Prevalence of Violence in Iranian Pregnant Women: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIMS: Violence against pregnant women is a significant public health problem, resulting in disability and various physical and mental health disorders. This systematic review and meta-analysis explored the prevalence of physical, verbal, sexual, psychological, emotional, economic, and other types of violence among pregnant women in Iran. METHODS: Bibliographic databases including PubMed, Embase, Web of Science (WoS), and Scopus, and also Iranian databases including Scientific Information Database (SID), Magiran, and Civilica were searched from 2002 to September 16, 2020. Following a random-effects meta-analysis, we estimated the pooled prevalence of exposure to different types of violence among Iranian pregnant women. Overall, 61 articles that met the inclusion criteria were analyzed in this systematic review. RESULTS: The prevalence of physical violence was 19.0% (95% confidence intervals [CI]: 14.0, 24.0), verbal violence was 42.0% (95% CI: 24.0, 61.0), sexual violence was 26.0% (95% CI: 20.0, 32.0), psychological violence was 37.0% (95% CI: 28.0, 46.0), emotional violence was 51.0% (95% CI: 40.0, 62.0), economic 39.0% (95% CI: 19.0, 60.0), and the prevalence of other types of violence was 54.0% (95% CI: 46.0, 62.0). CONCLUSIONS: This study revealed that Iranian pregnant women are often exposed to different types of violence. Therefore, screening for violence in this vulnerable group seems necessary due to the sensitive nature of pregnancy and its importance in maternal health. This alarming rate of violence calls for adopting upstream policies and interventions to reduce violent practices against pregnant women in Iran.

Comparing the effect of acupressure with or without ice in LI-4 point on labour pain and anxiety levels during labour: a randomised controlled trial.

The aim of this study was to assess the effect of acupressure with or without ice on reducing pain and anxiety during labour. The anxiety level of mothers was measured before and after study using Spielberger Inventory along with the labour pain. To improve the strength of this study, a meta-analysis was conducted on the effect of acupressure in point LI-4 on anxiety during labour. Ninety women in labour were randomly divided into three groups: acupressure with ice, acupressure without ice and the control group. The result suggested that women receiving both acupressure with ice (p = .005) or without ice (p < .001) experienced less labour pain in comparison with the control group. Also, the labour pain severity in acupressure without ice was lower than the group with ice (p < .001). Acupressure with (p = 1) or without (p = .09) ice was not significantly different from the control group in terms of the anxiety level. However, women in the group of acupressure without ice experienced less anxiety in comparison with acupressure with ice (p = .04). The difference in pain severity before and after treatment with acupressure with (RCI = 2.86) or without ice (RCI = 5.54) was clinically significant. The intervention was not clinically meaningful in terms of anxiety.Impact statementWhat is already known on this subject? Previous trials have exhibited that acupressure with/without ice reduced pain and anxiety during labour.What do the results of this subject add? The results of this research was consistent with previous studies, suggesting that acupressure, with or without ice, is more effective than the control group regarding labour pain. However, the group of acupressure with ice was not different from the control group with respect to the anxiety level.What are the implications of these findings for clinical practice and/or further research? In light of advantages, such as growing preference of women, researcher and health care providers for physiological delivery coupled with its safety and simplicity, it can be used as an effective technique to manage labour pain. Further studies are required to assess the effect of acupressure at L4 on the anxiety level.

The effect and safety of Berberine on polycystic ovary syndrome: a systematic review.

The aim of this systematic review is to assess the effect of Berberine (BBR) on women's health to provide greater insights about its effect on women with polycystic syndrome for both patients and health care providers. Electronic databases such as PubMed, Web of Science, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) were systematically searched from the base to July 1th, 2019 to identify clinical trials and randomised controlled trials that had explored the effect of BBR on the polycystic syndrome. With regard to the weight and composition body, BBR did not have any significant effect on reducing body weight and conflicting findings had been reported about waist circumference (WC) and body mass index (BMI). However, BBR led to a significant decrease in waist to hip ratio (WHR), profile hormonal insulin resistance (IR), and insulin resistance (HOMA-IR). Further, androstenedione dropped significantly following treatment with BBB. However, BBB did not have a significant effect on follicle stimulating hormone (FSH) and luteinizing hormone (LH).

