Healthcare online Keeping you up-to-date
VOL.  18     ISSUE:  12  December   2020 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management



Rubyeat Adnan



Dear Doctor,

Hope that you are enjoying this online healthcare bulletin.
Our current issue focused on some interesting features like -

"Heart Health !", "New Mystery of Coronavirus !", "Human Evolution Risk !", "Mother's Stress !",  "Social Media Addiction !", "Breast Cancer Hope !".

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

Please send your feedback !  We always value your comments !

Click on to reply mode.

On behalf of the management of SQUARE, we wish you all a very happy, healthy and prosperous life.

 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 Health !

                                        Assessment of heart health by climbing stairs

The researchers said that the stairs test is an easy way to check heart health. If it takes more than one & half minutes to ascend four flights (60 stairs), the health is suboptimal & it would be a good idea to consult a doctor. The results obtained from exercise testing in a laboratory. The idea was to find a simple and inexpensive method of assessing heart health. This can help physicians triage patients for more extensive examinations. Symptoms included chest pain or shortness of breath during exertion. Participants walked or ran on a treadmill, gradually increasing the intensity, and continuing until exhaustion. Exercise capacity was measured as metabolic equivalents (METs).After resting for 15 to 20 minutes, patients were asked to climb four flights of stairs (60 stairs) at a fast pace without stopping and the time was recorded. The researchers analysed the relationship between METs achieved during exercise testing and the time it took to climb four flights of stairs. Patients who climbed the stairs in less than 40-45 seconds achieved more than 9-10 METs. Previous studies have shown that 10 METs during an exercise test is linked with a low mortality rate (1% or less per year, or 10% in 10 years). In contrast, patients who took 1.5 minutes or longer to climb the stairs achieved less than 8 METs, which translates to a mortality rate of 2-4% per year, or 30% in 10 years. Some 58% of patients who completed the stairs climb in more than 1.5 minutes had abnormal heart function during the treadmill examination. In contrast, just 32% of those who climbed the stairs in less than one minute had abnormal heart function during the treadmill examination. Researchers said that the correlation between the stairs time and exercise capacity (i.e. METs) would be similar in the general population. But the corresponding mortality rates and heart function by imaging would be more favourable than for patients with symptoms and suspected or confirmed coronary artery disease.

SOURCE: Science Daily News, December 2020

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 New Mystery of Coronavirus !

                                 Rapid genomics strategy to trace coronavirus

The researchers published an analytical validation and best practice guidelines for Nanopore sequencing of SARS-CoV-2, which they hope will enable a greater uptake of the fast sequencing technology for health initiatives. Every time the SARS-CoV-2 virus passes from person to person, it may make copying errors that change a couple of its 30,000 genetic letters. By identifying this genetic variation it can be established how different cases of coronavirus are linked - to know where a case was potentially picked up from and who they may have given it to. One researcher says genomic testing is crucial for tracking virus transmission in cases where the source remains unclear from investigating known epidemiological contacts alone. By reconstructing the virus's evolutionary history, or 'family tree', Researchers understand the behaviors that help spread COVID-19 and identify so-called 'super-spreaders'. When a new 'mystery' coronavirus case is identified, every minute counts. Researchers repurposed genomic sequencing capabilities to enable a rapid analysis of a coronavirus genome in just a few hours. Rapid methods such as this provide a way forward, as a potential future option for contact tracing through real time genomic transmission studies. This technical advance is a testament to what's possible when public pathology collaborates with Research Institutes for a common goal. Pinpointing SARS-CoV-2 transmission quickly is crucial. Researchers have fine-tuned the protocols for cutting-edge to sequence SARS-CoV-2 in less than four hours. The current gold-standard method reads short genetic sequences of just 100-150 genetic letters at a time, whereas Nanopore technologies have no upper limit to the length of DNA fragments that can be sequenced and are able to more rapidly determine the complete sequence of a viral genome. However, as with many emerging technologies, there have been concerns about the accuracy of that sequencing. The researchers' analysis revealed the sequencing method to be highly accurate (variants were detected with >99% sensitivity and >99% precision in 157 SARS-CoV-2-positive patient specimens) and provides best practice guidelines, which the researchers hope will promote the uptake of the technology by other teams globally. The researchers say the sequencing even has the potential to enhance SARS-CoV-2 surveillance by enabling point-of-care sequencing and improved turnaround times for critical cases. Nanopore devices are cheaper, faster, portable and don't require the lab infrastructure needed by current standard pathogen genomics tools.

