ABSTRACT
Proton pump inhibitors (PPI), one of the most commonly prescribed medications, carry a myriad of adverse events. For colorectal cancer (CRC) patients, it still remains unclear whether the concurrent use of proton pump inhibitors (PPI) would negatively affect chemotherapy. PubMed, Medline, Embase, and Cochrane Library were searched from inception to 10 June 2022, to identify relevant studies involving CRC patients receiving chemotherapy and reporting comparative survival outcomes between PPI users and non-users. Meta-analyses were performed using random-effects models. We identified 16 studies involving 8,188 patients (PPI = 1,789; non-PPI = 6,329) receiving either capecitabine-based or fluorouracil-based regimens. The overall survival (HR, 1.02; 95% CI, 0.91 to 1.15; I2 = 0%) and progression-free survival (HR, 1.15; 95% CI, 0.98 to 1.35; I2 = 29%) were similar between PPI users and non-users in patients taking capecitabine-based regimens, with low statis-tical heterogeneity. Although the subgroup analysis indicated that early-stage cancer patients taking capecitabine monotherapy with concurrent PPI had a significantly higher disease progression rate (HR, 1.96; 95% CI, 1.21 to 3.16; I2 = 0%) than those who did not use PPIs, both groups had comparable all-cause mortality (HR, 1.31; 95% CI, 0.75 to 2.29; I2 = 0%). On the other hand, there was little difference in both OS and PFS in both early- and end-stage patients taking capecitabine combination therapy between PPI users and non-users. Conversely, the use of concomitant PPI in patients taking fluorouracil-based regimens contributed to a marginally significant higher all-cause mortality (HR, 1.18; 95% CI, 1.00 to 1.40; I2 = 74%), but with high statistical heterogeneity. In conclusion, PPI has little survival influence on CRC patients treated with capecitabine-based regimens, especially in patients taking capecitabine combination therapy. Thus, it should be safe for clinicians to prescribe PPI in these patients. Although patients treated with fluorouracil-based regimens with concomitant PPI trended toward higher all-cause mortality, results were subject to considerable heterogeneity. Systematic Review Registration: identifier https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022338161.
ABSTRACT
In late 2019, a queer type of pneumonia emerged in Wuhan city in the central part of China. On investigation, it was found to be caused by the coronavirus. Human coronaviruses were discovered in the 1960s. There are a total of seven types of coronaviruses that infect humans: 229E and NL63 are the alpha coronaviruses; OC43, HKU1, MERS-CoV, and SARS-CoV are beta coronaviruses, and SARS-CoV-2 or COVID-19 is a novel coronavirus. COVID-19 surfaced in China at the culmination of the year 2019. The pandemic then fanned out rapidly, involving Italy, Japan, South Korea, Iran, and the rest of the world.
ABSTRACT
BACKGROUND: A positive learning environment and quality of course content have an imperative role in academic achievement of students. This study aims to assess students' point of view about the quality of education and social environment of a public sector medical college in Pakistan. Relative scarcity of data from students' perspective merited this study. METHODS: A cross-sectional survey was undertaken at Ayub Medical College, Abbottabad, Pakistan, including 300 medical students from all five years of the MBBS course. Systematic random sampling was used with a kth interval of 4 for each class. Self-administered questionnaire was used and contained items related to academics, learning environment, learning resources, teaching methodologies and student-friendly activities. The data were analysed using SPSS-16. RESULTS: There were 265 respondents (88.3%) to the questionnaire with males accounting for 58.9% (n=156). In general students showed satisfaction with quality of content being taught; however there was discontent towards various academic and non- academic facilities provided to the students. Only 44.10% and 31.50% students reported provision of academic related facilities and interactive sessions as up to mark respectively; 83% students reported that undergraduate medical research was in need of improvement; 55.5% and 60.2% reported that facilities in hostel and recreational facilities needed improvement respectively; and 52.8% students stated presence of a healthy, student friendly, encouraging environment was not up to mark. CONCLUSION: Although course content and teaching methodologies are generally satisfactory, a healthy, student friendly, encouraging environment is vet to be created to help students foster their abilities completely.