A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy.

To assess the efficacy alternative medicine in the treatment of nausea and vomiting of pregnancy (NVP), three major databases of PubMed, Cochrane Library and Scopus were systematically searched since inception until January 14 2019 to investigate the effects of herbal medicines on NVD. The quality assessment of studies was performed according to Jadad scale. All studies showed that ginger had a positive effect on nausea in pregnant women. Unlike others studies, one study reported that ginger was not beneficial to the treatment of vomiting. Herbal medicines such as matricaria chamomilla, elettaria cardamomum, pomegranate and spearmint syrup, lemon provide safe and effective medical alternatives for treating pregnant women with mild to moderate NVD. The results suggested that ginger were more effective than vitamin B, but at the dose of 35-500 mg ginger, vitamin B6 and ginger had identical effect. However, over a longer treatment period (60 days), vitamin B6 was proved to be more effective than ginger. The same effect was observed in the comparison of quince and vitamin B6 as well as ginger and doxylamine plus pyridoxine. Mentha did not generated a positive effect on nausea and vomiting. However, this finding should be considered in the light of the above limitations.IMPACT STATEMENTWhat is already known on the subject? Previous systematic reviews have shown the superiority of ginger over the placebo. Lemon, chamomile and Mentha have been found to be more effective than the placebo.What do the results of this study add? This systematic review confirmed the results of previous systematic reviews in a larger sample size. Ginger was more effective than vitamin B, but at the dose of 35-500 mg ginger, vitamin B6 and ginger had identical effect. However, over a longer treatment period (60 days), vitamin B6 was proved to be more effective than ginger.What are the implications of these findings for clinical practice and further research? Matricaria chamomilla, elettaria cardamomum, pomegranate and spearmint syrup, lemon and ginger can be recommended to pregnant women for alleviation of NVP.

The association between green tea consumption and breast cancer risk: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to critically evaluate the relation between green tea (GT) consumption and the risk of breast cancer. Popular electronic databases were systematically searched for papers in English language. All case-control and cohort studies in addition to randomized clinical trials were included if they assessed the chemopreventive effects of GT on breast cancer. The quality of included studies was assessed using the Newcastle-Ottawa and Jadad scale. This systematic review comprised 14 studies: 9 case-control studies, 4 cohort studies, and 1 clinical trial. Odds ratio (OR) in case-control studies suggested that women in the group receiving the highest level of GT had 19% reduction in breast cancer risk compared with those who received the lowest level of GT (summary OR = 0.81, p = .031; 95% CI [0.66, 0.981]; heterogeneity, I2  = 71.53, p < .001, random effect model; 9 studies). OR in cohort studies also showed no significant difference (OR = 0.99, p = .94; 95% CI [0.81, 1.138]; heterogeneity, I2  = 19.06, p = .29; fixed-effect model; 4 studies). According to the only clinical trial, treatment with GT could not alter the mammographic density compared with placebo (26% vs. 25%). It cannot be concluded that GT consumption may decrease the risk of breast cancer. Due to high heterogeneity, a pooled analysis of case-control and cohort studies was not performed.

Factorial structure of the Persian version of Childbearing Questionnaire in first time engaged couples in Iran.

The primary aim of this study was to assess the factorial structure of a Childbearing Questionnaire (CBQ). Using confirmatory factor analysis, it examined modified eight-factor models on a sample of 448 couples. Cronbach's alpha coefficients were 0.90 and 0.83 for positive and negative childbearing motivation, respectively, and the intra-class correlation coefficient (ICC) was in the range of 0.81-0.86, which indicated that the reliability of the questionnaire was high. The modified model was found to have 'adequate' fitness based on the Root Mean Square Error of Approximation (RMSEA), but other indicators such as the Tucker-Lewis Index (TLI) and Comparative Fit Index (CFI) did not show any 'acceptable' fitness. In the eight-factor model, three factors with low loading were removed to achieve adequate fitness. Also, 13 correlated error terms were added to the modified model. The confirmatory factor analysis of the modified model showed 'adequate' fitness (CFI = 0.91, TLI =0.9, RMSEA = 0.06 and Chi-square to a degree of freedom ratio (χ2/df) = 3.49). This study supported the use of CBQ as a valid and reliable instrument of childbearing in engaged couples. Impact statement Current research on the subject: Some studies have suggested that the construct validity, internal consistency and the test-retest reliability of a Childbearing Questionnaire (CBQ) are high. The contribution made by the results of this study: It determined the reliability (internal consistency and test-retest reliability), the content validity and construct validity (confirmatory factor analysis) of the Persian version of the Childbearing Questionnaire. The implications of findings for clinical practice and further research: This reliable and valid instrument can be used for measuring the factors affecting childbearing motivations among engaged couples.

