Design and application of metal organic frameworks for heavy metals adsorption in water: a review.

The growing apprehension surrounding heavy metal pollution in both environmental and industrial contexts has spurred extensive research into adsorption materials aimed at efficient remediation. Among these materials, Metal-Organic Frameworks (MOFs) have risen as versatile and promising contenders due to their adjustable properties, expansive surface areas, and sustainable characteristics, compared to traditional options like activated carbon and zeolites. This exhaustive review delves into the synthesis techniques, structural diversity, and adsorption capabilities of MOFs for the effective removal of heavy metals. The article explores the evolution of MOF design and fabrication methods, highlighting pivotal parameters influencing their adsorption performance, such as pore size, surface area, and the presence of functional groups. In this perspective review, a thorough analysis of various MOFs is presented, emphasizing the crucial role of ligands and metal nodes in adapting MOF properties for heavy metal removal. Moreover, the review delves into recent advancements in MOF-based composites and hybrid materials, shedding light on their heightened adsorption capacities, recyclability, and potential for regeneration. Challenges for optimization, regeneration efficiency and minimizing costs for large-scale applications are discussed.

A survey of female sexual dysfunction in gynaecological cancer survivors: A case–control study / Una encuesta sobre la disfunción sexual femenina en sobrevivientes de cáncer ginecológico: un estudio de control de casos

Background: With diagnostic and treatment advancements in cancer management, the need for improvement of survivors’ quality of life has been increasing. One of the issues affecting the quality of life in gynecologic cancer survivors is a decline in their sexual function, which is affected in many ways. In order to assess sexual dysfunction in gynecologic cancer survivors. Objective: This study is designed to assess different areas of sexual function including desire, arousal, vaginal lubrication, orgasm, satisfaction, and pain. Materials and methods: Patients who had completed treatment since 6 months to 6 years ago included in the case–control study starting from January 2019 to January 2020. Twenty-nine sexually active gynecologic cancer survivors with sexual dysfunction were enrolled as cases and 91 sexually active ones without sexual problems were assigned to the control group. The Female Sexual Function Index (FSFI) questionnaire consisting of 19-items and six areas was completed for each participant. Results: Average sexual dysfunction score of the case group was 16.78 with cut-off point of 28 for dysfunction. The most common domain of sexual dysfunction was pain (96.55%), followed by sexual arousal (86.21%), vaginal lubrication (72.41%), orgasm (72.41%), satisfaction (65.52%) and sexual desire (55.17%). Conclusion: In gynecologic cancer survivors, sexual dysfunction was directly related to employment, brachytherapy and co-existing DM and inversely related to the time elapsed since cancer diagnosis and menopause. Asking about sexual problems and referral to a specialist should be included in the patient treatment process.(AU)

Antecedentes: Con los avances en el diagnóstico y tratamiento del cáncer, la necesidad de mejorar la calidad de vida de los sobrevivientes ha ido en aumento. Uno de los problemas que afectan la calidad de vida de las sobrevivientes de cáncer ginecológico es la disminución de su función sexual, que se ve afectada de muchas maneras. Objetivo: Con el fin de evaluar la disfunción sexual en sobrevivientes de cáncer ginecológico, este estudio está diseñado para evaluar diferentes áreas de la función sexual, incluido el deseo, la excitación, la lubricación vaginal, el orgasmo, la satisfacción y el dolor. Materiales y métodos: Pacientes que habían completado el tratamiento desde hacía seis meses a seis años, incluidas en el estudio de casos y controles a partir de enero de 2019 a enero de 2020. Veintinueve sobrevivientes de cáncer ginecológico sexualmente activas con disfunción sexual se inscribieron como casos y 91 sobrevivientes sexualmente activas sin problemas sexuales fueron asignados al grupo de control. El cuestionario del Índice de Función Sexual Femenina (FSFI) que consta de 19 ítems y seis áreas se completó para cada participante. Resultados: La puntuación media de disfunción sexual del grupo de casos fue de 16,78 con un punto de corte de 28 para disfunción. El dominio más común de disfunción sexual fue el dolor (96,55%), seguido de excitación sexual (86,21%), lubricación vaginal (72,41%), orgasmo (72,41%), satisfacción (65,52%) y deseo sexual (55,17%). Conclusión: En las sobrevivientes de cáncer ginecológico, la disfunción sexual estuvo directamente relacionada con el empleo, la braquiterapia y la DM coexistente e inversamente relacionada con el tiempo transcurrido desde el diagnóstico del cáncer y la menopausia. La consulta sobre problemas sexuales y la derivación a un especialista deben incluirse en el proceso de tratamiento del paciente.(AU)

