Objective: To evaluate the adnexal masses with conventional gray scale and color Doppler flow imaging and to assess their diagnostic reliability to differentiate benign and malignant adnexal masses.
Materials and methods: We evaluated 30 patients with adnexal mass. Morphological characterization of the mass was done using Sassone score. Color Doppler parameters noted down in each patient and Caruso vascular score was also used. The results were compared with surgical/ pathological and/or follow up scans.
Results: Using sonomorphological score (Sassone) overall reliability of differentiating adnexal masses had sensitivity of 91.7% and specificity of 77.7%. Using Caruso score alone we had sensitivity of 83.3% and specificity of 88.9%. Using Sassone and Caruso score together we had sensitivity of 90.9% and specificity of 93.3%.
Conclusion: In evaluation of adnexal masses combining both sonomorphological and color Doppler scores which gave higher specificity and positive predictive value (PPV) than using individual score alone.

Objective: This study focused on the factors affecting the institutional delivery and delivery assisted by health professionals in urban slums.
Materials and methods: A semi-structured questionnaire was developed to collect information from women aged 15-49 who had at least one birth. Totally 540 eligible women were interviewed.
Results: The results showed that around 20% of women delivered at an institute while 32.8% were assisted by health professionals. Logistic regression showed that respondent's education, number of ANC received by women, receiving TT, male participation, autonomy, attitude towards maternal health care services and distance from home to clinic had significant impact on both institutional delivery and delivery assisted by health professionals whereas birth order of the last child and respondent's knowledge on maternal health care services had a significant effect only on institutional delivery.
Conclusion: It might be concluded that in order to further increase the institutional delivery and delivery assisted by health professionals consideration should be given on the above-mentioned socio-economic and demographic factors.

Objective: The aims of this study were to determine the frequency of urinary and fecal incontinence and their determinants in pre-menopausal and menopausal women in Iran.
Materials and methods: This one-year cross-sectional study was performed on 304 women aged 40-55 who were admitted to women's clinic at Imam Khomeini Hospital. Symptoms of urinary, gas, and fecal incontinence and pelvic organs prolapse were diagnosed by a specialist through examination and a questionnaire. Patients were divided into two groups of with and without (urinary, gas, and fecal) incontinence symptoms. The probable risk factors of these disorders were studied and registered in the questionnaire and compared using t-test, chi-squared test, and regression of quantitative and qualitative variables.
Results: Generally, 129 (42%) out of 304 women had pelvic floor dysfunction (urinary and fecal incontinence, and pelvic organs prolapse). Risk factors including menopause, hormone therapy, history of hysterectomy, inactivity, age, BMI, and first child's birth weight were compared between the two groups using chi-squared and t tests. There was a statistically significant difference between the two groups (P=0.000) as risk factors were more frequently observed in women with incontinence symptoms.
Conclusion: Some risk factors of pelvic floor dysfunction are menopause, hormone therapy, history of hysterectomy, inactivity, age, BMI, and first child's birth weight. Therefore, some strategies should be included in women's health education programs to prevent the above-mentioned risk factors.

Objective: with regard to his human and social nature, sympathy is required that men and women live together in peace and rest. Since that family is manifestation and expression of life and love, divorce is a critical that consequences and undesirable effects on individuals, families and society. The present study based on gender People requesting a divorce in the family courts in Tehran has paid during the years 2006-2007.
Materials and methods: The sample included 300 people referred from the courts, and cross-sectional study approach, with structured interview was conducted. Causes and reasons for divorce after the interview and identified as economic factors, psychological, cultural - social, sexual problems, physical, addiction, violence and marriage with this classification and statistical methods chi-square, Fisher and Mann - Whitney two groups were compared.
Results: Results showed that although most divorce because both gender (84.4% of women and 90% of men) lack of understanding and compromise has been divorce for women, but more influenced by socioeconomic status (P< 0.001), violence (P< 0.001) sexual problems (P= 0.048) and addiction (P= 0.001), while men were more due to cultural problems - social (P= 0.023) had been demanded divorce.
Conclusion: The results also suggested the counseling of premarital and to aware in the field of professional advice at the time of the divorce that it can prevent the occurrence divorce.