Effect of Foeniculum vulgare (fennel) on symptoms of depression and anxiety in postmenopausal women: a double-blind randomised controlled trial.

The aim of this study was to evaluate the effect of Foeniculum vulgare (fennel) on anxiety and depression symptoms in postmenopausal women. This study was a double-blind, randomised, placebo-controlled trial, in which 60 eligible postmenopausal women were selected and then randomly assigned to fennel and placebo groups. Then, symptoms of anxiety and depression were measured using Hospital Anxiety and Depression Scale (HADS) and Zung's Self Rating Depression Scale (SDS). Following the intervention, the score of HADS (depression and anxiety subgroups) and SDS did not show any significant decrease in the sample under study. However, the analysis of patients with depression or anxiety disorder showed a borderline or significant improvement. Further studies with a larger sample size are required to confirm the findings. Impact statement Current knowledge on the subject: Based on the results of in vivo and in vitro animal studies, fennel may have anti-depressant and anti-anxiety properties. The contribution made by this study: It appears that fennel is effective in menopausal women with depression and anxiety disorders. The implications of findings for clinical practice and future research: Further studies with a larger sample size are required to confirm the actual effect of fennel in clinical setting.

The effect of a vaginal suppository formulation of dill (Anethum graveolens) in comparison to clotrimazole vaginal tablet on the treatment of vulvovaginal candidiasis.

The goal of this study was to compare the effect of Anethum graveolens (dill) vaginal suppositories and 100 mg clotrimazole vaginal tablets on vulvovaginal Candidiasis. This study was a single centre, single-blind, randomised, placebo-controlled trial, in which 60 women with microbiology-confirmed vulvovaginal candidiasis were randomly assigned to dill and clotrimazole groups. At the end of the study, the estimated prevalence of leucorrhoea, burning, and itching was 23%, 23% and 20% in dill users, respectively. This figure was 20%, 10% and 16.7% for the clotrimazole group, respectively. The difference between the two groups was not significant. 13% of suppository patients, compared with 10% of clotrimazole-treatment patients, had a positive culture, which was not significant (p = .68). According to findings, 2% dill vaginal suppositories were as effective as clotrimazole vaginal tablets in reducing both clinical and microbiological symptoms of Candidiasis. Studies with larger sample sizes are required to confirm current findings. Impact statement What is already known on the subject? Based on results from in vivo and in vitro animal studies, dill (Anethum graveolens) has anti-candida activity. What do the results of this study add? It appears that 2% dill vaginal suppositories were as effective as 100 mg clotrimazole vaginal tablets in reducing both the clinical and microbiological symptoms. What are the implications of these findings for clinical practice and further research? Obstetricians and gynaecologists can offer dill as a useful alternative to chemical drugs, especially in women who are often interested in herbal medicine, or in women who are resistant or are not allowed to use antifungal drugs.

The relationship between women's attitude towards menopause and menopausal symptoms among postmenopausal women.

OBJECTIVES: The purpose of this study is to assess the symptoms of menopausal women as well as the relationship between women's attitude towards menopause and menopausal symptoms. METHOD: This studied, following a cross-sectional method, included 349 selected postmenopausal women attending health care centers. The data was collected using the attitude toward menopause (ATM) checklist and Menopause-Specific Quality of Life (MENQOL) questionnaires. RESULTS: The most common menopausal symptoms were physical with joint and muscle pain. The highest mean score belongs to vasomotor symptoms (1.37 ± 1.43), followed by psychosocial (1.32 ± 1.16), physical (1.22 ± 0.96), and sexual (0.91 ± 0.94) symptoms. Attitude toward menopause was significantly influenced by sweat nights, poor memory, and sleeplessness. The marital status and educational level of the husband were the only demographic factors affecting the severity of menopausal symptoms. CONCLUSION: This study provides deeper insights about the relationship between attitudes towards menopause and menopausal symptoms, which can guide health-care professionals towards providing an optimal package.