Low-temperature synthesis, characterization and photocatalytic properties of lanthanum vanadate LaVO4.

In this study, we have successfully prepared tetragonal lanthanum vanadate LaVO4 nanoparticles by a facile co-precipitation method at room temperature. The obtained materials were characterized using different structural and micro-structural techniques such as the characterization by X-ray diffraction (XRD), UV-Vis diffuse reflectance spectrum (DRS), transmission electron microscopy (TEM), and Raman spectrometry. The obtained structure is crystallized in single tetragonal phase with pin-like nanostructure. A main optical transition with bandgap energy of 3.26 eV is evidenced, and the average lifetime of charges carriers was found to be 1 ns Furthermore, the photoluminescence occurs in the visible light range. The photocatalytic activity was evaluated by the photocatalytic degradation of methylene blue (MB) with initial concentration of 10 mg L-1. The result indicates that LaVO4 particles showed a best photocatalytic activity of 98.2% degradation for methylene blue solution after irradiation of 90 min under visible light. Furthermore, the photocatalytic mechanism and reusability were studied.

Bismuth tungstate Bi2WO6: a review on structural, photophysical and photocatalytic properties.

This review paper provides a comprehensive overview of the recent trends in bismuth tungstate (Bi2WO6) research, covering its structural, electrical, photoluminescent, and photocatalytic properties. The structural characteristics of bismuth tungstate are explored in detail, including its different allotropic crystal structures with respect to its isotypic materials. The electrical properties of bismuth tungstate, such as its conductivity and electron mobility, are also discussed, along with its photoluminescent properties. The photocatalytic activity of bismuth tungstate is a particular focus, with recent advances in doping and co-doping strategies with metals, rare earth and other elements summarized. The limitations and challenges of using bismuth tungstate as a photocatalyst are also examined, such as its low quantum efficiency and susceptibility to photodegradation. Finally, recommendations for future research directions are provided, including the need for further studies on the underlying mechanisms of photocatalytic activity, the development of more efficient and stable bismuth tungstate-based photocatalysts, and the exploration of new applications in fields such as water treatment and energy conversion.

A case report of primary intra-abdominal synovial sarcoma and review of the literature / Reporte de un caso de sarcoma sinovial intraabdominal primario y revisión de la literatura

Synovial sarcoma is a well-recognized soft tissue malignancy in adult population. Primary intraabdominal synovial sarcoma is a rare occurrence, of which 1% has retroperitoneal location. These are firm, rounded, slowly growing, well-circumscribed tumors which can sometimes be of multinodular texture. Histopathology and Immunohistochemistry (IHC) aid in confirming the diagnosis. Nearly 90% of the cases have an associated chromosomal translocation (X; 18), (p11; q11). Given its rare occurrence, management of this malignancy is challenging, though radical surgery combined with chemotherapy and radiotherapy have been described.A 54-year-old, grand multiparous lady was referred to gynecologic oncology clinic due to a large pelvic mass and abnormal uterine bleeding. Pelvic MRI showed solid cystic pelvic mass in the left adnexa. She underwent laparotomy and bilateral salpingo-oophorectomy, hysterectomy, omentectomy and pelvic lymphadenectomy. Final pathology report revealed synovial sarcoma.Synovial sarcoma should be considered in the differential diagnosis of abdomino-pelvic masses in young and middle-aged patients.

