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Healthcare online Keeping you up-to-date
VOL.  21     ISSUE: 8  August  2023 Medical Services Department

SQUARE Pharmaceuticals Ltd.

Features

EDITORIAL TEAM

OMAR AKRAMUR RAB

MBBS, FCGP, FIAGP,

P G Dip. Business Management

Rubyeat Adnan

MBBS, MPH, CCD

Moshfiqur Rahman

MBBS

EDITORIAL

Dear Doctor,

Hope you are enjoying this healthcare online !
Our current health bulletin issue focused on some latest features like -


"Heart Damage !", "Exercise Benefits !", "Cystic fibrosis !", "Influenza vaccination !",  "Gene therapy !", "Prostate cancer !".

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

We appreciate your feedback !

Click on to reply mode.

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.
 Heart Damage !

Arterial stiffness may cause and worsen heart damage

Left ventricular hypertrophy and left diastolic dysfunction are measures of structural and functional heart damage, which have been associated with an increased risk of cardiovascular-related death in adults. These cardiac measures are also used in the pediatric population as indicators of premature heart damage. Arterial stiffness estimated from carotid-femoral pulse wave velocity has been discovered as a novel cause of increased blood pressure, insulin resistance, and metabolic syndrome in adolescents and young adults. It was also recently shown that increased blood pressure in adolescence may cause premature heart damage, but it is not known whether arterial stiffness could independently cause structural and functional damage to the heart. The current study was conducted among 1,856 adolescents of whom 1,011 were female. The adolescents were 17 years old at baseline, and they were followed up for 7 years until young adulthood at age 24 years. Arterial stiffness, carotid intima-media thickness, and evidence of heart damage were assessed at baseline and follow-up. Signs of heart structure damage are left ventricular hypertrophy and high relative wall thickness, whereas signs of heart function damage are left ventricular diastolic dysfunction and increased left ventricular filling pressure. During the 7-year follow-up period, the prevalence of heart structural damage among adolescents doubled. With extensive control for fat mass, muscle mass, glucose, insulin, blood pressure, lipids, smoking status, sedentary time, physical activity, socio-economic status, and family history of cardiovascular disease, and using adults' cut points for diagnosing heart damage, it was observed that adolescents in the highest category of arterial stiffness and carotid intima-media thickness had a 23 -- 27% increased risk of progressively worsening structural heart damage. Only arterial stiffness appears to independently cause both structural and functional heart damage, whereas increased carotid wall thickness does not seem to have a causal role. Increased carotid wall thickness is an early indicator of atherosclerosis, whereas increased arterial stiffness describes arteriosclerosis. The study further reported that arterial stiffness caused heart damage by increasing blood pressure and insulin resistance. The increase in blood pressure explained 34% of the heart damage caused by arterial stiffness. Moreover, insulin resistance explained 15% of the heart damage caused by arterial stiffness. The scientist discovered that approximately 50% of the deleterious role of arterial stiffness in causing heart damage is enhanced by the mechanism of increased blood pressure and insulin resistance. Thus, preventing and lowering blood pressure and insulin resistance may potentially diminish the negative impact of arterial stiffness on the heart, by up to half.
SOURCE: Science daily News, August 2023

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 Exercise Benefits !

 Platelets can replicate the benefits of exercise in the brain

Researchers have found an injection of a specific blood factor can replicate the benefits of exercise in the brain. The team of researchers which discovered platelets, secrete a protein that rejuvenates neurons in aged mice in a similar way to physical exercise. Exercise increases production of new neurons in the hippocampus, the part of the brain important for learning and memory, but the mechanism hasn't been clear. In previous research has shown platelets are involved, but this study shows platelets are actually required for this effect in the aged mice. The researchers focused on exerkines, the biological compounds released into the bloodstream during exercise, which are believed to stimulate the exercise-induced response in the brain. Researchers discovered that the exerkine CXCL4/Platelet factor 4 or PF4, which is released from platelets after exercise, results in regenerative and cognitive improvements when injected into aged mice. The findings have significant implications for the development of drug interventions. For a lot of people with health conditions, mobility issues or of advanced age, exercise isn't possible, so pharmacological intervention is an important area of research. Researcher now target platelets to promote neurogenesis, enhance cognition and counteract age-related cognitive decline. The researchers said the next step is to test the response in Alzheimer diseased mice, before moving towards human trials. It's important to note this is not a replacement for exercise. But it could help the very elderly or someone who has had a brain injury or stroke to improve cognition.

