Statin use and risk of cancer:An overview of meta-analyses

AIM To conduct an overview of meta-analyses to critically appraise the evidence and present a comprehensive evaluation of the association between statin use and risk of site specific cancers.METHODSMEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and Web of Science databases were searched from inception until 31st May 2016. The electronic data-base search was supplemented by a hand search in PROSPERO and relevant journals which are not indexed in above databases. Meta-analyses that examined the association between statin use and risk of site specific cancers were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews （AMSTAR） tool.RESULTSOverall, 38 meta-analyses covered 13 site specific cancers were included. More than half （68%） of the meta-analyses were moderate in quality with an AMSTAR score 4-7 out of a possible 11. Based on current evidence from meta-analyses, use of statin decreases the risk of certain cancers, such as colorectal （8%-12%）, gastric （27%-44%）, hematological （19%）, liver （37%-42%）, oesophageal （14%-28%）, ovarian （21%） and prostate cancer （7%）. On the other side, evidence from meta-analyses also suggests that there is no association between statin use and risk of bladder, breast, endo-metrial, kidney, lung, pancreatic and skin cancers.CONCLUSIONThis overview of meta-analyses with variable quality has been shown that the statins may have a potential role in cancer chemoprevention and reduce the risk of some site specific cancers, but not all.

Sirturo(Bedaquiline):The first new anti tubercular drug in decades

Tuberculosis(TB) is an infection caused by Mycobacterium tuberculosis and is one of the world's deadliest diseases. Multidrug resistant TB(MDR-TB) is a serious form of TB and it implies resistance for at least two essential first-line agents like, Isoniazid and Rifampicin. The US Food and Drug Administration(FDA) granted accelerated approval to Janseen Therapeutics "Sirturo(Bedaquiline)", a diarylquinoline anti mycobacterial drug on December 28, 2012 as part of combination therapy in adults(≥ 18 years) to treat MDR-TB when other alternatives are not available. The FDA also granted Sirturo fast track designation, priority review and orphanproduct designation. Bedaquiline inhibits mycobacterial ATP(adenosine 5'-triphosphate) synthase, an enzyme that is essential for the generation of energy in Mycobacterium tuberculosis.

Impact of preterm birth and low birth weight on medical conditions, medication use and mortality among neonates: a prospective observational cohort study

Background There is a paucity of studies conducted in India on neonatal outcomes of preterm birth and low birth weight.Hence,we aimed to assess the impact of preterm birth and low birth weight on medical conditions,medication use and mortality among neonates.Methods A prospective observational cohort study was conducted at the neonatal intensive care unit (NICU) over a period of 9 months.Neonates of either sex,admitted to NICU and who received at least one medication were enrolled in the study.Perinatal and demographic data,reason(s) for NICU admission,diagnoses,medications prescribed,medication-related problems,discharge status and the direct medical cost were documented and analyzed.Results Four hundred and five neonates Were included in the study:60.5% were boys,32.7% were preterm and 44.2% were born underweight.Neonatal sepsis (n =125,16.7%),unconjugated hyperbilirubinemia (n =83,11.1%) and respiratory distress syndrome (n =62,8.3%) were the most common medical conditions and were significantly more common among preterm and underweight neonates.Nearly half of the medications prescribed were anti-infectives for systemic use (n =1310,47.4%).The mean number of medications received by neonates increased from term to extremely preterm (5.2-15.0) and normal birth weight to extremely low birth weight (5.0-14.9).Mortality rate was significantly higher among extremely preterm (66.7%),and very preterm (15.2%) neonates compared to term (2.9%) neonates.The median direct medical cost for NICU admission was INR 21,430 (USD 331).Conclusion Medical conditions,medications prescribed and mortality rate were significantly higher among preterm and underweight neonates admitted to NICU.