El sarcoma sinovial es una neoplasia maligna de tejidos blandos bien reconocida en la población adulta. El sarcoma sinovial intraabdominal primario es una ocurrencia rara, de la cual el 1% tiene localización retroperitoneal. Se trata de tumores firmes, redondeados, de crecimiento lento y bien delimitados, que en ocasiones pueden tener una textura multinodular. La histopatología y la inmunohistoquímica (IHC) ayudan a confirmar el diagnóstico. Casi el 90% de los casos tienen una translocación cromosómica asociada (X; 18), (p11; q11). Dada su rara ocurrencia, el manejo de esta neoplasia maligna es un desafío, aunque se ha descrito cirugía radical combinada con quimioterapia y radioterapia.Una mujer adulta multípara de 54 años fue remitida a la clínica de oncología ginecológica debido a una gran masa pélvica y sangrado uterino anormal. La resonancia magnética pélvica mostró una masa pélvica quística sólida en el anexo izquierdo. Fue sometida a laparotomía y salpingooforectomía bilateral, histerectomía, omentectomía y linfadenectomía pélvica. El informe patológico final reveló sarcoma sinovial.El sarcoma sinovial debe considerarse en el diagnóstico diferencial de masas abdominopélvicas en pacientes jóvenes y de mediana edad.

Vitamin D status in preschool children in Algeria.

It is well established today that an optimal vitamin D intake plays a crucial role in the constitution of optimal osseous mass during childhood, and hence in the prevention of the osteoporosis in adults. The prevalence of the vitamin D deficiency is increasing globally and Algeria is no exception in this regard. Our study is the first to be carried out with healthy children of preschool age in North Africa. AIMS: The study aimed to evaluate the vitamin D status of a pediatric population, during all four seasons of the year, living in the north of Algeria, as well as to estimate the prevalence of vitamin D deficiency, identifying the potential risk factors. MATERIAL AND METHODS: This was an analytic and cross-sectional study carried out between March 2014 and March 2016 with healthy preschool infants from an urban environment in the town of Hussein Dey. A total of 1016 infants aged 9-72 months were included during this period. The consensual threshold value was 20ng/mL. RESULTS: The sex ratio was of 1.47 (535 boys/481 girls) and the average age of the children was 36.5±1.79 months. The daily average calcium ratio was 395±23 mg/with food contributions in vitamin D at an estimated average of 164 UI/day (4.1µg/day). The average concentration of the total 25-OHD for all four seasons of the year was 18.6±10.4ng/mL with an average rate of parathyroid hormone (PTH) of 30.9±14.6pg/mL. There was a highly significant inverse correlation between the serum level of vitamin D and PTH (r=-0.57; P=0.0001), the point of inflection was situated at 34.1ng/mL. The prevalence of vitamin D deficiency follows a seasonal variation that is statistically significant (P=0.0001), and the prevalence is higher during the autumn-winter period. The risk factors identified by multiple logistic regression were autumn-winter season (OR: 7; 95% CI: 3-11; P=0.001), age less than 24 months (OR: 3.8; 95% CI: 3.4-4.4; P=0.0001), high body mass index (OR: 2; 95% CI: 1.2-3.2; P=0.3), darker skin pigmentation (OR: 2.8; 95% CI: 2.2-5.2; P=0.001), duration of sunlight exposure less than 15min (OR: 6.1; 95% CI: 3.6-10.2; P=0.0001), low socioeconomic status (OR: 3.9; 95% CI: 1.5-4.3; P=0.01), calcium intake lower than 500 mg/day (OR: 2.5; 95% CI: 1.8-6; P=0.001), and a weekly dietary intake of vitamin D lower than 200 UI (OR: 2.6; 95% CI: 1.6-4.2; P=0.02). DISCUSSION: No studies have been conducted in north Africa or Algeria concerning healthy preschool children; however, this population has a rapid growth rate and deserves special attention. The prevalence of vitamin D deficiency in the children of this study was higher than that reported in studies of children of the same age living in Europe or America, despite the fact that Algeria is closer to the equator (36° latitude north). CONCLUSION: The changes experienced by Algerian society and the shorter exposure of the population to the sun call for more efforts regarding the detection and treatment of vitamin D deficiency, as well as an update of the vitamin D supplementation schedule.

