Hospital response challenges and strategies during COVID-19 pandemic: a qualitative study.

Background: At the beginning of the COVID-19 pandemic, healthcare managers at hospitals did not have sufficient experiences to appropriately respond to the COVID-19 outbreak. Due to a lack of preparedness, many challenges arose in the healthcare system, and each country developed and implemented strategies depending on national policies. This study aimed to understand challenges during the COVID-19 pandemic and strategies used in Iranian hospitals. Methods: A qualitative research was conducted in four hospitals in an urban area of Iran. In-depth semi-structured interviews were performed with 32 participants including healthcare managers, nurses, and medical doctors. Data underwent qualitative content analysis. Results: Four categories were developed: 'capacity expansion', 'management affairs', 'diagnostic services," and therapeutic services'. Each category consisted of 2-3 subcategories. Conclusion: Hospitals should be prepared to intelligently respond to future epidemics. It is necessary to develop a comprehensive epidemic plan for the management of disasters to reduce the impact of the epidemic and minimize the risk to public health and ensure that resources are allocated in an efficient and effective manner.

Design of nanostructure chitosan hydrogels for carrying zinc phthalocyanine as a photosensitizer and difloxacin as an antibacterial agent.

Here, we develop homogeneous hydrogel networks containing zinc tetraamino-phthalocyanine (ZnTAPc) as photosensitizer cross-linked with glutaraldehyde. The cross-linking process occurs via imine bond formation by reaction of NH2 groups of ZnTAPc and chitosan with aldehyde groups of the glutaraldehyde. Insertion of ZnTAPc interestingly increases its solubility in water medium. 2.0% and 4% w/w of the ZnTAPc were used with respect to chitosan polymer to generate hydrogel photosensitizer. FT-IR and UV-Vis spectroscopy, scanning electron microscopy, and rheological measurements were applied to evaluate the properties of the prepared hydrogels. Finally, difloxacin HCl was selected as a fluoroquinolone drug for the assessment of the drug release features of the made hydrogels. The difloxacin release was affected by the amount of ZnTAPc and pH medium. The activity of the hydrogels in photosensitizing process was considered by computing the rate of 1,3-diphenylisobenzofuran adsorption reduction as a singlet oxygen chemical quencher.

Design of photodynamic chitosan hydrogels bearing phthalocyanine-colistin conjugate as an antibacterial agent.

The fabrication of a new antibacterial system is an essential medical requirement to treat wounds caused by multidrug-resistant Gram-negative bacteria, mostly Pseudomonas aeruginosa. Antibacterial photodynamic therapy (APDT) is an encouraging therapy modality for bacterial infection. Anyhow, the applications of most photosensitizers are restricted by their poor water solubility and their inefficiency in disruption of the outer membrane of Gram-negative bacteria. In this context, zinc phthalocyanine-colistin (ZnPc-Col) conjugate as a new photosensitizer was synthesized in the hope of improving interaction of phthalocyanine with the surface of Gram-negative bacteria. Overcoming the low solubility of phthalocyanine, was achieved by the incorporation of ZnPc-Col into chitosan hydrogel. The weight percentages of ZnPc-Col and glutaraldehyde had remarkable effects in determining the hydrogel microstructure. Different spectroscopic methods, SEM, and rheological measurements were used to assess the properties of ZnPc-Col and prepared hydrogels. The photosensitizing activity of the hydrogels was investigated by application of 1,3-diphenylisobenzofuran as a singlet oxygen chemical quencher. Hydrogels bearing zinc phthalocyanine-colistin adduct revealed an improved APDT efficiency compared to hydrogels containing just zinc phthalocyanine component. This enhancement has been seen against P. aeruginosa.

Diastereoselective synthesis of cyclohexadienes via tandem cyclization strategies.

A new protocol has been developed for the diastereoselective synthesis of 1,3-cyclohexadienes using vinyl malononitriles, dibenzalacetones and NaH as reagents in THF. This transformation is comprised of interesting steps like Michael addition, cyclization and ring-opening reactions.