مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 100 (هفته دوم خرداد 1392)

Ovarian masses are one of the most common diseases in women of reproductive age. They are usually benign and surgery is necessary if they are getting large or symptomatic. Two methods of laparoscopic surgery and laparotomy are used for treatment of ovarian masses. Nowadays، there is belief that the laparoscopy procedure has some advantages in compare with laparotomy. The purpose of this study was to compare laparoscopy versus laparotomy for surgical treatment of benign ovarian masses. This historical cohort study was conducted on 50 women with benign ovarian masses who underwent laparoscopy and 50 women who underwent laparotomy during 2006-2010 by the same gynecologist in Amir Almomenin hospital of Semnan، Iran. Data were gathered by a check list separately for each patient using hospital records and a check list from surgeon''s office records that contained a two year follow-up of recurrence rate and re-intervention rate of masses. Data were analyzed using SPSS software version 16، Kolmogorov–Smirnov، t-test، Mann-Whitney، Chi-square and Fisher exact tests. P value less than 0. 05 was considered significant. The mean duration of hospital stay after surgery (p<0. 001) and the mean number of dose of postoperative analgesic (p=0. 001) were significantly lower in the laparoscopy group than laparotomy group (p<0. 001). There were no significant differences between two groups regarding the duration of surgery (p=0. 079)، rate of blood transfusion (p=0. 117)، postoperative complications such as nausea and vomiting (p=0. 372) and the incidence of fever in the first 24 hours after surgery (p=0. 678). Sonographic evidence of recurrence (p=0. 445) and re-intervention rate performed within 2 years (p=0. 392) were not significantly different between two groups. Laparoscopic treatment of benign ovarian masses seems to have potential benefits includes shorter hospital stay after the surgery، less pain and less dose of postoperative analgesic. Also there is no difference between laparoscopy and laparotomy in recurrence and re-intervention rates of the same ovarian mass after 2 years.

Breast cancer is the most common cancer in women worldwide and HER-2 is one importantly prognostic factor in this cancer. Tumor markers use as a criterion for predicting recurrence، but in breast cancer physical examination and mammography are important factors that are recommended for following up the recurrence. The aim of this study was to assess the correlation between breast cancer recurrence and HER2-overexpressing in breast cancer patients in Arak، Iran. This cross-sectional study was conducted on 140 patients with primary breast cancer referred to Ayatollah Khansari hospital of Arak، Iran during 2006-2010. Estrogen and progesterone receptors and HER-2 expression were evaluated by immunohistochemistry procedure in tissue samples. At arrival patients underwent complete physical examination and chest CT-scan. After operation and dissection of involved lymph node، patients treated properly by oncologist and followed up for 2 years for recurrence of symptoms. Data were analyzed by SPSS software version 16 and Chi-square test. P value less than 0. 05 was considered significant. Out of 140 cases، 102 patients (78. 85%) had lymph node metastasis. No significant association was found between HER2، estrogen and progesterone receptors and lymph node metastasis (p>0. 05). Rate of recurrence was 42. 1% in HER2 positivecases and 25. 6% in HER2negative. Rate of recurrence in both HER2 positive and HER2 negative groups showed no statistically significant difference (p=0. 16). There is no significant relation between breast cancer recurrence and over expression of HER2.

Reproductive ill-health related to the violation of sexual and reproductive rights has accounted for a significant part of the global disease burden in women and men of reproductive ages. The novelty of concept، its large domain and the current challenges in realization of sexual and reproductive rights led to carrying out this review in order to look at its history، concept، and the most important structure to enhance health care providers'' awareness on this concept.

This review was carried out in the period of 1946–2013 by searching in PubMed، Google Scholar، as well as websites of various international relevant organizations using key words including «reproductive rights»، «sexual rights»، «reproductive health»، «sexual health»، and «human rights». Articles، reports، and official publications of World Health Organization، United Nations، International Planned Parenthood Federation، United Nations Fund for Population Activities، Center for Reproductive Rights، Guttmacher Institute، and Ibis international nonprofit organization (totally، 11 deceleration and conventions، and 4 cultural documents) were reviewed. Also the findings of Quran''s content analysis were included in this study.

The concept of sexual and reproductive rights implies that all people are able to regulate their fertility and enjoy a mutually satisfying and safe relationship free from discrimination، coercion، and violence. The structure of sexual and reproductive rights include the right to choose whether or not to marry and to plan a family، the right to decide whether and when to have children، the right to sexual decision making free from discrimination and violence، and the right to information and education.

Sexual and reproductive rights with two main pillars including the right of decision making related to reproductive and sexual health free from discrimination، coercion، and violence and the right of access to information and effective education guarantees sexual and reproductive health of all persons. Complexities in the international concept of sexual and reproductive rights have raised the need to adapt it with socio-cultural context of Iranian society.