Przeglądanie według Autor "Lee, E Lyn"

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Comparative efficacy of topical microbicides in the prevention of HIV transmission – results from a systematic review and network meta-analysis
(Rzeszów University Press, 2025-03) Lee, E Lyn; Shanmugham, Suresh; Kumar, Suresh; Smales, Frederick Charles; Noreen, Nabeela; Veettil, Sajesh K.
Introduction and aim. Preventing new HIV infections is crucial, particularly for women and girls at high risk. Vaginal microbi cides offer a female-controlled HIV prevention method. This systematic review evaluated the comparative efficacy of topical microbicides in preventing HIV transmission. Material and methods. Electronic databases were searched up to May 2024 for randomized controlled trials (RCTs) comparing topical microbicides versus placebo/no treatment in sexually active women. The primary outcome was the incidence of HIV. A random effects network meta-analysis (NMA) was employed. Relative ranking was assessed using surface under the cumula tive ranking curve (SUCRA) probabilities. Analysis of literature. Thirteen RCTs were included in the review comparing the dapivirine ring, the tenofovir gel, BufferGel, PRO 2000, Carraguard, cellulose sulfate, or SAVVY against placebos. Compared to placebo, only dapivirine significantly reduced HIV incidence (risk ratio (RR) 0.71 [95% CI 0.56 to 0.91]). Dapivirine was superior to BufferGel (RR 0.61 [95% CI 0.39 to 0.94]) and SAVVY (RR 0.52 [95% CI 0.28 to 0.97]). Dapivirine ranked highest in efficacy (SUCRA=0.93), followed by tenofovir (SUCRA=0.76). In general, consistent network results with some small study effects. Conclusion. This study supports the use of the vaginal dapivirine ring for HIV prevention over SAVVY or BufferGel. More high-quality trials are needed to validate the efficacy of tenofovir gel.
Probiotics for the prevention of antibiotic-associated diarrhea – an umbrella review of meta-analyses of randomized controlled trials
(Rzeszów University Press, 2025-03) Lee, E Lyn; Sidhick, Sulfath Thekkumcheril; Maharajan, Mari Kannan; Shanmugham, Suresh; Ingle, Pravinkumar Vishwanath; Kumar, Suresh; Ching, Siew Mooi; Lee, Yeong Yeh; Veettil, Sajesh K.
Introduction and aim. Antibiotic therapies induce diarrhea by disrupting the intestinal microbiota, prompting research into probiotics to prevent antibiotic-associated diarrhea (AAD). The aim of this study was to systematically identify and summarize meta-analyses of randomized controlled trials (RCT) on probiotics for AAD prevention. Material and methods. Databases including PubMed, EMBASE, Epistemonikos, and the Cochrane Database were searched up to December 11, 2023. Systematic reviews and meta-analyses of RCTs on probiotics for AAD prevention in any age group were included. Meta-analyses were re-performed to calculate pooled risk ratios (RR) with 95% confidence intervals (CI). Evidence quality was assessed using GRADE criteria. Analysis of the literature. The review included 16 articles with 39 unique meta-analyses. Probiotics reduced AAD risk across various groups: adults (RR 0.47, 95% CI 0.40–0.56), all ages (RR 0.58, 95% CI 0.50–0.68), and outpatients (RR 0.49, 95% CI 0.36 0.66) with a moderate level of evidence. For the use of any probiotics in pediatrics, the initial high-quality evidence (RR 0.48, 95% CI 0.44–0.63) was downgraded to moderate after a sensitivity analysis excluding small studies. Conclusion. Probiotics are beneficial in preventing AAD, but evidence quality varies from low to moderate. High-quality trials are needed to identify the most effective probiotic species and strains, dosages, and target patient populations.