Adenoid cystic carcinoma is a malignant tumor of the major and minor salivary glands. Because it grows very slowly, it is often diagnosed at a late stage. The combination of a delayed diagnosis and the tumor's propensity for early perineural and hematologic spread increases the risk of local recurrence and systemic metastasis, often many years after the primary tumor has been diagnosed and treated. Only 80 cases of adenoid cystic carcinoma of the larynx have been previously reported in the literature. We report a new case of laryngeal subglottic adenoid cystic carcinoma in a 12-year-old boy.

Fine needle aspiration cytology (FNAC) is commonly used in the study of parotid masses; however controversy exists regarding its diagnostic accuracy. The objective of this study was to evaluate the effectiveness of FNAC as a preoperative diagnostic tool of parotid tumors. Sixty-five patients had satisfactory preoperative FNAC and underwent subsequent surgery to the parotid between March 2002 and July 2009 at our institution. The results of the FNAC were compared to the permanent histopathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and the overall accuracy of FNAC for parotid masses were 57.9, 97.8, 91.7, 84.9, and 86%, respectively. FNAC is useful in the preoperative assessment of parotid tumors and surgical planning. The non-diagnostic and false-negative results are the limitations of FNAC that should be reduced to improve its usefulness in the evaluation of parotid tumors.

Sialolipoma of the salivary gland is a tumor with ambiguous histogenesis. Histologically, this lesion is composed of mature adipose tissue and salivary glandular components. To the best of our knowledge, only 12 documented cases of sialolipoma have been reported in the literature. Except for 1 congenital case, all of the cases were found in adult patients. In this report, we present a unique case of sialolipoma with diffuse sebaceous differentiation in a 3-year-old female child. The differential diagnoses are discussed.

Background & Objectives: Cardio Pulmonary Resuscitation (CPR) is a procedure which was done both in hospital or pre-hospital in order to return life after clinical death. Although the most cardiac attacks happen out of hospital, but there are lack of existing studies related to CPR assessment in pre-hospital conditions. Then this study carried out in order to show the outcome of pre-hospital CPR procedures and its related factors in Medical Emergency Centers of Ardebil city. Method:This descriptive cross-sectional study was conducted on 272 CPR cases in the Emergency Medical Center (EMS) in Ardabil, between 2012 and 2013. The researcher-made questionnaire was used. For data analyzing the descriptive and analytical statistical method such as the Chi-square test and the Chi-square details test were used with SPSS 16 software. The values of P<0.05 were considered significant. Results:The overall rate of successful CPR reported only 19.1%. The mean (SD) of patient's age was 74.19±79.60 years and the most of them (66.2%) were men. The most patients (64.3%), had heart problems as a chief complaint. From all CPRs, 83.1% and 11.5% were done in patient homes and public place respectively. There was no statistically significant relationship between the successful CPR with age (p=0.15), sex (p=0.44), the arrival time of emergency personnel to the scene (p=0.98) and patient's pulse rate (p=0.52). But there was statistically significant relationship between the successful CPR with underlying diseases (p=0.003), Location of CPR (P=0.002), patient blood pressure (p=0.00) and patient respiratory rate (p=0.04). Conclusion:According to the findings, the rate of successful CPR was at a low level in the pre-hospital that need to be investigated further about its cause and its related factors.

IntroductionQuality is a key factor for the success of any organization. Moreover, accessing quality in the emergency department is highly significant due to the sensitive and complex role of this department in hospitals as well as the healthcare and medical treatment system. This study aimed to identify, from the perspective of medical experts and nurses serving in the military health and medical treatment system, the factors that affect the quality of emergency service provided in selected military hospitals in Iran.MethodsThis qualitative research was performed in Valiaser Hospital of Tehran (Iran) in 2015, using the framework analysis method. The purposive sampling technique was used for data collection. A total of 14 participants included two emergency medicine specialists, four general physicians, two senior nurses (holding M.Sc. degrees), and six nurses (holding B.Sc. degree). Data were collected through semistructured interviews. Sampling continued until data saturation occurred. The Atlas/Ti software was employed for data analysis.ResultsFour basic themes emerged as the effective factors on the quality of emergency services, namely, structural themes, process/performance themes, outcome themes, and environmental/contextual themes. Moreover, through a framework analysis, 47 subthemes were specified and summarized as indicators of the different aspects of the main themes.ConclusionThe factors affecting the quality of emergency services in Iran’s selected military hospitals are especially complicated due to the diversity of the missions involved; thus, different factors can influence this quality. Therefore, an effort should be made to tackle the existing obstacles, facilitate the identification of these effective factors, and promotion of the quality of healthcare services.