Background: Toxoplasma gondii infection, if acquired as an acute infection during pregnancy, can have substantial adverse effects on mothers, fetuses and newborns. Latent toxoplasmosis also causes a variety of pathologies and has been linked to adverse effects on pregnancy. Objective: Here, we present results of a comprehensive systematic review and meta-analysis of the global prevalence of latent toxoplasmosis in pregnant women. Data source: We searched PubMed, EMBASE, Web of Science, SciELO and Scopus databases for relevant studies that were published between 1 January 1988 and 20 July 2019. Study eligibility criteria: All population-based, cross-sectional and longitudinal studies reporting the prevalence of latent toxoplasmosis in healthy pregnant women were considered for inclusion. Participants: Pregnant women who were tested for prevalence of latent toxoplasmosis. Interventions: There were no interventions. Method: We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CIs). We grouped prevalence data according to the geographic regions defined by the World Health Organization (WHO). Multiple subgroup and meta-regression analyses were performed. Results: In total, 311 studies with 320 relevant data sets representing 1 148 677 pregnant women from 91 countries were eligible for inclusion in the meta-analysis. The global prevalence of latent toxoplasmosis in pregnant women was estimated at 33.8% (95% CI, 31.8e35.9%; 345 870/1 148 677). South America had the highest pooled prevalence (56.2%; 50.5e62.8%) of latent toxoplasmosis in pregnant women, whereas the Western Pacific region had the lowest prevalence (11.8%; 8.1e16.0%). A significantly higher prevalence of latent toxoplasmosis was associated with countries with low income and low human development indices (p < 0.001). Conclusion:Our results indicate a high level of latent toxoplasmosis in pregnant women, especially in some low-and middle-income countries of Africa and South America, although the local prevalence varied markedly. These results suggest a need for improved prevention and control efforts to reduce the health risks to women and newborns.

Background:Regarding the contradictions about positive and negative effects of hysterectomy on women’s sexual functioning, this study was conducted to review the studies on the effect of hysterectomy on postoperative women’s sexual function.Method:This study was a narrative review and performed in 5 steps: a) Determining the research questions, b) Search methods for identification of relevant studies, c) Choosing the studies, d) Classifying, sorting out, and summarizing the data, and e) reporting the results.Findings:The review of the studies yielded 5 main categories of results as follows: The effect of hysterectomy on Sexual desire, the effect of hysterectomy on sexual arousal, the effect of hysterectomy on orgasm, the effect of hysterectomy on dyspareunia, and the effect of hysterectomy on sexual satisfaction.Conclusion:According to the studies reviewed in this study, most of the sexual disorders improve after hysterectomy for uterine benign diseases, and most of the patients who were sexually active before the surgery experienced the same or better sexual functioning after the surgery. An important solution for making these women ready to face with postoperative sexual complications is to train them on the basis of needs assessment in order that the patients undergoing hysterectomy be ready and capable of coping with the complications, and their sexual functioning improves after the surgery.

Background:Considering the controversial results of previous reports on awareness of bill of patients’ rights in different regions, as well as the fact that no report is available on the awareness of patients of their rights in teaching hospitals of Sari, we conducted the present study.Materials and Methods:This is a cross-sectional Study conducted in teaching hospitals of Sari in 2011. The study population consisted of 336 patients recruited from 4 hospitals affiliated with Mazandaran University of Medical Sciences in Sari, through calculating the selection quota of each hospital. Data were collected through face-to-face interview on discharge, using a two-section questionnaire based on the bill of patient rights and with verified reliability and validity. Data analysis was accomplished on SPSS soft- ware version 10.Results:55.4% of patients were women and 44.6% were men. The patients’ mean age was 40.93 ± 15.04 years and the mean length of stay was 4.6 ± 3.34 days. Most patients had elementary education (36%) or were illiterate (25%). The majority (63.4%) had not seen the bill of patients’ rights. 58.9% had poor knowledge, 12% had intermediate knowledge, and 29.1% had good knowledge. As for the articles of the bill, the poorest awareness correlated to the 9th article (the right to participate or refrain from participating in research). We found a significant relationship between awareness of the bill, and the patient’s education, seeing the bill, and age (p<0.0005).Conclusion:The results of the present study indicate that patients are not sufficiently aware of their rights, and this problem requires comprehensive planning to be resolved.

Background:Failure to progress remains a key indication for cesarean section which caused by different factors including uterine contractions. If it is diagnosed in the primary phase of labor, a better prognosis can thus be made. The purpose of this study was to find a possible correlation between pattern of uterine contraction and progression of labor.Method:During this study, 120 women referred for delivery to an educational hospital’s maternity ward in the North of Iran in 2010 were included. Uterine contractions of mothers were recorded in dilatation of 4 to7 cm for an hour. In this way, F/R ratio which means the time that a contraction needs to return from its peak to baseline (Fall) divided to the time for a contraction to rise to its peak (Rise) was calculated. All of the participants were followed until delivery, vaginal delivery or caesarean section.Results:Mean and standard deviation of fall to raise ratio was 1.54 ± 0.26 in mothers with vaginal delivery versus 1.74 ± 0.21 for others underwent caesarean section (OR = 0.44, 95% CI: 0.005- 0.42, P < 0.001). Sensitivity, specificity, and predictive values (positive and negative) of mentioned ratio were 68.32%, 70.01%, 69.55%, and 68.91%, respectively.Conclusion:By considering acceptable predictive value of uterine contractions’ pattern in the active phase of labor, it could help to timely diagnosis of failure to progress and consequently suitable intervention which probably maintain better health of both mother and fetus.

Previous studies have demonstrated that latent toxoplasmosis is associated with neuropsychiatric disorders. We evaluated the correlation between Toxoplasma gondii infection and prenatal depression. In this case-control study, we enrolled 116 depressed pregnant women and 244 healthy controls. The Edinburgh Postpartum Depression Scale (EPDS) was used to evaluate the depression symptom severity in study participants. All participants were screened for the anti-Toxoplasma IgG by enzyme-linked immunosorbent assay. Seroprevalence of T. gondii did not significantly differ between the depressed pregnant women and healthy controls (OR = 1.4; 95 % CI = 0.9-2.19; P = 0.142). T. gondii IgG titer was significantly higher in depressed women (18.6 ± 10.9 IUs) than those in the control group (13.6 ± 8.1 IUs) (z = -5.36, P < 0.001). The T. gondii-positive depressed women showed a positive correlation of T. gondii IgG titer with the EPDS scores (r = 0.52; P < 0.01). The mean EPDS score was also significantly higher in the T. gondii-positive depressed women (20.7 ± 2.7) compared with the controls (18.36 ± 2.7) (P < 0.001). The results obtained from the current study revealed that T. gondii infection might affect susceptibility to depression and severity of depressive symptoms in pregnant women, particularly in those patients who have high antibody titers. Further study is required to fully elucidate the characteristics and mechanisms of this association.