Hospital Practices and Research

Abstract Letter to Editor

Abstract This highlights the significance of parasitic infections as an important and overlooked aspect of infectious diseases amid the COVID-19 pandemic. Despite the focus on viral and bacterial infections, parasitic infections continue to pose a substantial public health challenge, especially in areas with restricted access to healthcare. The interaction between parasitic infections and COVID-19, including possible co-infections and their impact on disease severity, requires further investigation...

Abstract I would like to draw attention to the emerging challenges in treating dermatophytosis, particularly the increasing resistance posed by new fungal strains, such as Trichophyton indotineae. Dermatophytosis is the most common superficial fungal infection affecting the skin, hair, and nails. Although it is not considered life-threatening, its high prevalence and negative impact on patients' quality of life make it one of the most widespread infectious diseases in various populations...

Abstract Non-cardiac CT angiograms may be helpful when searching for the etiology of cardiac arrest in out-of-hospital cardiac arrest cases and may be effective in the decision of early percutaneous coronary intervention. We want to share an experience related to this topic. A 51-year-old male patient returned home after travelling by plane from abroad and suddenly collapsed while hugging his relatives at home, followed by cardiac arrest (CPA). CTA showed no obvious pathology in the aorta and pulmonary artery, but the proximal left anterior descending artery (LAD) branching from the left main coronary artery (LMCA) was not contrast enhanced and was thought to be an occluded lesion. The cardiology unit was contacted and the patient was taken to the emergency coronary angiography unit. Coronary angiography revealed a critical stenosis in the proximal LAD. In this case, the patient's heart rate was not suitable for a coronary CT angiography (90 beats/minute), and the option of slowing the heart down was not an option as the patient was unstable and had ROSC after CPA. In addition, no radiologic editing of the images for artifacts due to heart rate was performed. Thoracic aorta angiography is not a standard imaging method for coronary artery lesions. However, in this case, it raised suspicion of coronary artery occlusion and was indicative of an occlusion that could not be detected on ECG.

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Abstract International experience has shown that the increasing diversity in healthcare services precludes the integration of all services under a government health insurance plan in terms of performance and economy; no institution receiving a fixed amount of money per capita is able to provide all services. Supplementary insurance is used in many countries.¹ In Iran, comprehensive coverage of medical costs through a basic government medical insurance program is not possible because of the rising costs of diagnosis, use of more up-to-date and expensive medical technologies, and the development of new treatment methods. The number of people deprived of the right to healthcare is increasing daily. The structure of complementary insurance is based on participation and provides three types of coverage: completion of services, completion of costs, and integration of costs and services. In many leading countries, insurance is provided to a group with the participation of the insured and the insured’s employer who pays the employee’s premiums.

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Abstract Letter to Editor

Abstract Letter to Editor

Abstract Hand hygiene is crucial in preventing healthcare-associated infections. Despite global efforts, hospital-acquired infections persist, and hand hygiene compliance remains low, averaging around 40%. While alcohol-based hand rubs (ABHR) effectively prevent infection spread, improper glove use and non-compliance with the World Health Organization's five moments for hand hygiene are common challenges in healthcare settings. A key barrier to compliance is the high workload of healthcare workers, who often lack time to remove gloves and disinfect hands between patient interactions. In situations where glove changes are impractical, glove disinfection may offer a feasible alternative. Evidence suggests that disinfecting gloves with ABHR could reduce contamination and improve compliance. With limited personal protective equipment resources in hospital settings, glove disinfection has shown potential benefits, including reduced workload, cost savings, and environmental impact. Studies demonstrate that regular glove disinfection significantly reduces microbial transmission compared to the gold standard of hand hygiene. Despite these findings, further research is necessary to assess the long-term safety and effectiveness of glove disinfection before it can be widely adopted as an alternative to glove removal and hand hygiene.

Abstract The choice between disposable and reusable medical supplies remains a critical challenge in healthcare systems worldwide, particularly in low- and middle-income countries. While disposable items offer the advantage of infection prevention, they contribute significantly to biomedical waste and impose recurring financial burdens. Reusable supplies, on the other hand, present economic and environmental benefits but carry infection control risks if sterilization practices are inadequate. This paper explores the trade-offs between safety, sustainability, and cost in the context of Indian healthcare institutions, including experiences from apex institutes like AIIMS. Global trends, environmental implications, and emerging innovations in reprocessing technologies are also discussed. The findings support the need for a hybrid, risk-based strategy that optimizes both resource utilization and patient safety. Strengthening sterilization infrastructure, establishing national reuse protocols, and investing in low-cost innovations are recommended to balance the competing priorities of modern healthcare delivery.

Abstract Patient safety is a fundamental principle in healthcare, enshrined as a basic right of patients and a core responsibility of nurses. Negligence in ensuring safety can lead to adverse outcomes for patients and healthcare providers alike. Within the discourse on patient safety, two related yet distinct concepts emerge: "safe care" and "care safety." While these terms may appear synonymous, their differences have significant implications for nursing practice. This letter explores these concepts, contrasts their applications, and argues for the prioritization of safe care, supported by empirical evidence and practical examples.

Abstract The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) showed that over the past decade, the global disability-adjusted life years (DALYs) had increased mainly due to population aging and the associated increase in the incidence of non-communicable diseases (NCDs). In 2021, NCDs caused two-thirds of all-cause mortality, with cardiovascular disease, cancer, chronic respiratory disease, and diabetes accounting for more than 80% of NCD mortality. Thus, NCDs should be prioritized from a public health perspective, with an ambitious Sustainable Development Goal (SDG) of a reduction in NCDs by one-third from 2015 to 2030. Unfortunately, the likelihood of achieving this target appears slim.

Abstract Neonatal Intensive Care Units (NICUs) face a persistent challenge in controlling healthcare-associated infections (HAIs), with reported rates ranging from 6% to 25% globally. While traditional infection control strategies have focused on symptomatic patients and high-risk groups, a growing body of evidence suggests that “silent spreaders,” asymptomatic carriers of multidrug-resistant organisms (MDROs) among healthcare workers, parents, and neonates themselves may represent a critical blind spot in current surveillance paradigms. If this is the case, then fundamental assumptions underpinning NICU infection control may warrant reexamination. We argue that existing approaches, which rely heavily on active surveillance cultures (ASCs) and hand hygiene compliance, are structurally ill-suited to detect asymptomatic transmission. Emerging genomic, environmental, and data-driven methodologies offer not merely incremental improvements but a necessary reconceptualization of surveillance itself.