Healthcare online Keeping you up-to-date
VOL.  21     ISSUE:  4   April 2023 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management



Rubyeat Adnan


Moshfiqur Rahman




Hope that you are enjoying this online healthcare bulletin.

Our current issue focused on some interesting features like -

"Insulin Risk !", "Cluster Headache !", "Lyme Disease !", "Lipid Molecules !",  "Maternal Stress !", "Alzheimer's Proteins !".

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

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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.

 Insulin Risk !

Too much insulin can be as dangerous as too little

Researcher have greatly advanced medical and biochemical understanding of how insulin works and what happens when it is lacking. In a new study, researcher describe a key player in the defense mechanism that safeguards us against excessive insulin in the body. Although insulin is one of the most essential hormones, whose insufficiency can result in death, too much insulin can also be deadly. Patients who are treated with insulin or drugs that stimulate insulin secretion often experience hypoglycemia, a condition that if gone unrecognized and untreated can result in seizures, coma and even death, which collectively define a condition called insulin shock. The body's natural defense or safety valve that reduces the risk of insulin shock. That valve is a metabolic enzyme called fructose-1,6-bisphosphate phosphatase or FBP1, which acts to control gluconeogenesis, a process in which the liver synthesizes glucose during sleep and secretes it to maintain steady supply of glucose in the bloodstream. Some antidiabetic drugs, such as metformin, inhibit gluconeogenesis but without apparent ill effect. Children born with a rare, genetic disorder in which they do not produce sufficient FBP1 can also remain healthy and live long lives. But in other cases, when the body is starved for glucose or carbohydrates, an FBP1 deficiency can result in severe hypoglycemia. Without a glucose infusion, convulsions, coma and possibly death can ensue. The roles of FBP1, researchers created a mouse model with liver specific FBP1 deficiency, accurately mimicking the human condition. Like FBP1-deficient children, the mice appeared normal and healthy until fasted, which quickly resulted in the severe hypoglycemia and the liver abnormalities and hyperlipidemia described above. This peptide works like an insulin mimetic, activating AKT. When injected into mice that have been rendered insulin resistant, a highly common pre-diabetic condition, due to prolonged consumption of high-fat diet, the peptide can reverse insulin resistance and restore normal glycemic control.

SOURCE: Science Daily, April 2023

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 Cluster Headache !

Cluster headache may be more severe in women

Cluster headache is still often misdiagnosed in women, perhaps because some aspects can be similar to migraine. It is important for physicians to be aware of how the disorder manifests differently in men and women so the most effective treatment can be given as fast as possible. The study involved 874 people diagnosed with cluster headache, with 66% male and 34% female. Participants answered a detailed questionnaire about their symptoms, medications, headache triggers and lifestyle habits. Women were more likely to be diagnosed with chronic cluster headache than men. Chronic cluster headache is defined as recurring cluster headache attacks for one year or more without interruption, or with short intermissions with no symptoms that last less than three months. Eighteen percent of women were diagnosed with chronic cluster headache, compared to 9% of men. Attacks also lasted longer for women than for men. For example, 8% of women said headache bouts lasted an average of four to seven months, compared to 5% of men, while 26% of women said bouts on average lasted less than one month, compared to 30% of men. Women were also more likely to report that their attacks occurred at various times throughout the day than men, 74% to 63%. Women were more likely to have a family member with a history of cluster headache, 15% to 7%. While the ratio of men to women with cluster headache has been shifting over the years, it is still considered mainly a disorder of men, making it more difficult for women with milder symptoms to be diagnosed with cluster headache than men. It's possible this could contribute to the higher rate of chronic cluster headaches in women.

SOURCE: Science Daily, April 2023

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 Lyme Disease !

Children recover from Lyme disease within six months of treatment

Lyme disease is the most common vector-borne disease. Most cases caused by the bacterium Borrelia burgdorferi transmitted through the bites of infected black-legged or deer ticks. Children between the ages of 5 and 9 years account for a large proportion of the approximately 476,000 Lyme disease cases diagnosed and treated. Common symptoms of Lyme disease include: fever; headache; fatigue; and a distinct skin rash called erythema migrans. Without treatment, the infection can spread to joints, the heart and the nervous system. Antibiotic treatment resulting in full recovery is successful in most Lyme cases. For some, however, symptoms of pain, fatigue, or difficulty thinking persist or return after antibiotic treatment. Symptoms that substantially reduce levels of activity and impact quality of life for more than six months after treatment are classified as post-treatment Lyme disease (PTLD) syndrome. The research studied the long-term outcomes of children with Lyme disease through a cross-sectional evaluation using validated surveys. The study collected survey responses from the parents of 102 children ages 5 to 18 years who had been diagnosed with Lyme disease between six months and 10 years before enrollment. Adolescents ages 10 to 18 years old were also invited to complete adolescent-specific questionnaires. According to these parent survey responses, 75% of children fully recovered within six months of completing treatment: 31% of all children recovered within one month; 30% recovered in one-to-three months; and 14% recovered in four-to-six months. Approximately 22% of children in the study experienced at least one symptom that persisted six or more months after completing treatment; of those, 9% had symptoms classified as PTLD syndrome. Six percent of the children were not fully recovered at the time of the survey, with 1% experiencing symptoms significant enough to impair daily functioning. This study supports previous data showing an excellent overall prognosis for children with Lyme disease, which should help alleviate understandable parental stress associated with lingering non-specific symptoms among infected children. The researchers suggest this new data could help reduce the potential for families seeking dangerous alternative therapies for children who experience prolonged recovery times.

