Healthcare online Keeping you up-to-date
VOL.  18     ISSUE:  7    July 2020 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management






Dear Doctor:

Welcome to our healthcare bulletin 'e-SQUARE' !

Our current issue focused on some interesting features like

"COVID-19 False Negative !", "COVID-19 & Immune-suppressant !", "Early Menstruation !", "New Pathway !", "Probiotics Ease Depression !", "World's Smallest Imaging Device !".

In our regular feature, we have some new products information of SQUARE Pharmaceuticals Ltd. as well.

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Yours sincerely,


Editorial Team

Reply Mode      : e-square@squaregroup.com

The views expressed in this publication do not necessarily reflect those of its editor or SQUARE PHARMACEUTICALS LTD.

COVID-19 False Negative !

COVID-19 false negative test results if used too early

In a new study, Johns Hopkins researchers found that testing people for SARS-CoV-2 the virus that causes COVID-19 too early in the course of infection is likely to result in a false negative test, even though they may eventually test positive for the virus. Researcher said that, a negative test, whether or not a person has symptoms, doesn't guarantee that they aren't infected by the virus. However, those infected with the virus are still able to potentially spread the virus. Patients who have a high-risk exposure should be treated as if they are infected, particularly if they have symptoms consistent with COVID-19. This means communicating with patients about the tests' shortcomings. One of several ways to assess for the presence of SARS-CoV-2 infection is a method called reverse transcriptase polymerase chain reaction (RT-PCR). However, as shown in tests for other viruses such as influenza, if a swab misses collecting cells infected with the virus, or if virus levels are very low early during the infection, some RT-PCR tests can produce negative results. Since the tests return relatively rapid results, they have been widely used among high-risk populations such as nursing home residents, hospitalized patients and health care workers. Previous studies have shown or suggested false negatives in these populations. Using RT-PCR test results, along with reported time of exposure to the virus or time of onset of measurable symptoms such as fever, cough and breathing problems, the researchers calculated the probability that someone infected with SARS-CoV-2 would have a negative test result when they had the virus infection. In the published studies, health care providers collected nasal and throat samples from patients and noted the time of virus exposure or symptom onset and sample collection. Researcher said they are using these tests to rule out COVID-19, and basing decisions about what steps taken to prevent onward transmission, such as selection of personal protective equipment for health care workers.

SOURCE: Science Daily News, July 2020

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COVID-19 & Immune-suppressant !

Anti-inflammatory medication is used to fight dangerous immune response in COVID-19

Researcher observed that most patients hospitalized with COVID-19 pneumonia experienced improvement after receiving a Food and Drug Administration-approved drug normally given for rheumatoid arthritis. Outcomes for patients who received the drug, tocilizumab, included reduced inflammation, oxygen requirements, blood pressure support and risk of death, compared with published reports of illness and death associated with severely ill COVID-19 patients. While the patient outcomes were encouraging, investigators said they were not sufficient to prove the drug was safe and effective for use in COVID-19 patients because they did not conduct a clinical trial with a control group. The team examined laboratory and clinical changes including oxygen levels, the need for medication to increase blood pressure and patient survival in 27 patients with COVID-19 pneumonia who received the immunosuppressive drug tocilizumab to slow an out of control immune response. The researchers observed improved inflammatory markers and patient survival, compared with reports of patients not treated with tocilizumab. A cytokine storm is a severe reaction in which immune cells flood and attack healthy organs they are supposed to protect. In COVID-19 patients, the virus stimulates immune cells that lead to collateral lung damage, which may cause blood vessels to leak and blood to clot. The patient's blood pressure sinks, and organs start to fail. Most of the patients who received tocilizumab were on ventilators to support breathing. They each received one dose of tocilizumab, which helps block the signaling of the cytokine, interleukin 6 the only cytokine detected in damaging amounts in all of the study patients. Post-treatment results showed that 23 patients experienced significant drops in body temperature and C-reactive protein (CRP) levels. CRP levels increase when infection is present in the body. Researcher said that four patients did not have rapid declines in CRP levels, and three of them had poorer outcomes. Adverse events were minimal, but two deaths unrelated to tocilizumab occurred & this observational study suggests the medication may help reduce inflammation, oxygen requirements, blood pressure support and the risk of death.

SOURCE: Science Daily News, July 2020

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Early Menstruation !

                               Early menstruation linked to increased menopause symptoms 

A new study found that early menstruation increases the likelihood of hot flushes and night sweats decades later at menopause. Researchers analysed data from more than 18,000 middle aged women across the UK, USA and Australia, as part of the Life course Approach to reproductive health and Chronic disease Events (InterLACE) international collaboration & study showed women who started menstruating aged 11 or younger had a 50 per cent higher risk of experiencing frequent hot flushes and night sweats known as vasomotor symptoms at menopause. The group was compared with women who had their first period at 14 or older. Researcher said that the risk of the women who menstruated early experiencing both symptoms was greater than having either hot flushes or night sweats alone & early menstruation previously had been linked to adverse health conditions later in life, including type 2 diabetes and cardiovascular diseases. Researcher also said that women who experienced early menstruation and were overweight or obese in midlife had a two times greater risk of frequent hot flushes and night sweats, compared with women who experienced their first period aged 14 years or older, and had normal weight. These findings encourage women with early menstruation to engage in health promotion programs, especially weight management in adulthood.

SOURCE: Science Daily News, July 2020

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New Pathway !