SOURCE: Science Daily News, December 2020

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 Human Evolution Risk !

                           Human Evolution Linked to Cancers Risk

A recent study suggests that an evolutionary genetic mutation unique to humans may be at least partly to blame. At some point during human evolution, the SIGLEC12 gene and more specifically, the Siglec-12 protein it produces as part of the immune system suffered a mutation that eliminated its ability to distinguish between self and invading microbes, so the body needed to get rid of it. But it's not completely gone from the population. It appears that this dysfunctional form of the Siglec-12 protein went rogue and has now become a liability for the minority of people who still produce it. In a study of normal and cancerous tissue samples, the researchers discovered that the approximately 30 percent of people who still produce Siglec-12 proteins are at more than twice the risk of developing an advanced cancer during their lifetimes, compared to people who cannot produce Siglec-12. Normally, genes that encode such dysfunctional proteins are eliminated by the body over time, and approximately two-thirds of the global human population has stopped producing the Siglec-12 protein. Where the gene still hangs around in humans, it was long thought be of no functional relevance, and there have been very few follow-up studies over the two decades since it was discovered. Meanwhile, chimpanzees still produce functioning Siglec-12. When the team set out to detect the Siglec-12 in non-cancerous tissue samples using an antibody against the protein, approximately 30 percent of the samples were positive, as expected from the genetic information. In contrast, the majority of advanced cancer samples from the same populations were positive for the Siglec-12 protein. Looking at a different population of patients with advanced stage colorectal cancer, the researchers found that more than 80 percent had the functional form of the SIGLEC-12 gene, and those patients had a worse outcome than the minority of patients without it. These results suggest that the minority of individuals who can still make the protein are at much greater risk of having an advanced cancer. The researchers also validated their findings in mice by introducing tumor cells engineered to produce Siglec-12. The resulting cancers grew much faster, and turned on many biological pathways known to be involved in advanced cancers, compared to control tumor cells without functioning Siglec-12. According to Author this information is important because it could be leveraged for future diagnostics and treatments.

SOURCE: Science Daily News, December 2020

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Mother's Stress !

                                 Mothers' stress lead to preterm births

Some people age faster than others. A new study indicates that a mother's stress prior to giving birth may accelerate her child's biological aging. The researchers found that maternal stress adversely affects the length of a baby's telomeres - the small pieces of DNA at the ends of chromosomes that act as protective caps. Shortened telomeres have been linked to a higher risk of cancers, cardiovascular and other diseases, and earlier death.The new study tracked maternal stress prior to conception and followed up in the second and third trimesters. The researchers identified an especially important period in the third trimester but not earlier- during which children are at higher risk for shortened telomeres. Overall, the study followed 111 mothers and their children from preconception into early childhood. Between the ages of 3 and 5, the children provided cell samples from inside their cheeks, from which the researchers extracted DNA, including telomeres. The team was then able to compare childhood telomere length with the stress measurements they had taken while the children were in utero. Researchers reach on hypotheses that stress can activate inflammation and metabolic activity, both of which, in high amounts, can contribute to damage to DNA. Telomeres are vulnerable to damage and, if unrepaired before cell division, they can become shortened by this damage. Another study from the same research group found that women suffering from high stress during the months and even years before conception, defined as feeling overwhelmed and unable to cope and had shorter pregnancies than other women. The researchers found that women who were exposed to the lowest or highest amounts of stress in their environment had the shortest pregnancies, while women who had a moderate level of environmental stress before conception had the longest pregnancies. It may even be more influential than prenatal health because some of what is put in motion before conception may be hard to stop during pregnancy. For example, a mother with dysregulated immune function due to stress may be at risk when she becomes pregnant. The scientists say their research just scratches the surface of the impact of mothers' preconception health and the fetal environment on biological factors that affect children's health.

SOURCE: Science Daily News, December 2020

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 Social Media Addiction !