Sociodemographic and behavioural determinants of early childhood caries knowledge among expectant mothers in Kuwait.

PURPOSE: Early Childhood Caries (ECC) is a highly prevalent disease in Kuwait. It poses health, economic, and social implications affecting patients, their families and communities. ECC awareness campaigns targeting expectant mothers hold a promising potential as primary prevention tools. Understanding the baseline of ECC knowledge (ECC-K) is an important foundational step in planning such interventions. The aim of this study was to assess the level of ECC-K in a sample of expectant mothers, and to identify the sociodemographic and behavioural determinants of that knowledge. METHODS: A multiple-choice questionnaire was distributed to 430 expectant women from one maternity hospital in Kuwait. The questionnaire gathered information on the demographics, ECC-K, and the oral health behaviours of the participants. Bivariate analysis assessed the relationship between ECC-K scores and the different socio-demographic variables and oral health practices of the participants. A multiple linear regression model was developed to identify the predictors of ECC-K scores RESULTS: The response rate was 94% (n = 405). The mean ECC-K score was 6.4 [standard deviation (SD) = 2.5] out of a maximum score of 14. Age, education, number of children, frequency of dental visits, and flossing frequency were significantly associated with ECC-K levels (p < 0.05). CONCLUSIONS: ECC-K among this cohort of expectant mothers was inadequate. Educational interventions are needed to foster better ECC preventive practices.

In vitro removal of polycyclic aromatic hydrocarbons by lactic acid bacteria.

AIMS: The current study aimed to investigate the ability of lactic acid bacteria (LABs) in removing four polycyclic aromatic hydrocarbons (PAHs) namely, benzo(a)pyrene (BaP), benz(a)anthracene (BaA), chrysene (Chr) and benzo(b)fluoranthene (BbF) from contaminated phosphate buffer saline (PBS). METHOD AND RESULTS: The effect of initial PAH concentrations (5, 10, 15, 20 µg ml-1 ), bacterial population (107 , 108 , 109 , 1010 CFU per ml) and pH (3, 5, 7) was studied to evaluate bacterial binding ability. All the tested bacteria could remove BaA, Chr, BbF and BaP from phosphate buffer solution and in almost all assays, removing of PAHs was as follows: BaP>Chr>BaA>BaF. Bifidobacterium lactis BB-12 had the lowest binding rate for all four PAHs, while the highest binding ability was related to Lactobacillus acidophilus LA-5. Moreover, cell viability was not required for the binding ability and even acid-treated, heat-treated and ultrasonic-treated bacterial cells showed more binding ability. The results showed that the bacteria-PAH complex was irreversible after washing with PBS. CONCLUSIONS: The removal of PAHs was significantly related to pH of media, strains of bacteria, type and concentration of PAHs SIGNIFICANCE AND IMPACT OF THE STUDY: This study has been focused on the reduction of polycyclic aromatic hydrocarbons using LABs and probiotics. Our results showed that not only live strains but also inactivated tested strains are able to remove PAHs from aqueous media, presenting new methods to diminish the amount of these contaminants in foods. Furthermore, the results of this study can be used in future research on evaluating the effects of oral administration of probiotic supplements and even dead probiotic strains on reducing PAHs in humans.

Microshear bond strength of different restorative materials to teeth with molar-incisor-hypomineralisation (MIH): a pilot study.