Researchers discover new pathways that could help treat RNA viruses

Researchers have identified new pathways in an RNA-based virus where inhibitors, like medical treatments, unbind. The finding could be beneficial in understanding how these inhibitors react and potentially help develop a new generation of drugs to target viruses with high death rates, like HIV-1, Zika, Ebola and SARS-CoV2, the virus that causes COVID-19. Similar to how humans are made up of a series of different chromosomes, known as DNA, many viruses have a genetic makeup of RNA molecules. These RNA-based genomes contain potential sites where inhibitors can attach and deactivate the virus. Part of the challenge in drug development can be fluctuations in the viral genome that may prevent the inhibitors from attaching. Researchers looked specifically at an RNA fragment from the HIV-1 virus and its interaction with a ligand/inhibitor, a complex compound that is known to interfere with the virus replication process. Using computer modeling, the researchers discovered the pathways of the inhibitor unbinding from the viral RNA in several rare events that unexpectedly showed a coordinated movement in many parts of the binding pocket that are the building blocks of RNA. The scientists focused on the structural elements from the HIV-1 RNA genome because they are considered a good model for studying the same processes across a wide range of RNA viruses. The researchers conducted simulations at the molecular level of the rare structural and conformational actions of the binding/unbinding process which are often difficult to observe using experimental methods in the lab.

SOURCE: Science Daily News, July 2020

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Probiotics Ease Depression !

Probiotics alone or combined with prebiotics may help ease depression

New research suggest that Probiotics either taken by themselves or when combined with prebiotics, may help to ease depression. But as to whether they might help to lessen anxiety isn't yet clear, say the researchers. Foods that broaden the profile of helpful bacteria in the gut are collectively known as probiotics, while prebiotics are compounds that help these bacteria to flourish. A two-way relationship exists between the brain and digestive tract, known as the gut-brain axis. And the possibility that the microbiome -- the range and number of bacteria resident in the gut -- might help treat mental ill health has become a focus of interest in recent years. Out of an initial haul of 71 studies, just 7 met all the criteria for inclusion. All 7 investigated at least 1 probiotic strain; 4 looked at the effect of combinations of multiple strains. In all, 12 probiotic strains featured in the selected studies, primarily Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidium. One study looked at combined pre-probiotic treatment, while one looked at prebiotic therapy by itself. The studies varied considerably in their design, methods used, and clinical considerations, but all of them concluded that probiotic supplements either alone or in combination with prebiotics may be linked to measurable reductions in depression. And every study showed a significant fall or improvement in anxiety symptoms and/or clinically relevant changes in biochemical measures of anxiety and/or depression with probiotic or combined pre-probiotic use. Nevertheless on the basis of the preliminary evidence to date, pre- and probiotic therapy warrant further investigation & Probiotics may help reduce the production of inflammatory chemicals, such as cytokines, as is the case in inflammatory bowel disease, suggest the researchers. Or they may help direct the action of tryptophan, a chemical thought to be important in the gut-brain axis in psychiatric disorders. As anxiety disorders and depression affect people very differently, they require treatment approaches that take account of these complexities.People with depression and/or anxiety disorders also often have other underlying conditions, such as impaired insulin production and irritable bowel syndrome, they point out. However, there are inadequate data to suggest anything meaningful to support or refute the use of either pre/probiotic agents (or a combination of both) in patients with clinically recognised anxiety disorders; this would be a useful area to investigate further.

SOURCE: Science Daily News, July 2020

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World's Smallest Imaging Device !

World's smallest imaging device has heart disease in focus

A team of researchers led by the University of Adelaide and University of Stuttgart has used 3D micro-printing to develop the world's smallest, flexible scope for looking inside blood vessels.The camera-like imaging device can be inserted into blood vessels to provide high quality 3D images to help scientists better understand the causes of heart attack and heart disease progression, and could lead to improved treatment and prevention. In a study a multidisciplinary team of researchers and clinicians was able to 3D print a tiny lens on to the end of an optical fibre, the thickness of a human hair. The imaging device is so small that researchers were able to scan inside the blood vessels of mice. Researcher said that, A major factor in heart disease is the plaques, made up of fats, cholesterol and other substances that build up in the vessel walls & Preclinical and clinical diagnostics increasingly rely on visualising the structure of the blood vessels to better understand the disease. Miniaturised endoscopes, which act like tiny cameras, allow doctors to see how these plaques form and explore new ways to treat them. Using 3D micro-printing, researcher are able to print complicated lenses that are too small to see with the naked eye. The entire endoscope, with a protective plastic casing, is less than half a millimetre across. Researcher said that It's exciting to work on a project where we take these innovations and build them into something so useful & It's amazing what we can do when we put engineers and medical clinicians together.

SOURCE: Science Daily News, July 2020

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Products of SQUARE Pharmaceuticals Ltd.

  Product RemdinilTM
  Generic Name Remdesivir
  Strength 100 mg/20 ml
  Dosage form Solution for IV infusion
  Therapeutic Category Antiviral
  Product Secrin M
Generic Name Glimepiride and Metformin Hydrochloride
Strength Glimepiride 2 mg & Metformin Hydrochloride 500 mg
Dosage form Bilayer Tablet
Therapeutic Category Antidiabetic
  Generic Name Baricitinib
Strength 2 mg
  Dosage form Tablet
  Therapeutic Category Anti-rheumatic agents

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