SOURCE: Science Daily, April 2023

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 Lipid Molecules !

                                      Lipid molecules help to get stroke therapies into the brain

Researchers have found that a promising stroke therapy, known as antisense oligonucleotides, is preferentially taken up from the blood into areas of stroke damage in the brain when the molecules are linked to a specific kind of lipid. This therapy can be given relatively late after a stroke occurs, and is hoped to lead to reduced stroke-related disabilities. Current stroke therapies are only effective if they are delivered within a short window of time, which limits their effectiveness in many patients. Many new therapies are being investigated that can be applied outside this short window of opportunity. One such therapy involves the use of antisense oligonucleotides, which can be targeted to increase the production of beneficial proteins after a stroke. Researcher recently developed an antisense oligonucleotide known as a DNA/RNA heteroduplex oligonucleotide, or HDO. To see how different lipids affect the uptake of HDO in the brain & linked it to either cholesterol or TOC and then injected it into the blood of mice who had been given an experimentally induced stroke in just one side of the brain. Unexpectedly, the TOC-linked molecules were observed at very high levels in the stroke-lesioned side of the brain only, whereas the cholesterol-linked molecules were high in both sides of the brain. This suggests that TOC specifically increases HDO uptake after stroke, while cholesterol does not. Furthermore, because HDO can be tailored to target different genes, it was used to silence a gene known to be beneficial in stroke. Together, Researcher findings suggest that TOC-linked HDO is safe to use and is preferentially taken up and incorporated into cells in areas of stroke damage. This method is potentially very useful for the targeted up-or down-regulation of protein expression after stroke.

SOURCE: Science Daily, April 2023

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 Maternal Stress !

                       Impact of maternal stress during pregnancy on child's health

Prenatal maternal stress life events are associated with adverse neurodevelopmental outcomes in offspring. Biological mechanisms underlying these associations are largely unknown, but a chemical reaction in the body in which a small molecule known as a methyl group gets added to DNA, called DNA methylation, likely plays a role, according to researchers. These findings could provide new insights into how the fetal environment potentially influences not only neurodevelopment, but metabolism and immunologic functions as well. More than 5,500 people took part in the study .The study is the first to look at such a large sample size and examine. The research examines five separate categories of stress that expectant moms face during pregnancy. They are financial stress, conflict with a partner, conflict with a family member or friend, abuse (including physical, emotional and mental) and death of a friend or relative, plus a cumulative score that combines all the categories. Researcher found that when mom experienced a cumulative amount of stress during pregnancy, there was, in fact, an association with DNA methylation in umbilical cord blood, which is a kind of epigenetic modification in the baby that's developing in the womb. An epigenetic modification is something that doesn't change the sequence of the DNA, however, the DNA is modified which is something that's dynamic and can change in response to environmental exposures & found five specific locations of DNA methylation with three different maternal stressors during pregnancy. These were occurring in genes that have been shown to be involved in neurodevelopment. The next steps are to do some functional analyses to see how these genes really work and how DNA methylation affects their expression. Epigenetic modifications are a very dynamic process, there are a lot of changes that can happen in response to environmental factors. It's fascinating as a biologist to begin to uncover some of the biological clues to how neurodevelopment is affected during fetal development.

SOURCE: Science Daily, April 2023

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 Alzheimer's Proteins !

                Sleeping pill reduces levels of Alzheimer's proteins 

Sleep disturbances can be an early sign of Alzheimer's disease. A small, two-night study has shown that people who took a sleeping pill before bed experienced a drop in the levels of key Alzheimer's proteins, since higher levels of such proteins tracks with worsening disease. The study, involved a sleeping aid known as suvorexant is already approved by the Food and Drug Administration (FDA) for insomnia. This drug is already available and proven safe. Suvorexant belongs to a class of insomnia medications known as dual orexin receptor antagonists. Orexin is a natural biomolecule that promotes wakefulness. When orexin is blocked, people fall asleep. Three orexin inhibitors have been approved by the FDA, and more are in the pipeline. As a first step to assess the effect of orexin inhibitors on people, Researchers included 38 participants ages 45 to 65 and with no cognitive impairments to undergo a two-night sleep study. The participants were given a lower dose (10 mg) of suvorexant (13 people), a higher dose (20 mg) of suvorexant (12 people), or a placebo (13 people) at 9 p.m. and then went to sleep in clinical research. Researchers withdrew a small amount of cerebrospinal fluid via spinal tap every two hours for 36 hours, starting one hour before the sleeping aid or placebo was administered, to measure how amyloid levels changed over the next day and a half. Amyloid levels dropped 10% to 20% in the cerebrospinal fluid of people who had received the high dose of suvorexant compared to people who had received a placebo. Researcher can lower amyloid every day & think the accumulation of amyloid plaques in the brain will decrease over time. The study is preliminary since it only looked at the effect of two doses of the drug in a small group of participants. The researcher has studies underway to assess the longer-term effects of orexin inhibitors in people at higher risk of dementia.

SOURCE: Science Daily, April 2023

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Products of SQUARE Pharmaceuticals Ltd.

  Product Betaburn TM
  Generic Name Beta-Sitosterol


Dosage form Ointment
  Therapeutic Category Topical Antibacterial
Product DK  TM
Generic Name

Vitamin D3 + Vitamin K1 + Vitamin K2

Strength 400IU+60mcg+30 mcg
Dosage form Soft Gel Capsule
Therapeutic Category Vitamin
  Product Ulrif  TM
Generic Name Sucralfate
  Strength 1g/5ml
Dosage form Suspension
  Therapeutic Category Non Systemic Antiulcerant

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