a lack of clinical trials evaluating infection outcomes or real-world adherence to drying recommendations.
Conclusion: Accelerating the drying of alcohol-based antiseptics can compromise antimicrobial efficacy by shortening contact time and has no support in current guidelines. Despite its widespread use, fanning remains unvalidated and potentially harmful. There is a need for clinical research on the impact of drying practices and adherence to protocols in real-world settings.