Association between anthropometric indices and quality of life in menopausal women.

OBJECTIVE: To investigate whether body mass index (BMI), abdominal obesity or fat distribution influence the quality of life of postmenopausal women. METHODS: Subjects in this cross-sectional study were 233 postmenopausal women (aged 45-70 years) with an intact uterus and ovaries and who were sexually active and not using hormone therapy. Anthropometric measurements were recorded and subjects were interviewed using a specific health-related quality of life (HR-QoL) instrument, the MENQoL scale. RESULTS: According to BMI values, 31.5% of the women were obese, 42.2% were overweight, 25.8% were normal weight and none were underweight. However, according to the MENQOL scale results, obese women scored significantly higher on symptoms for physical domains. The women with the android pattern of fat distribution had significantly higher scores in the vasomotor and physical domains (p < 0.05). CONCLUSIONS: Obesity did not affect global HR-QoL in postmenopausal women, but appeared to have an influence on the psychical domains. Other anthropometric measurements were not associated with differences in HR-QoL. Keeping the anthropometric indices in the normal/premenopausal might improve the quality of life in menopause women.

Developing and Validating a Questionnaire to Measure Attitude toward Child Adoption: A Psychometric Process.

Background: Despite the mutual benefit of adoption, due to the adverse attitude related to the barriers perceived by the couples, some people are not interested in adoption. The purpose of this study was to develop and validate a questionnaire to measure attitudes toward child adoption. Materials and Methods: This secondary analysis is part of a larger study on 178 infertile couples referring to the Afzalipour Infertility Center in Kerman, Iran. Factor Analysis (FA) was performed. The sampling was conducted using the convenience sampling method. The questionnaire was implemented using a mixed-method approach in three phases. Firstly, a pool was created. The second phase involved content validity. Lastly, construct validity was conducted. Results: The final version of the questionnaire with 20 questions had a total Cronbach's alpha of 0.70%. Six factors with eigenvalues of higher than 1.00 were extracted, which accounted for 52% of the total variance. These factors were "spiritual-psychological status of the new parents," "psychological status of the adopted child," "undesirable behaviors of others in the future," "anxiety of the new parents," "physical-behavioral characteristics of the adopted child," and "socio-economic factors." The model extracted from the Exploratory Factor Analysis (EFA) was confirmed by Confirmatory Factor Analysis (CFA). The 6-factor structure adequately fitted the data (Comparative Fit Index (CFI) = 0.93; root mean square error of approximation [RMSEA] = 0.047; X2/df = 1.393; p = 0.002. Conclusions: The internal consistency and construct validity of the questionnaire were confirmed. This instrument can be used in clinical and research practices.

Psychometric and clinical assessment of the Persian-SCREENIVF among infertile couples.

There is a significant rate of infertility and subsequent psychological problems among couples worldwide. Screening and treatment of the emotional burden of infertility and related Assistant Reproductive Therapies help to improve the quality of life of infertile people. Specific instruments which measure infertility-related status are more accurate. This study aimed to validate the SCREENIVF questionnaire to be used for the psychological screening and care of couples who seek infertility treatment. This quantitative psychometric study was run in infertility private and governmental clinics in XXX on 344 infertile women and men. They filled Persian-SCREENIVF. The Rasch-Andrich rating scale model was applied to investigate the psychometric quality of the survey. Additionally, structural equation modelling was run for model fit and construct validity as well. Moreover, multivariate analysis of variance (MANOVA) was applied to examine the effects of demographic variables on the extracted constructs of the instrument in the population of the study. The results revealed five constructs in the questions with the corresponding items. Overall, the demographic variables have no contribution to these five constructs. Persian-SCREENIVF can be used for further studies about emotional disturbances in infertility problems.

The effects of hydroxychloroquine on pregnancy outcomes in infertile women: a systematic review and meta-analysis.

