Healthcare online Keeping you up-to-date
VOL. 19  ISSUE:  6  June  2021 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management









Welcome to our healthcare bulletin 'e-SQUARE' !

Our current issue focused on some interesting features like -

"Suicide & COVID-19 !", "Prion Protein !", "Depression Risk !", "Stem Cell & Type-1 DM !,  "Cat Allergy !", "Fertility Drugs !".

In our regular feature, we have some new 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.

Suicide & COVID-19 !

                          Suicide cases due to fear of COVID-19

The novel coronavirus COVID-19 pandemic has become a global concern. Healthcare systems in many countries have been pushed to breaking point in an attempt to deal with the pandemic. At present, there is no accurate estimation about how long the COVID-19 situation will persist, the number of individuals worldwide who will be infected, or how long people’s lives will be disrupted. Like previous epidemics and pandemics, the unpredictable consequences and uncertainty surrounding public safety, as well as misinformation about COVID-19 (particularly on social media) can often impact individuals’ mental health including depression, anxiety, and traumatic stress. Additionally, pandemic related issues such as social distancing, isolation and quarantine, as well as the social and economic fallout can also trigger psychological mediators such as sadness, worry, fear, anger, annoyance, frustration, guilt, helplessness, loneliness, and nervousness. In extreme cases, such mental health issues can lead to suicidal behaviors. It is well stablished that around 90 % of global suicides are due to individuals with mental health conditions such as depression. In the south Asian country like Bangladesh and India, village people arguably less educated than those that live in cities. Suicide is the ultimate human sacrifice for anyone who cannot bear the mental suffering. However, the fact that the fear of having COVID-19 led to suicide is preventable. Hence there is an urgent need to carry out a nationwide epidemiological study to determine the level of fear, worry, and helplessness, as well as other associated issues concerning mental health in relation to COVID-19. This would help in developing targeted mental wellbeing strategies. Additional mental health care is also needed for patients confirmed as having COVID-19, patients with suspected COVID-19 infection, quarantined family members, and healthcare personnel. Researchers also suggest the following to the general people, avoid unreliable and non-credible news and information sources to reduce fear of COVID-19, help individuals with known mental health issues where possible, offer basic help like foods, medicines to those most in need during lock-down situations . It is also recommended that online-based mental health intervention programs as a way of promoting more reliable and authentic information about COVID-19, and making available possible telemedicine care.

SOURCE: Elsevier: June 2021

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Prion Protein !

                        New hints explain how the Alzheimer's spreads in human brains

The ultimate goal of the research is to help design a strategy to stop prion disease in humans and, ultimately, to translate new approaches to work on Alzheimer's and other neurodegenerative diseases. Prions were first discovered in the late 1980s as a protein-containing biological agent that could replicate itself in living cells without nucleic acid. Prions dramatically accelerated the development of a new scientific concept of self-replicating protein. Human prions can bind to neighboring normal proteins in the brain, and cause microscopic holes. In essence, they turn brains into sponge-like structures and lead to dementia and death. Human prion diseases are conceivably the most heterogeneous neurodegenerative disorders, and a growing body of research indicates that they are caused by distinct strains of human prions. However, the structural studies of human prions have lagged behind the recent progress in rodent laboratory prions, in part because of their complex molecular characteristics and prohibitive biosafety requirements necessary for investigating disease which is invariably fatal and has no treatment. The researchers developed a new three-step process to study human prions: 1) Human brain-derived prions were first exposed to a high-intensity synchrotron X-ray beam. That beam created hydroxyl radical species which, with short bursts of light, selectively and progressively changed the prion's surface chemical composition. The unique properties of this type of light source include its enormous intensity; it can be millions of times brighter than light from the sun to the Earth. 2) The rapid chemical modifications of prions by short bursts of light were monitored with anti-prion antibodies. The antibodies recognize the prion surface features, and mass spectrometry that identifies exact sites of prion-specific, strain-based differences, providing an even more precise description of the prion's defects. 3) Illuminated prions were then allowed to replicate in a test tube. The progressive loss of their replication activity as the synchrotron modifies them helped identify key structural elements responsible for prions' replication and propagation in the brain. This structural approach also provides a template for how to identify structurally important sites on misfolded proteins in other diseases such as Alzheimer's, which involves protein propagation from cell to cell in a similar way to prions.

SOURCE: Science Daily News, June 2021

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Depression Risk !