AIM: To compare the microshear bond strength of resin based composite (RBC) and resin modified glass ionomer cement (RMGIC) restorations when bonded to teeth with molar incisor hypomineralisation (MIH). METHODS: Eleven first permanent molars with MIH were included in this study. Teeth were sectioned mesio-distally producing a total of 22 surfaces for testing. Each specimen was placed inside a plastic ring with the flattened surface in contact with a glass slab. The plastic ring was filled with autopolymerising acrylic resin to imbed the specimen leaving the enamel surface exposed. Each surface was then bonded to 0.96 mm diameter RBC and light cured RMGIC following the manufacturers' instructions. Microshear bond testing was performed after 24 h storage in distilled water at 37 °C. A Bisco shear tester was used to apply shear stress of 1 mm/min until failure. Wilcoxon signed-rank paired-test was used for comparison of bond strength values. RESULTS: Microshear bond strength of RBC (30.80 ± 8.19 MPa) was significantly higher than that of RMGIC (11.13 ± 6.91 MPa) when bonded to hypomineralised permanent first molars (p < 0.001). CONCLUSION: The microshear bond strength of RBC is significantly higher than that of RMGIC when bonded to MIH affected teeth. Therefore, RBC can be recommended as the restoration of choice for teeth with MIH whenever the clinical scenario allows.

Predicting In vitro Culture Medium Macro-Nutrients Composition for Pear Rootstocks Using Regression Analysis and Neural Network Models.

Two modeling techniques [artificial neural network-genetic algorithm (ANN-GA) and stepwise regression analysis] were used to predict the effect of medium macro-nutrients on in vitro performance of pear rootstocks (OHF and Pyrodwarf). The ANN-GA described associations between investigating eight macronutrients (NO[Formula: see text], NH[Formula: see text], Ca(2+), K(+), Mg(2+), PO[Formula: see text], SO[Formula: see text], and Cl(-)) and explant growth parameters [proliferation rate (PR), shoot length (SL), shoot tip necrosis (STN), chlorosis (Chl), and vitrification (Vitri)]. ANN-GA revealed a substantially higher accuracy of prediction than for regression models. According to the ANN-GA results, among the input variables concentrations (mM), NH[Formula: see text] (301.7), and NO[Formula: see text], NH[Formula: see text] (64), SO[Formula: see text] (54.1), K(+) (40.4), and NO[Formula: see text] (35.1) in OHF and Ca(2+) (23.7), NH[Formula: see text] (10.7), NO[Formula: see text] (9.1), NH[Formula: see text] (317.6), and NH[Formula: see text] (79.6) in Pyrodwarf had the highest values of VSR in data set, respectively, for PR, SL, STN, Chl, and Vitri. The ANN-GA showed that media containing (mM) 62.5 NO[Formula: see text], 5.7 NH[Formula: see text], 2.7 Ca(2+), 31.5 K(+), 3.3 Mg(2+), 2.6 PO[Formula: see text], 5.6 SO[Formula: see text], and 3.5 Cl(-) could lead to optimal PR for OHF and optimal PR for Pyrodwarf may be obtained with media containing 25.6 NO[Formula: see text], 13.1 NH[Formula: see text], 5.5 Ca(2+), 35.7 K(+), 1.5 Mg(2+), 2.1 PO[Formula: see text], 3.6 SO[Formula: see text], and 3 Cl(-).

Alfentanil during rapid sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg: tracheal intubation conditions.

