Healthcare online Keeping you up-to-date
VOL.  22     ISSUE:  4   April 2024 Medical Services Department

SQUARE Pharmaceuticals PLC.





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 -

"Eclampsia Risk !", "Heart Disease !", "Etripamil Advantages !", "Stroke Therapy !",  "Depressive CAD !", "Thyroid Alert !".

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

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Editorial Team

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

 Eclampsia Risk !

Eclampsia increase risk of cardiovascular death

Health researchers identify patients at risk for preventable death in the year after pregnancy. Among the hypertensive disorders that cause dangerously high blood pressure during pregnancy chronic hypertension, gestational hypertension, preeclampsia without severe features, preeclampsia with severe features, superimposed preeclampsia and eclampsia all but gestational diabetes were associated with a doubling in the risk of fatal cardiovascular disease compared to women with normal blood pressure. Eclampsia, a condition whereby hypertensive disorders cause seizures, was associated with a nearly 58-fold increase in fatal cardiovascular disease. This study provides new information about how each hypertensive disorder is related to fatal cardiovascular disease, so healthcare providers can monitor patients with such complications more closely and develop strategies for keeping them healthy postpartum. The researchers used the Nationwide Readmissions Database to examine pregnancy-related mortality rates for females 15 to 54 years old from 2010 to 2018. Data from more than 33 million delivery hospitalizations identified hypertensive disorders in 11 percent of patients, but that number increased with time. In 2010, 9.4 percent of patients in the study had hypertensive disorders of pregnancy. By 2018, that figure had risen by more than half to 14.4 percent. Cases of chronic hypertension are rising sharply among people of childbearing age, but optimal treatment strategies remain uncertain. While treating more pregnant people with mild hypertension with antihypertensive medications, there remain many questions about the right definitions of hypertension in pregnant compared to non-pregnant individuals. Pregnant people with hypertensive disorders, especially those with pre-existing hypertension, need high-quality care as heart disease and related cardiac symptoms can be confused with common symptoms of normal pregnancy. Early identification and optimal treatment of hypertensive disorders, especially preeclampsia-eclampsia, are crucial for the primary prevention of maternal stroke.

SOURCE: Daily science April 2024

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 Heart Disease !

Preventive angioplasty does not improve prognosis

For heart attack patients, treating only the coronary artery that caused the infarction works just as well as preventive balloon dilation of the other coronary arteries, according to a new large study. Heart attack is a common disease with risks of serious complications. It has long been unclear what the best strategy is for treating narrowing in coronary arteries separate from the specific vessel that caused the infarction. A new large Swedish study has investigated whether it is sufficient to treat only the coronary artery that caused the infarction, or whether long-term results are better if other narrowed vessels are also treated with balloon dilation as a preventive measure. The clinical randomized study included 1542 patients from 32 hospitals in 7 countries. Patients were followed up for five years after the procedure. The results show no difference between the groups in terms of new heart attacks, new unplanned balloon dilations or the total number of all-cause deaths. The study shows that it is possible to avoid patients coming back for new balloon dilations through preventive treatment. But for those patients where there is some circumstance that makes a complete revascularization complicated, one might choose to wait, since there was no difference in the most serious complications If problems with angina occur, these patients can then come back later for a new treatment. A positive finding of the study was that most patients do not come back with new problems, regardless of the treatment strategy chosen. Nowadays, heart attack patients are so well treated with drugs that it is difficult to find other interventions that provide further significant risk reduction. The researchers will now go on to investigate how angina and other quality of life parameters in the patients were affected by the different treatment strategies, as well as health economic aspects of the chosen strategy.

SOURCE: Daily science, April 2024

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 Etripamil Advantages !

Nasal spray (Etripamil) safely treats recurrent abnormal heart rhythm

A clinical trial showed that a nasal spray that patients administer at home, without a physician, successfully and safely treated recurrent episodes of a condition that causes rapid abnormal heart rhythms. The study provides real-world evidence that a wide range of patients can safely and effectively use the experimental drug, called etripamil, to treat recurrent paroxysmal supraventricular tachycardia (PSVT) episodes at home, potentially sparing them the need for repeated hospital trips for more invasive treatments. The study is the latest in a series to demonstrate the potential of nasal spray calcium-channel blocker etripamil as an at-home treatment PSVT. Patients with PSVT experience sudden and recurrent rapid heart rhythms triggered by abnormal electrical activity in the upper chambers of the heart. Though the episodes are not commonly life-threatening, they can be frightening and cause shortness of breath, chest pain, dizziness or fainting and lead to frequent emergency department visits. Treatment for PSVT often requires hospitalization to receive intravenous medication. Some patients undergo a procedure called cardiac ablation, where the physician threads thin wires through their blood vessels to the heart and uses them to treat the short circuits the cause the abnormal normal heart rhythm. The latest study builds on those findings, showing that etripamil is safe and effective under more real-world circumstances in a larger patient population, and could be safely used to treat multiple episodes of PSVT. It also included patients with a history of atrial fibrillation or atrial flutter, who were excluded from the previous studies. Patients monitored their heart for one hour with a home electrocardiogram monitor after self-administering the first dose, took an additional dose if necessary, and were allowed to self-treat up to four PSVT episodes with etripamil. Two-thirds of the patients experienced relief within an hour, and the average time needed for symptom relief was 17 minutes. Mild, temporary nasal symptoms such as runny nose, nasal congestion or discomfort, and bloody nose were common after the first use of etripamil but became less common with subsequent use.