                                             Waking up one hour earlier can reduce depression risk by double digits

As people emerge, post-pandemic, from working and attending school remotely, a trend that has led many to shift to a later sleep schedule. According to a study conducted over 840,000 people by researchers at University of Colorado Boulder and the Broad Institute of MIT and Harvard, represents some of the strongest evidence that chorotype a person's propensity to sleep at a certain time influences depression risk. It is found that, there is a relationship between sleep timing and mood, but a question we often hear from clinicians is how much earlier do we need to shift people to see a benefit? Researchers found that even one-hour earlier sleep timing is associated with significantly lower risk of depression. Previous observational studies have shown that night owls are as much as twice as likely to suffer from depression as early risers, regardless of how long they sleep. But because mood disorders themselves can disrupt sleep patterns, researchers have had a hard time deciphering what causes what. The researchers assessed unidentified genetic data on these variants from up to 850,000 individuals, including data from 85,000 who had worn wearable sleep trackers for 7 days and 250,000 who had filled out sleep-preference questionnaires. This gave them a more granular picture, down to the hour, of how variants in genes influence when we sleep and wake up. In the largest of these samples, about a third of surveyed subjects self-identified as morning larks, 9% were night owls and the rest were in the middle. Overall, the average sleep mid-point was 3 a.m., meaning they went to bed at 11 p.m. and got up at 6 a.m. Using novel statistical techniques, they asked: Do those with genetic variants which predispose them to be early risers also have lower risk of depression? The answer is a firm yes. Each one-hour earlier sleep midpoint (halfway between bedtime and wake time) corresponded with a 23% lower risk of major depressive disorder. This suggests that if someone who normally goes to bed at 1 a.m. goes to bed at midnight instead and sleeps the same duration, they could cut their risk by 23%; if they go to bed at 11 p.m., they could cut it by about 40%.It's unclear from the study whether those who are already early risers could benefit from getting up even earlier. But for those in the intermediate range or evening range, shifting to an earlier bedtime would likely be helpful. Some research suggests that getting greater light exposure during the day, which early-risers tend to get, results in a cascade of hormonal impacts that can influence mood. Others note that having a biological clock, or circadian rhythm, that trends differently than most peoples' can in itself be depressing.

SOURCE: Science Daily News, June 2021

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Stem Cell & Type-1 DM !

                              Stem cell therapy for type 1 diabetes (IDDM)

Type 1 diabetes, which arises when the pancreas doesn't create enough insulin to control levels of glucose in the blood, is a disease that currently has no cure and is difficult for most patients to manage. Scientists using stem cells to create insulin-producing cells (called beta cells) that could replace nonfunctional pancreatic cells. Additionally, when these beta cells were tested in a mouse model of type 1 diabetes, the animals' blood sugar was brought under control within about two weeks. In the current work, the investigators started with human pluripotent stem cells (hPSCs). These cells, which can be derived from adult tissues (most often the skin), have the potential to become any kind of cell found in the adult body. Using various growth factors and chemicals, the investigators coaxed hPSCs into beta cells in a stepwise fashion that mimicked pancreatic development. Producing beta cells from hPSCs in the lab is not new, but in the past the yields of these precious cells have been low. With existing methods, only about 10 to 40 percent of cells become beta cells. By comparison, techniques used to create nerve cells from hPSCs have yields of about 80 percent. Another issue is that if undifferentiated cells are left in the mix, they could eventually turn into another kind cell that would be unwanted. To address the problem, the researchers took a stepwise approach to create beta cells. They identified several chemicals that are important for inducing hPSCs to become more specialized cells & ultimately identified several cocktails of chemicals that resulted in beta cell yields of up to 80 percent. Normally cells are grown on a flat plate, but researcher allowed them to grow in three dimensions. Growing the cells in this way creates more shared surface area between the cells and allows them to influence each other, just as they would during human development. After the cells were created, they were transplanted into a mouse model of type 1 diabetes, The model mice had a modified immune system that would not reject transplanted human cells. The researchers will continue to study this technique in the lab to further optimize the production of beta cells. More research is needed to assess safety issues before clinical trials can be initiated in humans.

SOURCE: Science Daily News, June 2021

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Cat Allergy !