BACKGROUND: Opioids have become an integral part of anaesthesia induction. We aimed to determine the dose of alfentanil needed to obtain perfect tracheal intubation conditions during rapid sequence induction with standard doses of thiopental and rocuronium, where laryngoscopy was initiated 55 s after commencement of drug administration. The influence of covariates (sex, body weight, age, alfentanil plasma concentration at laryngoscopy) was tested. METHODS: Eighty-four healthy individuals were randomly assigned to receive one of the seven assessor-blinded alfentanil doses (0, 10, 20, 30, 40, 50 and 60 µg/kg) in conjunction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. For drug administration, 15 s was allowed. Laryngoscopy was initiated 40 s after rocuronium and tracheal intubation concluded within 70 s after commencement of drug administration. Alfentanil doses associated with 50%, 90% and 95% probability of perfect intubation conditions were determined with logistic regression. Multiple logistic regressions were used to test the influence of covariates. The relationship between alfentanil dose and concentration at laryngoscopy was analysed with linear regression. The effects of covariates on plasma concentrations of alfentanil were tested with multiple linear regressions. RESULTS: Perfect intubation conditions of 95% probability was obtained with 56 µg/kg (confidence intervals 44-68). None of the covariates were significant predictors of perfect intubation conditions. Alfentanil plasma concentration correlated with dose and increased with increasing body weight (1.7 ng/ml/kg). CONCLUSION: Perfect intubation conditions during rapid sequence induction can be obtained with clinically relevant doses of alfentanil in most healthy patients anaesthetized with thiopental 4 mg/kg and rocuronium 0.6 mg/kg.

On a cubically convergent iterative method for matrix sign.

We propose an iterative method for finding matrix sign function. It is shown that the scheme has global behavior with cubical rate of convergence. Examples are included to show the applicability and efficiency of the proposed scheme and its reciprocal.

On a derivative-free variant of king's family with memory.

The aim of this paper is to construct a method with memory according to King's family of methods without memory for nonlinear equations. It is proved that the proposed method possesses higher R-order of convergence using the same number of functional evaluations as King's family. Numerical experiments are given to illustrate the performance of the constructed scheme.

On a new iterative scheme without memory with optimal eighth order.

The purpose of this paper is to derive and discuss a three-step iterative expression for solving nonlinear equations. In fact, we derive a derivative-free form for one of the existing optimal eighth-order methods and preserve its convergence order. Theoretical results will be upheld by numerical experiments.

The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran.

BACKGROUND: Service quality is perceived as an important factor for developing patient's loyalty. The aim of this study was to determine the hospital service quality from the patients' viewpoints and the relative importance of quality dimensions in predicting the patient's loyalty. METHODS: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 items about the service quality and 3 items about the patient's loyalty. Exploratory factor analysis was employed to extracting the dimensions of service quality. Also, regression analysis was performed to determining the relative importance of the service quality dimensions in predicting the patient's loyalty. RESULT: The mean score of service quality and patient's loyalty was 3.99 and 4.16 out of 5, respectively. About 29% of the loyalty variance was explained by the service quality dimensions. Four quality dimensions (Costing, Process Quality, Interaction Quality and Environment Quality) were found to be key determinants of the patient's loyalty in the private hospitals of Tehran. CONCLUSION: The patients' experience in relation to the private hospitals' services has strong impact on the outcome variables like willingness to return to the same hospital and reuse its services or recommend them to others. The relationship between the service quality and patient's loyalty proves the strategic importance of improving the service quality for dragging and retaining patients and expanding the market share.

Quality of working life on residents working in hospitals.

BACKGROUND: Residents play an important role in the delivery of hospital care. They regularly work overnight, in emergency situations and with workload and stress which can affect their performance and quality of working life (QWL). This study explores the QWL and its contributory factors in residents working at hospitals affiliated with Tehran University of Medical Sciences (TUMS), Tehran, Iran. METHODS: Medline was searched to identify questionnaires for measuring QWL in healthcare professionals and these questionnaires were used to design a comprehensive questionnaire for measuring residents QWL. Face and content validity of the questionnaire were examined by 7 experts. The questionnaire then was completed twice with one-week interval by 14 residents to assess the intera-rater reliability. Then 310 questionnaires were distributed among residents working at different specialties in 7 hospitals affiliated to TUMS including a large general hospital, two medium general hospitals and four small single specialty hospitals. Statistical analyses were performed by SPSS. RESULTS: Totally, 263 residents (84%) completed the questionnaire. The quality of working life was very well in 18%, well in 32%, moderate in 31%, low in 14% and very low in 5% of residents. Pediatric residents had the highest and urology and internal medicine residents had the lowest quality of working life. CONCLUSION: The QWL is high in the majority of residents, but the QWL is still not desirable in a significant proportion of them. The questionnaire used in this study is reliable and valid. The residents' QWL still need improvement.