A promising strategy for controlling repeated implantation failure (RIF) may be the use of hydroxychloroquine (HCQ). To the best of our knowledge, no systematic review has been conducted on the effects of hydroxychloroquine on pregnancy outcomes. A systematic research of the following electronic databases was conducted: Cochrane, EMBASE-Ovid, PubMed, Web of Science, and Scopus from inception to December 2021, using the following keywords [hydroxychloroquine] AND [infertility]. Fertilization and rate of live birth were significantly higher in the HCQ+ prednisone (PDN) group than in the PDN alone group. However, the abortion rate was not different between the two groups. The meta-analysis of two studies revealed no statistical significance between the PDN group and HCQ+PDN group regarding clinical pregnancy rate (OR=.14 [95%CI: 0.4-4.370]; heterogeneity; P=0.13; I2=54%; random effect model) and implantation rate (OR=1.99 [95%CI: 0.94-4.2]; heterogeneity; P=0.37; I2=0%; fixed-effect model). While HCQ may help improve fertilization and live birth rates, adding it to prednisone did not improve overall pregnancy outcomes. This systematic review should be used with caution due to the small size, study design, and difference in the studies' population.

The Effects of Aroma on Apnea Attacks and Oxygen Saturation Among Preterm Infants: A Systematic Review and Meta-Analysis:.

Researchers and clinicians need to be aware of procedures that are more adaptable to new and different environments in premature infants; therefore, it is important to conduct a comprehensive review of the effect of aromatherapy on apnea attacks and oxygen saturation (SpO2 ) in premature newborns. In this review, databases such as PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched without language and time limitations up to November 1, 2022. Initially, 153 studies were founded, and after duplicate removal, title as well as full-text review, seven studies were enrolled in the final analysis. Studies indicated that aromatherapy with Rosa damascena, vanilla, and breast milk odors could significantly reduce apneas in preterm infants and improve SpO2 levels. Hence, aromatherapy could consider as an effective adjuvant treatment for the reduction of apnea attacks among preterm infants.

The Effectiveness of Herbal Medicines on Cyclic Mastalgia: A Systematic Review on Meta-analysis.

OBJECTIVE: Different drugs are used to treat mastalgia, such as danazol and bromocriptine, and both are associated with side effects, due to which most of women and healthcare providers are interested in herbal medicines. Therefore we aim to study the effectiveness of phytoestrogens on the severity of cyclic mastalgia. METHODS: To carry out the present study, English electronic resources such as the Cochrane Library, ISI Web of Science, Scopus, and PubMed were used systematically and with no time limitation up to February 10, 2020. RESULTS: In total, 20 studies were included in the present meta-analysis. The results of the meta-analysis showed that herbal medicines versus the control group (standard mean difference [SMD] = - 0.585; 95% confidence interval [CI]: - 0.728-- 0.44; heterogeneity; p = 0.02; I2 = 42%), herbal medicines versus the B group (SMD = - 0.59; 95%CI: - 0.75-- 0.44; heterogeneity; p = 0.03; I2 = 42%), and its subgroups, such as phytoestrogen (SMD = - 0.691; 95%CI: - 0.82-- 0.55; heterogeneity; p = 0.669; I2 = 0%), Vitex-agnus-castus (SMD = - 0.642; 95%CI: - 0.84-- 0.44; p < 0.001; p = 203; I2 = 32%), flaxseed (SMD = - 0.63; 95%CI: - 0.901-- 0.367; p = 0.871; I2 = 0%), and evening primrose (SMD= - 0.485; 95%CI:- 0.84-- 0.12; p = 0.008; heterogeneity; p = 0.06; I2 = 56%] may have effective and helpful effects on improving cyclic breast mastalgia. Also, chamomile, isoflavone, cinnamon, and nigella sativa significantly reduced mastalgia symptoms. CONCLUSION: Herbal medicines and their subgroups may have effective and helpful effects on improving cyclic breast mastalgia. The findings of our meta-analysis must be done cautiously because low methodological quality in some evaluated studies of this systematic review.

