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      The scenario of self-medication practices during the covid-19 pandemic; a systematic review

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          Abstract

          Background

          Self-medication association with an ongoing pandemic is evident in the studies conducted throughout the world. To summarize the findings of previous papers, we carried out a systematic review to observe the current scenario of self-medication during COVID-19.

          Methodology

          Scopus, Embase, Web of Science, PubMed, MedRxiv preprints, SciELO Preprints, google, and google scholar were searched using keywords related to the topic. Studies reporting original data and assessing the self-medication practices during Covid-19 were included.

          Results

          A total of 660 papers were collected and 14 cross-sectional studies among them were finalized from 12 different countries after apposite screening processes. Our study measured that during the COVID-19 pandemic, and there was a 44.786% prevalence of self-medication. Analgesics, antibiotics, and nutritional supplements were commonly practiced drugs. Pharmacy and hospital outlets were the main sources of the drugs. Fever, sore throat, body ache (muscle pain), and flu or cough were among the most frequently recorded illnesses; treatment and prevention of COVID-19 were the main culprit behind self-medication. During COVID-19, the major factors associated with self-medication were fear, anxiety, and perception regarding COVID-19. Thus, in this pandemic, fear, anxiety, and rumors regarding immunity boosters, nutritional supplements, financial burden, and easy accessibility to even non-OTC drugs; all have their fair share in self-medication practices.

          Conclusion

          As there was heterogeneity regarding COVID-19 and self-medication found among the assessed studies, educating general people about safe self-medication practices, hazards of superfluous drug usage, and provision of an affordable quality-health system should become a priority, especially in low and middle-income countries.

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          Most cited references50

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          Is Open Access

          The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.

          Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement--a reporting guideline published in 1999--there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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            Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results

            Abstract Background World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs — remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a — in patients hospitalized with coronavirus disease 2019 (Covid-19). Methods We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. Results At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan–Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval [CI], 0.81 to 1.11; P=0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P=0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P=0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P=0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration. Conclusions These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. (Funded by the World Health Organization; ISRCTN Registry number, ISRCTN83971151; ClinicalTrials.gov number, NCT04315948.)
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              Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review

              The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.
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                Author and article information

                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
                2049-0801
                27 August 2022
                27 August 2022
                : 104482
                Affiliations
                [a ]M Abdur Rahim Medical College, Rajshahi University, Dinajpur, Bangladesh
                [b ]Central Institute of Science and Technology, Pokhara University, Kathmandu, Nepal
                [c ]KIST Medical College, Imadol, Patan, Nepal
                [d ]Department of Pediatrics, Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh
                [e ]Chittagong Medical College, Chittagong, Bangladesh
                Author notes
                []Corresponding author. Chittagong Medical College, Chittagong, Bangladesh.
                Article
                S2049-0801(22)01242-0 104482
                10.1016/j.amsu.2022.104482
                9419440
                36059596
                00925efb-123f-4c87-b9c5-502b1b08036c
                © 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 1 July 2022
                : 17 August 2022
                : 19 August 2022
                Categories
                Systematic Review / Meta-analysis

                covid-19,drugs,pandemic,review,self-medication
                covid-19, drugs, pandemic, review, self-medication

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