The Psychometric Properties of the Farsi Version of "Hospital Survey on Patient Safety Culture" In Iran's Hospitals.

BACKGROUND: If you want to start a long journey towards patient safety, you should create a good culture of patient safety among employees alongside structural interventions. The first step in doing so is the assessment of current culture in the organization using different tools. One of the most commonly used instruments of measuring patient safety culture is Hospital Survey of Patient Safety culture (HSOPS). The aim of this study was to assess the validity and reliability of Farsi version of this questionnaire for the first time in Iran's hospitals. METHODS: We purposefully selected four hospitals out of seven general Tehran University of Medical Sciences affiliated hospitals. Then a 420 sample of staff of these hospitals were taken randomly. Staff was asked to complete the questionnaire. Confirmative factor analysis, correlation coefficient, Cronbach's alpha were employed in statistical analyses. RESULTS: Factor loadings for almost all questions were acceptable. Factors jointly explained 77.8% of the variance in the responses. The Cronbach's alpha coefficient was between 0.57 and 0.8. The study revealed that over 70% of employees were working at their hospitals more than 40 hours a week and also more than half of the employees were not reporting errors. CONCLUSION: Farsi version of HSOPS with 12 dimensions and 42 questions is a valid and reliable questionnaire to measure patient safety culture for the first time in Iran hospitals. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Iran.

Primary anaplastic large cell lymphoma of trachea with subcutaneous emphysema and progressive dyspnea.

Primary anaplastic large cell lymphoma of the trachea is a rare tumor. Common complaints are dyspnea and cough that could mimic a partially refractory asthma in some cases. We report a 16-year-old female with an anaplastic large cell lymphoma (null cell type) in which tracheal involvement was presented with life-threatening airway obstruction and subcutaneous emphysema. After debulking the tumor by endobronchial curettage, the patient was treated with chemotherapy followed by local radiotherapy. She had no evidence of local or distant recurrence after 25 months. Primary anaplastic large cell lymphoma of the trachea is a rare life-threatening disease. Nevertheless, this condition has a good prognosis if diagnosed immediately and treated with chemotherapy and radiotherapy.

Assessing health system responsiveness: a household survey in 17th district of tehran.

BACKGROUND: Responsiveness is an indicator by WHO to evaluate the performance of health systems on nonmedical expectations of consumers. This study measures the health system responsiveness and the factors affecting responsiveness in Iran health system. METHODS: World Health Survey (WHS) questionnaire was used to collect data on a two-stage cluster sampling in 17th District of Tehran in 2003. Of a sample of 773, 677 and 299 individuals who respectively had outpatient or inpatient services utilization responded to the responsiveness module of WHS questionnaire. RESULT: More than 90% of respondents believed that responsiveness issues were very important. Performance of outpatient services was better than hospital services in terms of responsiveness. "Prompt attention" and "quality of basic amenities" received low score for outpatient services. Service user variables had no significant effect on responsiveness, while type of centers was significantly related to responsiveness. Principal component analysis found three factors for both outpatient and inpatient services that explained 62% and 61% of total variances respectfully. CONCLUSION: Iran health system should pay more attention to responding non-medical expectations of service users. It sounds that health system interventions are main determinant of responsiveness score compared to demographic or user variables. Training health staff, allocating more resources and reengineering some processes may play a role in improving responsiveness. Responsiveness domains seems to be tailored based on each society's cultural factors.