RESUMEN
OBJECTIVE: The present study aims to conduct a comprehensive meta-analysis of randomized controlled trials (RCTs) investigating the efficacy of probiotics as an adjunct treatment for preventing and treating gynecological infections. MATERIALS AND METHODS: The study adopted a systematic review of scientific databases including PubMed, Cochrane, and EMBASE, using defined MeSH terms. The inclusion and exclusion criteria were set to refine the search, with the data extraction and quality assessment being conducted by two independent investigators. RESULTS: A total of 35 articles, comprising 3751 patients, were included in the meta-analysis. The application of probiotics demonstrated a notable increase in the cure rates of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) as compared to control groups. A significant BV cure rate (OR: 5.972; 95% CI: 2.62-13.59; p-value: 0.01) was noted with probiotic use, which was even more pronounced when used as an adjunctive treatment with antibiotics (OR: 2.504; 95% CI: 1.03-6.06; p-value: 0.04). Additionally, probiotic use significantly reduced the recurrence rates of BV (OR: 0.34; 95% CI: 0.167-0.71; p-value: 0.004). For VVC, a significant increase in the cure rate was observed in the probiotic group (OR: 3.425; 95% CI: 2.404-4.879; p-value: 0.01), along with a lower recurrence rate (OR: 0.325; 95% CI: 0.175-0.606; p-value: 0.01). CONCLUSION: Our findings underscore the potential role of probiotics as a beneficial adjunctive treatment for gynecological infections, indicating an improved cure rate and decreased recurrence. However, additional well-designed studies are necessary to corroborate these findings.
Asunto(s)
Candidiasis Vulvovaginal , Probióticos , Ensayos Clínicos Controlados Aleatorios como Asunto , Vaginosis Bacteriana , Humanos , Probióticos/uso terapéutico , Femenino , Vaginosis Bacteriana/terapia , Vaginosis Bacteriana/tratamiento farmacológico , Candidiasis Vulvovaginal/prevención & control , Candidiasis Vulvovaginal/terapia , Antibacterianos/uso terapéutico , Resultado del Tratamiento , Terapia Combinada , RecurrenciaAsunto(s)
Inteligencia Artificial , Hepatopatías , Humanos , Hepatopatías/diagnóstico , Hepatopatías/terapiaRESUMEN
Background: The size estimation of key populations is a necessary part of surveillance systems to access global human immunodeficiency virus (HIV) infection. In this study, the NSU method was used to estimate injection drug users (IDUs). Methods: NSU method was performed on 1000 individuals in Iranshahr province with street-based sampling from 2016 to 2017. A questionnaire comprising items on demographic information and items measuring the network size of participants about IDUs was administered. The estimated size was adjusted for transmission error and barrier effect with PF and VF factors. The relationship between knowing IDUs and demographic variables was assessed using logistic regression. All analyses were performed in SPSS 19 and Microsoft Excel. Results: In this study, 500 men and 500 women were included. The average age (standard deviation) of the participants was 29.6 (7.8) years. IDUs were estimated at 1263 per 100 000 population of Iranshahr in Sistan and Baluchestan province, Iran. The estimated size was 7.5 times more in men than in women (2766 vs 364). Moreover, the highest estimated size belonged to the population of 18- 30-year-olds (1187). Sex and education level had significant relationships with knowing IDUs (p<0.001). Conclusion: To improve preventive programs, the number of outreach teams must be increased to have access to IDUs, educate them, and upgrade the coverage of harm-reduction services. According to cultural considerations and the illegal nature of injection drug use, social mobilization is essential to reduce the stigma.