          Novel immunotherapy approach to treat cat allergy

Cat allergy is a rapidly increasing phenomenon characterized by an hypersensitivity and excessive immune response to certain allergens associated with felines typically found in their saliva, glands, skin and fur. Cat allergy manifestations can range from mild symptoms to the development of severe conditions such as rhinitis and asthma, with potentially fatal outcomes. While pharmacotherapy is an option for the milder forms, only allergen-specific immunotherapy (AIT) can ensure an effective and longer lasting treatment in the more advanced cases. AIT typically consists in the subcutaneous injection of gradually increasing quantities of the allergen in question, until a critical dose is reached that induces long-term immune tolerance. Nevertheless, there is still the need to improve cat AIT in terms of efficacy and safety. The researchers hypothesized that the most effective cat AIT could be achieved by optimizing the response of immune system T- and B-cells through immune adjuvants to induce the production of antibodies against Fel d 1 while minimizing inflammatory reactions, thereby boosting immune tolerance to this allergen. To study the cellular and clinical effects of an AIT based on the injection of the Fel d 1 allergen in combination with a high dose of CpG adjuvant, the team challenged Fel d 1-allergic mice with the allergen, both in the presence and absence of AIT. The scientists observed that AIT-treated allergic mice showed a significantly improved lung resistance, similar to that of non-allergic control mice, when compared with untreated allergic mice, with signs of airway inflammation and hyper-responsiveness being considerably reduced. Indeed, when looking at the Fel d 1-specific antibodies, the team noticed that AIT-treated allergic mice displayed lower levels of IgE, which are commonly associated with allergic responses, and higher levels of IgA and IgG, which can have anti-inflammatory properties. In addition, AIT-treated allergic mice showed a reduction in the levels of certain pro-allergic cytokine molecules, produced by type 2 helper T cells (Th2), compared to untreated allergic animals. The researchers also noticed that, already very soon after AIT-injection, there was an increase in the tissues of AIT-treated mice in the abundance of immune cell types involved in allergy regulation and tolerance, namely plasmacytoid dendritic cells (pDCs), Natural Killer cells (NKs), regulatory T cells (T-regs) and regulatory B cells (B-regs). These cells were found to express higher levels of the Tumor Necrosis Factor alpha (TNF-α) receptor 2 (TNFR-2), with NK cells also producing the TNF-α cytokine, which are known to play a role in suppressing the allergen-specific immune response, thereby allowing these regulatory cells to act as a 'brake' on the immune system.

SOURCE: Science Daily News, June 2021

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Fertility drugs !

                                               Fertility drugs do not increase breast cancer risk

Drugs routinely used during fertility treatments to release eggs do not increase the risk of developing breast cancer, new research has shown. Researchers analyzed studies involving 1.8 million women undergoing fertility treatments. These women were followed up in studies for an average period of 27 years and had no increase in the risk of developing breast cancer. Fertility treatments can range from using medications to boost the release of an egg in a women's natural cycle to more complex treatment such as IVF which involves stimulating a patient's ovarian cycle, extracting eggs from their ovaries, fertilizing them with sperm in a laboratory, then transferring the embryo into the womb to develop. There has been concern that this could turn the cells cancerous, which has led to an uncertainty about the potential risk of infertility drugs causing breast cancer. Researchers found no significant increase in risk to women exposed to treatment versus untreated women, and untreated women who were infertile. Researcher showed that the use of drugs to stimulate ovaries in fertility treatment did not put women at increased risk of breast cancer. This study provides the evidence needed to reassure women and couples seeking fertility treatments. So much of the fear, stress and anxiety associated with fertility treatment is rooted in navigating uncertainty. This study not only gives patients peace of mind at an emotional level, but also enables us to make more informed decisions about treatment risks and benefits at a rational level. Previously it was unclear whether fertility drugs affect breast cancer risk. While this analysis of existing published studies does provide welcome reassurance that fertility treatment is unlikely to increase breast cancer risk, further long-term and detailed studies are now needed to confirm these findings.

SOURCE: Science Daily News, June 2021

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Telmilok  TM
  Generic Name Telmisartan
  Strength 40 & 80 mg
  Dosage form Tablet
Therapeutic Category Antihypertensive
  Product Sulprex TM
Generic Name

Salbutamol+Ipratropium Bromide


2.5 mg+500 mcg

Dosage form Nebuliser Solution
Therapeutic Category Anti asthma
  Product Cef-3 Max TM
  Generic Name Cefixime

100 mg/ml

  Dosage form Pediatric Drops
  Therapeutic Category Cephalosporin

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