SOURCE: Science daily News, August 2023

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 Cystic fibrosis !

Triple combination therapy brings improvement in cystic fibrosis

Cystic fibrosis is one of the most common fatal hereditary diseases worldwide .The mucus in the airways is not as sticky and inflammation in the lungs significantly reduced. Triple combination therapy can achieve these positive, lasting effects in patients with cystic fibrosis (CF). Researchers have just recently published their findings in the European Respiratory Journal. According to their research, this form of medication improves the symptoms of CF in many patients. Two years ago, a research group headed by showed that combination therapy involving three drugs elexacaftor, tezacaftor, and ivacaftor is effective in a large portion of patients with cystic fibrosis, a hereditary disease, meaning that the treatment noticeably improves both lung function and quality of life. Now, researchers in both studies, has investigated for the first time whether this form of treatment is also helpful in the long term, meaning over a period of 12 months or more. To examine this, the researchers took a closer look at the sputum. In patients with cystic fibrosis, the mucus in the airways is very sticky because it doesn't contain enough water and the mucins, the molecules that form mucus, adhere too much due to their chemical properties. This results in thick, sticky mucus, which clogs the airways, making it harder for patients to breathe and leading to chronic bacterial infection and inflammation of the lungs. In the current study, the researchers show that a combination of elexacaftor, tezacaftor, and ivacaftor results in less viscous respiratory secretions and decreasing inflammation and bacterial infection in the lungs of cystic fibrosis patients. This is really important because previous medications caused a rebound in the bacterial load in the airways. 79 adolescents and adults with cystic fibrosis and chronic lung disease participated in the trial. This is a major step forward in treating cystic fibrosis. At the same time, it would be premature to say that patients have been normalized, let alone cured. Chronic lung changes arising over many years of living with the disease cannot be reversed, unfortunately." This means patients with advanced lung disease will still need to rely on established treatments involving inhaling mucus-thinning medications, taking antibiotics, and physical therapy. The researchers are also working to advance their understanding of mucus defects in cystic fibrosis and develop new mucolytics, drugs that thin and loosen the mucus. This research could also benefit patients with common chronic inflammatory lung diseases such as asthma and COPD.

SOURCE: Science daily News, August 2023

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 Influenza vaccination !

Influenza shows no seasonality, posing challenges for health care

The World Health Organization estimates that seasonal influenza kills up to 650,000 people worldwide each year due to respiratory disease, alone; this does not include the number of people who die from cardiovascular disease caused by influenza. Without the ability to identify a regular interval at which epidemics occur in tropical areas, preparations such as timing an annual vaccine campaign or preparing healthcare settings for higher caseloads are not possible. The researchers collected weekly counts of patients with influenza from fifteen hospitals over ten years across Vietnam to identify any consistency in the timing of influenza epidemics. Next, they developed a mathematical model incorporating the peak timings of transmission and the repeatability of these peak timings. After accounting for different subtypes of influenza, the team found little evidence of a repeatable pattern throughout Vietnam. The lengths of time between epidemics were highly irregular in Vietnam. Researchers found strong evidence of annual seasonality in the temperate locations, which suggests that our statistical estimation procedure performed as expected & noted that the four temperate locations consistently showed peak transmission during winter months. Possible explanations for this winter peak could include seasonal changes in behavior, such as the notable change in indoor versus outdoor gatherings in cold winter months, as well as different conditions for virus transmission, such as having cold, dry air in temperate winters. In contrast to temperate regions, where vaccination and health communication efforts can be strategically focused on autumn, the optimal timing for prioritizing vaccines in Vietnam to achieve maximum protection remains uncertain. While Vietnam has a vaccine policy targeting specific at-risk groups, influenza vaccination is not yet widespread. The findings of this study underscore the challenges in implementing a comprehensive national vaccination strategy.
SOURCE: Science daily News, August 2023

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 Gene therapy !