OBJETIVO: Diferentes drogas são utilizadas para tratar a mastalgia, como danazol e bromocriptina, e ambas estão associadas a efeitos colaterais, devido aos quais a maioria das mulheres e dos profissionais de saúde está interessada em medicamentos fitoterápicos. Portanto, nosso objetivo no presente estudo é estudar a eficácia dos fitoestrogênios na gravidade da mastalgia cíclica. MéTODOS: Para a realização do presente estudo, foram utilizados recursos eletrônicos em inglês como a Cochrane Library, ISI Web of Science, Scopus e PubMed, de forma sistemática e sem limitação de tempo até 10 de fevereiro de 2020. RESULTADOS: No total, 20 estudos foram incluídos na presente metanálise. Os resultados da metanálise mostraram que fitoterápicos versus grupo controle (SMD = - 0,585; intervalo de confiança (IC) 95%: - 0,728­- 0,44; heterogeneidade; p = 0,02; I2 = 42%), fitoterápicos versus grupo B (SMD = - 0,59; IC95%: - 0,75­- 0,44; heterogeneidade; p = 0,03; I2 = 42%) e seus subgrupos, como fitoestrogênios (SMD = - 0,691; IC95%: - 0,82­- 0,55; heterogeneidade; p = 0,669; I2 = 0%), Vitex-agnus-castus (SMD = - 0,642; IC95%: - 0,84­- 0,44; p < 0,001; p = 203; I2 = 32%), linhaça (SMD = - 0,63; IC95%: - 0,901­- 0,367; p = 0,871; I2 = 0%) e prímula (SMD = - 0,485; IC95%: - 0,84­- 0,12; p = 0,008; heterogeneidade; p = 0,06; I2 = 56%) podem ter efeitos eficazes e úteis na melhora da mastalgia cíclica da mama. Além disso, camomila, isoflavona, canela e Nigella sativa reduziram significativamente a mastalgia. CONCLUSãO: Os medicamentos fitoterápicos e seus subgrupos podem ter efeitos eficazes e úteis na melhora da mastalgia mamária cíclica. Os achados do presente estudo devem ser explantados com atenção devido ao pequeno número de estudos existentes sobre o tema, a maioria dos quais com um tamanho de amostra pequeno.

Examining the Effect of Chamomile on Clinical Symptoms and Hormonal Parameters Among Patients With Polycystic Ovarian Syndrome.

Objective: Polycystic ovarian syndrome is the most common cause of infertility and endocrine disorder among women due to anovulation. The aim of the present study is to investigate the effect of chamomile on oligomenorrhea and hirsutism symptoms as well as hormonal parameters among patients suffering from polycystic ovarian syndrome. Materials and methods: The present study is a randomized clinical trial performed on 70 patients with diagnosis of polycystic ovarian syndrome according to Rotterdam criteria referring to the infertility clinic of a university hospital. The patients were randomly assigned into intervention and control groups, with the former receiving two chamomile capsules 500 mg for three months, and the latter receiving two placebo capsules for 3 months. Both groups were evaluated in terms of laboratory parameters (FBS, LDL, and testosterone) on the third day of first and third cycles. The collected data were analyzed by SPSS 20. Results: The mean age, body mass index, marital status, history of infertility, and pregnancy rate showed no significant difference between the two groups. In the chamomile group, clinical symptoms of hirsutism (p<0.001) and oligomenorrhea (p=0.048) decreased following the treatment, but significant difference was found between the two groups only in hirsutism symptoms (p=0.028). Regarding the parameters of FBS (p=0.06), HDL (p=0.224), cholesterol (p=0.99), triglyceride (p=0.106), testosterone (p=0.894), and LDL (p=0.61), no significant difference was observed between the two groups. Nevertheless, following the treatment, testosterone decreased in both placebo (p=0.005) and chamomile (p=0.001) groups. Conclusion: overall, the chamomile therapeutic regimen has relatively been able to mitigate the clinical symptoms and testosterone levels in patients suffering from polycystic ovarian syndrome. Use of chamomile plant as a simple, inexpensive, and effective measure can be suggested for improving and treating patients with PCOS after confirmation by further studies.

Prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic: a meta-analysis.

