BackgroundEmerging evidence suggests that statins may decrease the risk of cancers. However, available evidence on prostate cancer (PCa) is conflicting. We therefore examined the association between statin use and risk of PCa by conducting a detailed meta-analysis of all observational studies published regarding this subject.MethodsLiterature search in PubMed database was undertaken through February 2012 looking for observational studies evaluating the association between statin use and risk of PCa. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using random-effects model (DerSimonian and Laird method). Subgroup analyses, sensitivity analysis and cumulative meta-analysis were also performed.ResultsA total of 27 (15 cohort and 12 case-control) studies contributed to the analysis. There was heterogeneity among the studies but no publication bias. Statin use significantly reduced the risk of both total PCa by 7% (RR 0.93, 95% CI 0.87–0.99, p = 0.03) and clinically important advanced PCa by 20% (RR 0.80, 95% CI 0.70–0.90, p<0.001). Long-term statin use did not significantly affect the risk of total PCa (RR 0.94, 95% CI 0.84–1.05, p = 0.31). Stratification by study design did not substantially influence the RR. Furthermore, sensitivity analysis confirmed the stability of results. Cumulative meta-analysis showed a change in trend of reporting risk from positive to negative in statin users between 1993 and 2011.ConclusionsOur meta-analysis provides evidence supporting the hypothesis that statins reduce the risk of both total PCa and clinically important advanced PCa. Further research is needed to confirm these findings and to identify the underlying biological mechanisms.

This meta-analysis provides strongest evidence supporting that Type 2 diabetes is significantly inversely associated with risk of developing prostate cancer.

No abstract

Macrolides for chronic asthma.

Background: Self-medication (SM) is a practice of using medications to treat the self-diagnosed symptoms without legitimate prescription by a health care professional. Alongside posing burden on to a patient, SM practices are associated with certain unfavourable health conditions such as drug-resistance, adverse effects, drug-interactions, including death. Objective: To systematically review and quantify the prevalence of SM practices and its associated factors in India. Methodology: A comprehensive systematic search was performed using scientific databases such as PubMed and Cochrane library for the peer-reviewed research articles that were conducted in India without any language and date restrictions. Studies which are cross-sectional by design and assessing the prevalence and predictors of SM practices in India were considered for the review, and all the relevant articles were screened for their eligibility. Results: Of 248 articles, a total of 17 articles which comprises of 10,248 participants were included in the meta-analysis. Overall, the mean prevalence of SM practices in India was observed to be 53.57%. Familiarity with the medication appears to be a major reason to practice SM (PR: 30.45; 95% confidence interval [CI]: 17.08-43.82; 6 studies), and the practice was noticed more among individuals from a middle-lower class family with a prevalence rate of 26.31 (95%CI: 2.02-50.60; P<0.0001). Minor ailments were the primary reason for practising SM (PR: 42.46; 95%CI: 21.87-63.06), among which headache was the most commonly reported (PR: 41.53; 95%CI: 18.05-65.02). Conclusion: Prevalence of self-medication practices are observed quite high in India. While, NSAIDs and anti-allergic are the most frequently utilized self-medicated drugs used for headache and cold & cough.

Inconsistent results regarding the association between statin use and risk of Parkinson's disease (PD) have been reported. We therefore examined the association between statin use and risk of PD by conducting a detailed meta-analysis of all observational studies published regarding this subject. A literature search in the PubMed database was undertaken through April 2012, looking for observational studies evaluating the association between statin use and risk of PD. Combined relative risk (RR) estimates and 95 % confidence intervals (CIs) were calculated using a random-effects model. Subgroup and sensitivity analyses were also performed. A total of eight (five case-control and three cohort) studies contributed to the analysis. There was heterogeneity and publication bias among the studies. Statin use significantly reduced the risk of PD by 23 % (RR 0.77, 95 % CI 0.64-0.92, p = 0.005). However, long-term statin use did not significantly affect the risk of PD (RR 0.72, 95 % CI 0.45-1.13, p = 0.15). Stratification of studies by age and smoking status significantly affected the final estimate (age-adjusted RR 0.61, 95 % CI 0.42-0.86, p = 0.005; age-not-adjusted RR 0.93, 95 % CI 0.83-1.05, p = 0.23 and smoking-adjusted RR 0.60, 95 % CI 0.42-0.87, p = 0.007; smoking-not-adjusted RR 0.92, 95 % CI 0.82-1.02, p = 0.10). Furthermore, sensitivity analysis confirmed the stability of results. Our meta-analysis supports the hypothesis that statin use reduced the risk of PD. Nevertheless, more randomized clinical trials and observational studies are required to confirm this association with underlying biological mechanisms in the future.

The results show that PIM prescribing is common among hospitalized elderly Indian patients. It is feasible to reduce this practice through the provision of appropriate unbiased information to healthcare professionals.

Background The novel coronavirus disease 2019 (COVID-19) is considered the most serious global health threat in recent times. As there is a current lack of approved treatments and vaccines, universal safety precautions (USPs) must be taken to deal with this emergency.Objective The aim of this study was to assess the knowledge and beliefs of the Indian public with regard to USPs during the COVID-19 pandemic. Methods A cross-sectional, web-based survey was conducted during March 2020. A 20-item self-administered questionnaire was developed, validated and distributed using Google Forms through social media networks. Binary logistic regression analysis was used to identify the factors influencing knowledge regarding COVID-19 USPs. Results Of the 1117 individuals who participated in the survey, the mean age was 28.8 ± 10.9 years, 32.9% had a postgraduate education, 45% had a professional job, and 40% belonged to the upper-middle economic class. Overall, the mean correct response scores were 63% for USP knowledge and 83% for USP beliefs. All the sociodemographic variables were significantly (p < 0.001) associated with the USP knowledge levels. Importantly, students were less likely to have a lower level of USP knowledge compared with the other occupations (odds ratio 0.35, 95% CI 0.23-0.53; p < 0.001). Conclusion Although the knowledge and beliefs of the Indian public towards USPs are encouraging, there is a need for long-term educational interventions as the dynamics and severity of COVID-19 rapidly change. These findings could guide public health authorities to make and implement precautionary measures to combat this pandemic.