SOURCE: Science Daily, April 2024

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Stroke Therapy !

                                      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 2024

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 Depressive CAD !

                      Heart disease depression linked by inflammation

Coronary artery disease (CAD) and major depression may be genetically linked via inflammatory pathways to an increased risk for cardiomyopathy, a degenerative heart muscle disease, researchers have found. The drugs prescribed for coronary artery disease and depression, when used in combination, potentially may reduce inflammation and prevent the development of cardiomyopathy. This work suggests that chronic low-level inflammation may be a significant contributor to both depression and cardiovascular disease. As many as 44% of patients with coronary artery disease (CAD), the most common form of cardiovascular disease, also have a diagnosis of major depression. Yet the biological relationship between the two conditions remains poorly understood. A possible connection is inflammation. Changes in the levels of inflammatory markers have been observed in both conditions, suggesting that there may be a common biological pathway linking neuro inflammation in depression with atherosclerotic inflammation in CAD. In the current study, the researchers used a technique called transcriptome-wide association scans to map single nucleotide polymorphisms (genetic variations) involved in regulating the expression of genes associated with both CAD and depression. The technique identified 185 genes that were significantly associated with both depression and CAD, and which were "enriched" for biological roles in inflammation and cardiomyopathy. This suggests that predisposition to both depression and CAD, which the researchers called (major) depressive CAD, or (m)dCAD, may further predispose individuals to cardiomyopathy. However, when the researchers scanned large electronic health record databases at VUMC, Mass General, and the National Institutes of Health's All of Us Research Program, they found the actual incidence of cardiomyopathy in patients with the enriched genes for (m)dCAD was lower than in patients with CAD alone. One possible explanation is that medications prescribed for CAD and depression, such as statins and antidepressants, may prevent development of cardiomyopathy by reducing inflammation, the researchers concluded. A minimum this work suggests that patient heart and brain health should be considered together when developing management plans to treat depression or cardiovascular disease.

SOURCE: Science Daily, April 2024

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 Thyroid Alert !

                Anti-rheumatic drugs could prevent thyroid disease 

Anti-rheumatic drugs used for rheumatoid arthritis might prevent the development of autoimmune thyroid disease, according to a new observational study. It is well known that patients with rheumatoid arthritis are at increased risk of autoimmune thyroid diseases such as Hashimoto's disease and Graves' disease. While patients with RA are usually treated with immunomodulatory drugs that affect the immune system, such drugs are rarely used in autoimmune thyroid diseases Instead, such patients are treated with thyroid hormone to compensate for the changes in normal thyroid function that accompany autoimmune thyroid disease. The researchers in the current study wanted to investigate whether immunomodulatory drugs that reduce inflammation in the joints of patients with RA might also reduce the risk of these patients developing autoimmune thyroid disease. Previous studies in mice suggest that so-called DMARDs, a type of immune-modulatory drugs used to treat rheumatoid arthritis, can reduce inflammation in the thyroid gland. Still, knowledge of whether this effect also applies to humans is limited, according to the research team. The researchers used data between 2006 and 2018 on over 13,000 patients with rheumatoid arthritis and their treatment, as well as data from over 63,000 individuals in a matched control group without rheumatoid arthritis. The researchers found that the risk of developing an autoimmune thyroid disease among RA patients was lower after their onset of the rheumatic disease than before diagnosis. The most pronounced reduction in the risk of autoimmune thyroid disease was seen in patients with rheumatoid arthritis treated with immunomodulatory drugs or 'biological DMARDs'. In these patients, the risk of autoimmune thyroid disease was 46 percent lower than in the control group without rheumatoid arthritis. These results support the hypothesis that certain types of immunomodulatory drugs could have a preventive effect on autoimmune thyroid disease. The results do not prove that it is the treatment with immunomodulatory drugs that led to the reduced risk of autoimmune thyroid disease, but provide support for this hypothesis. The results, if they can be replicated in further studies, open up the possibility of studying more directly in clinical trials whether the immunomodulatory drugs currently used for rheumatoid arthritis could also be used for the early treatment of autoimmune thyroid disease.

SOURCE: Science Daily, April 2024

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Products of SQUARE Pharmaceuticals PLC.

  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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