PURPOSE: Coronavirus disease (COVID-19) is a newly emerged respiratory illness, which has spread around the world. Pregnant women are exposed to additional pressure due to the indirect adverse effects of this pandemic on their physical and mental health. Since the psychological wellness framework is weak in developing countries, it is likely that geographical factors affect the prevalence. Therefore, the goal of this meta-analysis is to investigate the prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic. METHODS: We searched databases including PubMed/MEDLINE, Web of Science, Cochrane Library for articles. The quality of studies was determined based on the STROBE checklist. I2 and Cochrane Q-test were used to determine heterogeneity. Fixed effects and/or random effects models were also employed to estimate pooled prevalence. RESULTS: Since heterogeneity was fairly high in all analyses, the random effect model was used. According to the results of random effects in the meta-analysis, the pooled prevalence was 18.7% (95% CI: 0.06-0.36%; I2=99%,P<0.001) for anxiety and 25.1% (95% CI: 0.18-0.33%; I2=97%, P<0.001) for depression. The results of continent subgroup analysis showed that the prevalence of anxiety was higher in western country (38%) than in Asia country (7.8%). The prevalence of anxiety in Italy (38%), Canada (56%), Pakistan (14%), Greece (53%), Sri Lanka (17.5%), and China (0.3-29%) and Iran 3.8% as well as the prevalence of depression in Canada (37%), Belgium (25%), Turkey (35.4%), Sri Lanka (19.5%), and China (11-29%) has been reported. CONCLUSION: Covid-19 may impose extra pressure on the emotional wellbeing of pregnant women. Therefore, there is an urgent need for resources to help mitigate anxiety and depression in pregnant women.

Investigating the effectiveness of tele-counseling for the mental health of staff in hospitals and COVID-19 clinics: a clinical control trial.

OBJECTIVE: To investigate the effectiveness of tele-counseling for the mental health of staff working in hospitals and reference clinics during the COVID-19 outbreak. METHODS: In the first stage of the study, using a convenience sampling strategy, 313 staff members working at Iran's hospitals and COVID-19 clinics answered a Hospital Anxiety and Depression Scale and the Short Health Anxiety Inventory online. In a second stage, 95 staff members who were willing to participate in the intervention were randomly assigned to the intervention (n = 51) or control (n = 44) groups. The intervention consisted of seven intensive tele-counseling sessions. RESULTS: In the first stage, the percentages of anxiety and depression related to coronavirus were 79.2% and 82.1% and the mean health anxiety score was 17.42. In the intervention phase, anxiety related to coronavirus and to perceived risk of illness (likelihood of illness) were significantly lower in the intervention group in comparison with the control group (p = 0.001). Depression related to coronavirus and anxiety related to the negative consequences of infection were non-significantly reduced in the intervention group compared to the control group (p = 0.08 and 0.12; respectively). CONCLUSION: Continuous monitoring of the negative psychological impacts on medical staff of outbreaks as well as implementation of appropriate interventions to respond to them should be emphasized in order to improve staff mental health.

The effectiveness of intervention with cognitive behavioral therapy on pornography: A systematic review protocol of randomized clinical trial studies.

BACKGROUND: The increasing rate of problematic pornography use (PPU) among the general population has risen. There are limited data on the efficacy of Cognitive Behavioral Therapy (CBT) on online pornographic addiction; therefore, this study aimed at investigating the issue. METHODS: SCOPUS, PubMed, PubPsych, WOS (Web of Science), Cochrane Central Register of Controlled Trials, Google Scholar, Scientific Information Database (SID) & Iranmedex, and other databases (for gray literature) (eg, conference papers, key journals) will be systematically reviewed. Preliminary search strategies were started on March 2, 2019, and will be updated in April 2021. Eligibility criteria were having PPU, with designs of interest including randomized trials with three or more months of follow-up with CBT intervention. Two authors will independently conduct data extraction and quality assessment. A modified Verhagen checklist for clinical trial studies will be used for quality assessment. Pooled measures of association will be computed using random-effects model meta-analyses. Between-study heterogeneity will be assessed using the I2 statistic and the Cochrane χ2 statistic. Minor study effects will be evaluated for meta-analyses with sufficient studies using funnel plots and Egger's test. If a meta-analysis is appropriate, quantitative data will be pooled using the comprehensive meta-analysis software. DISCUSSION: The evidence obtained in this meta-analysis will help to determine whether CBT can decrease PPU severity, anxiety, depression, and compulsive sexual behavior. In addition, due to the comprehensive view on CBT effects on PPU patients, which was not clarified before, we can expect that the results of this study will benefit psychiatrists.