Gene therapy hope for children with kidney disease

The research project has shown that just one dose of gene therapy targeting cells in the kidney has the potential to cure a condition known as steroid-resistant nephrotic syndrome.The findings suggested that replacing one faulty gene that codes for a protein known as podocin could cure the condition. Podocin is a protein essential for the functioning of cells called podocytes which have a critical role within the kidney's filtration system. Nephrotic syndrome is a condition where the kidney's filtering units are damaged, allowing large amounts of protein that should be kept in the bloodstream to leak into the urine. This can lead to swelling, particularly in the eyes and legs, and an increased risk of infections and blood clots, and the risk of kidney damage. It can occur at any age but is most commonly diagnosed in children under five years old. Around 10% of children with nephrotic syndrome do not respond to steroids and many will go on to develop kidney failure and will need dialysis or transplant within two to five years. This is the group where a faulty gene is frequently the cause of the disease. Researchers are hoping that this treatment could be curative & keep the same podocytes for life. With most kidney diseases, there is a reasonable window of opportunity, often years, before you get irreversible damage to the kidneys, where we would hope to be able to intervene with gene therapy and avoid the need for dialysis or transplantation. The discovery could bring major benefits to hundreds of children who currently suffer from nephrotic syndrome. If the intervention works, patients will be saved from a life of kidney failure and subsequent dialysis and transplant treatments. For gene therapy to be successful, researchers must make sure the new genetic material reaches the right cells and is used by those cells for a long time to restore their normal function. The team used a virus incapable of causing disease but excellent at carrying genetic information directly into cells called adeno-associated virus (AAV) to deliver the podocin gene to the correct cell type. Using this technique, the team were able to replace the original faulty gene in the podocytes, successfully treating several different laboratory-based models of nephrotic syndrome. Researcher said: "If successful, this method could effectively rescue people from a life on gruelling dialysis treatment or from needing a kidney transplant. This work offers real hope for patients impacted by steroid-resistant nephrotic syndrome and potentially other genetic kidney diseases too. Researcher are delighted to see that our funding has helped progress a project that has real potential to be used in a clinical setting. Further research in the next few years will determine whether this application of the therapy is viable to be used within the health service.
SOURCE: Science daily News, August 2023

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 Prostate cancer !

Use of diabetes medication for treatment of metastatic prostate cancer 

Patients with localized prostate cancer have a good chance of survival, but mortality rates among those with advanced, metastatic forms of the condition remain high. Until now, the precise mechanism behind the spread of the tumor has not been fully explained. But an international research team has succeeded in decoding the underlying cellular signal pathway and has carried out research using a common diabetes medication that could provide a new treatment option. In the course of the study, the researchers also found that activation of STAT3 in the prostate leads to increased levels of cell components (LKB1/pAMPK) that are responsible for the regulation of glucose metabolism and are linked to type 2 diabetes mellitus. The proteins LKB1/pAMPK block certain cancer molecules (mTOR and CREB) and as a result also stop the tumour growing. In light of this finding, researche used a common diabetes drug in our research and his team discovered that the active ingredient metformin, which is used in the treatment of type 2 diabetes to regulate glucose levels, can significantly slow the progression of STAT3-positive prostate cancer, a condition with a metabolism that is very similar to type 2 diabetes. As metformin is already available, our research findings could be useful in developing new treatment options for patients with STAT3-positive prostate cancer in the foreseeable future & looking ahead to further research into the newly discovered approach. Prostate cancer has been the most common type of cancer in men. In 2019, 6,039 new cases and 1,352 deaths due to prostate cancer were recorded. In the vast majority of cases, tumours in the prostate gland remain localised, meaning that they can be treated effectively. However, about 20% of patients develop metastatic prostate cancer, which is still incurable. Malignant prostate tumours are the second most common cause of cancer-related death in men worldwide (after lung cancer).
SOURCE: Science daily News, August 2023

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Products of SQUARE Pharmaceuticals Ltd.
Product RapilogTM  
Generic Name Insulin Aspart
  Strength 100 IU/ml
  Dosage form Injection (Vial)
Pen Cartridge
  Therapeutic Category Anti-diabetic (Analog Insulin)
Product NasovapTM
Generic Name

Menthol + Eucalyptus Oil 

Strength 100 ml
Dosage form Suspension for Inhalation
Therapeutic Category Nasal Decongestants (Topical Nasal Preparations)
Product TeconinTM
  Generic Name Teicoplanin
  Strength 200 & 400 mg
Dosage form IM/IV Injection
  Therapeutic Category Other Antibacterial
(Glycopeptide antibiotic)

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