Objective: Health Technology Assessment (HTA) aims at informing healthcare policymakers, managers and practitioners of the "clinical consequences, but also the economic, ethical, and other social implications of the diffusion and use of a specific procedure or technique on medical practice". So considering the policy-oriented nature of HTA that calls for a close integration into the functioning and governance of health systems the present study focuses on executive processes and function of the HTA office of Iran.
Materials and methods: Data of this review study were collected through documented sources and observations from 2007 to 2010.
Results: Health Technology Assessment began its activities as a secretariat in the Deputy of Health in 2007 and it continues as a Health Technology Assessment Office at the Management of Health Technology Assessment, Standardization, and Tariff at the Deputy of curative affairs of MOHME in the beginning of 2010.14 Technology of modern medical equipment and 8 pharmaceutical medicine are assessed, Now many of measures for HTA establishment  such as cooperation National Institute of Health Research (NIHR), Holding scientific committee meetings, Establishing  the  Master's degree of  health technology assessment ,Building capacities for health technology assessment through education in major universities of the country.
Conclusion: pay attention to health technology assessment, selection and application of proper technologies in the frameworks of policy-making and managerial strategies and make efforts to develop it with the support of the governmental in Iran is necessary.

Objective: To compare the effect of intrathecal midazolam versus neostigmine added to lidocaine on the duration of sensory block and the duration of postoperative pain relief in women undergoing colporaphy in spinal anesthesia.
Materials and methods: In this double blind clinical trial we evaluated 60women (ASA) I,II that were candidate to elective colporaphy. The patients were randomly divided in three groups ,first group(midazolam group)received hyperbaric lidocaine and 1mg midazolam(0.5cc),second group ( neostigmine group) received hyperbaric lidocaine  and 50µg midazolam(0.5cc) and third group were considered as control and received hyperbaric lidocaine plus normal saline(0.5cc).VAS  pain score 4,12 and 24 hours after surgery and duration of  analgesia in tree groups were compared.
Results: The duration of sensory block in the midazolam group was 98.4±18.2minuts, 74.5±32.6 in neostigmine and 64.5±9.9 in control group and difference between three groups was significant (p=0.001). Postoperative pain scores in midazolam group was 1.5±1.3, in neostigmine group was 2.4±1.6 and in control group was 3.5±2.7 and difference between three groups was significant (P=0.009).
Conclusion: Midazolam & neostigmine added to lidocaine 5% prolonged postoperative analgesia in colporrhaphy surgery in spinal anesthesia but midazolam was more effective than neostigmine.

Objective: Zinc is the second main element in the body after iron. Its importance in pregnancy is related to role in DNA and protein synthesis and consequently the necessity of its availability for the appropriate growth and development of the fetus and neonate. The purpose of this study was to assess the effect of zinc supplement on fetal outcomes (height, weight, head and chest circumference of the fetus, low birth weight, and pre-term birth) in pregnant women with lower-than-median serum zinc.
Materials and methods: Participants of this experimental double-blind clinical trial study were 263 healthy singleton pregnant women with a mean age of 26.46 (±4.52) years and gestational age of 14.52 (±4.51) weeks whose (non-fasting) serum zinc levels were lower than median of the study population. All eligible individuals were randomly divided into two groups of zinc supplement and placebo. Individuals in the zinc supplement group (128 participants) took one zinc supplement capsule including 25 mg elemental zinc and participants in the placebo group (135 people) took one placebo capsule per day until the end of pregnancy. All women were under control and supervision until the end of the pregnancy and their information about labor, delivery, and neonate measures were collected through their obstetric records and then compared.
Results: Findings of this study showed no significant difference in fetal measures at birth (weight, height, head and chest circumference), pre-term delivery, and low birth weight between zinc supplement and placebo groups.
Conclusion: According to our findings, administration of 25mg elemental zinc per day does not improve fetal measures in pregnant women with lower-than-median serum zinc concentration; however, more in-depth studies with larger sample sizes are recommended to achieve more reliable results.

Objective: To report a case of long-term disease free and successful pregnancy after fertility sparing staging surgery with adjuvant chemotherapy in a 46,Xy gonadal dysgenetic with malignant germ cell tumor.
Materials and methods: A case report from a university hospital about a 19-year-old female with 46,XY karyotype ( Swyer syndrome). The patient underwent bilateral gonadectomy and staging with uterus preservation. Six course adjuvant chemotherapy with VBP (Vinblastin, Bleomycin, Cisplatin) was given. The case got pregnant through IVF- embryo donation. Disease free period and successful pregnancy is reported.
Results: After treatment the patient is free of the disease after 11 years follow-up. She underwent in vitro fertilization treatment with oocyte donation and gave birth to a healthy ch.
Conclusion: Improved multimodality treatment, allowance for consideration of fertility options for some women with gynecologic cancers. Since major concern in women with XY gonadal dysgenesis is ovarian malignancy, even with stage II dysgerminoma hysterectomy may not be required in some cases considering the opportunity for childbearing with the use of embryo transfer.