                                 Social media leads to depresion

Compared with participants who used less than 120 minutes per day of social media, for example, young adults who used more than 300 minutes per day were 2.8 times as likely to become depressed within six months.We know from other large studies that depression and social media use tend to go together, but it's been hard to figure out which came first. This new study sheds light on these questions, because high initial social media use led to increased rates of depression. In 2018, Reseachers studied that they measured depression using the validated nine-item Patient Health Questionnaire and asked participants about the amount of time they used social media on platforms like Facebook, Twitter, Reddit, Instagram, and SnapChat. Their analyses controlled for demographic factors like age, sex, race, education, income and employment, and they included survey weights so the results would reflect the greater U.S. population.One reason for these findings may be that social media takes up a lot of time. Excess time on social media may displace forming more important in-person relationships, achieving personal or professional goals, or even simply having moments of valuable reflection.The authors suggest that social comparison may also underlie these findings.Social media is often curated to emphasize positive portrayals.This can be especially difficult for young adults who are at critical junctures in life related to identity development and feel that they can't measure up to the impossible ideals they are exposed to.The findings are of particular importance given that depression was recently declared to be the leading global cause of disability by the World Health Organization and accounts for more disability-adjusted life years than all other mental disorders.These findings are also particularly important to consider in the age of COVID-19,Now that it's harder to connect socially in person, we're all using more technology like social media. While I think those technologies certainly can be valuable, I'd also encourage people to reflect on which tech experiences are truly useful for them and which ones leave them feeling empty.

SOURCE: Science Daily News, December 2020

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 Breast Cancer Hope !

                                   Surgery may offer survival advantage in certain metastatic breast cancers

Stage four breast cancer accounts for 6% of newly diagnosed breast cancer cases. Systemic therapy, which may include treatments like chemotherapy, hormone therapies and immunotherapies, is routinely part of treatment plans for those patients. The benefits of surgery to remove the primary breast cancer are currently only recommended for relieving symptoms of advanced breast cancer such as pain and bleeding. Surgery is the standard of care for some other types of cancers that have spread from the site of origin to another part of the body, lead author of the study said that previous studies evaluating surgical interventions for metastatic breast cancer had conflicting results which has led to a lack of consensus among clinicians and researchers. Results from previous trials evaluating surgical benefit in metastatic breast cancer patients have been questioned because of the small number of participants or the fact that patients weren't also receiving chemotherapy or other systemic therapies. They found another key factor missing from those studies was whether the biologic subtype of breast cancer affected the survival rates in relation to surgical intervention. These patients' cancer cells had a growth-promoting protein called HER2 and hormone receptors for estrogen and progesterone, which can fuel cancer growth. The researchers said knowing these characteristics of a cancer's biological subtype can help to determine which treatment plans may be effective. They studied patients who either had systemic therapy alone, had systemic therapy and surgery, or had systemic therapy, surgery and radiation. Then evaluated whether certain biologic subtypes and timing of chemotherapy were associated with survival advantages. Also evaluated whether the hormone status had an influence on surgical benefit in these treatment-responsive breast cancer patients. Some types of breast cancer, especially like triple negative, where the cancer is hormone receptor and HER2 negative, are not very responsive to treatment. So the goal was to see if surgery made a difference in metastatic breast cancers that were responsive to treatment. The researchers excluded patients who died within six months of their diagnoses, in order to ensure that treatment-responsive cancers were being studied. They found that patients with a surgical intervention tended to have a longer length of survival compared to patients with other treatment plans. Patients whose cancers were HER2 positive especially saw prolonged survival when their treatment plan included surgery. Researchers further analyzed the patients who received surgery to see whether receiving chemotherapy before or after surgery had an impact on their length of survival. They found that regardless of hormone receptor or HER2 status, patients who received systemic therapy including chemotherapy and targeted treatments before surgery tended to live longer than those who had surgery before systemic treatment. Researchers find that surgery may be beneficial for treatment-responsive metastatic breast cancer patients, they also uncovered that getting chemotherapy before that surgery had the greatest survival advantage in patients with positive HER2 and estrogen and progesterone receptor status. The researchers said that randomized, controlled trials evaluating the role of surgery after systemic therapy in a younger demographic with minimally metastatic cancers could be used to confirm their results, but said that patient resistance to randomization in trials like this have resulted in poor study recruitment. Therefore, they encourage clinicians to evaluate real-world evidence, including their study, to choose optimal treatment for metastatic breast cancer patients.

SOURCE: Science Daily News, December 2020

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Square Zinc 20  
  Generic Name Zinc Sulphate Monohydrate
  Strength 900 mg + 100 mg
  Dosage form Tablet
  Therapeutic Category Mineral Supplement
  Product FonidelTM 2.5
Generic Name

Fondaparinux Sodium

Strength 2.5 mg/0.5 ml
Dosage form Injection
Therapeutic Category Anti Coagulant
  Product CombicidTM  Cream
  Generic Name Clobetasol Proprionate+ Ofloxacin+ Ornidazole+ Terbinafine+ Hydrochloride
  Strength 15 gm
  Dosage form Cream
  Therapeutic Category Topical Stroid Combination

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