Healthcare online Keeping you up-to-date
VOL.  21     ISSUE:  3  March    2023 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management



Rubyeat Adnan


Mushfiqur Rahman




Dear Doctor:

Welcome to this edition of "e- SQUARE" !

Hope you are enjoying this online healthcare bulletin !

This issue features a variety of articles including-

 "Risk of Hypertension !", "ADHD in Kids !", "Migraines During Menstruation !", "Anxiety Biomarker !", "Teens Screen time  !", " Alcohol Use Disorder!".

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

Risk of Hypertension !

                                      Road Noise Makes Your Blood Pressure Rise

Studies have shown a connection between noisy road traffic and increased risk of hypertension. The new research shows that it is exposure to road traffic noise itself that can elevate hypertension risk. Researcher showed that traffic noise and hypertension were linked, but failed to show a causal relationship. Researchers analyzed data from more than 240,000 people (aged 40 to 69 years) who started out without hypertension. They estimated road traffic noise based on residential address and the Common Noise Assessment Method, a European modeling tool. Using follow-up data over a median 8.1 years, they looked at how many people developed hypertension. Not only did they find that people living near road traffic noise were more likely to develop hypertension, they also found that risk increased in tandem with the noise "dose." These associations held true even when researchers adjusted for exposure to fine particles and nitrogen dioxide. However, people who had high exposure to both traffic noise and air pollution had the highest hypertension risk, showing that air pollution plays a role as well. The findings can support public health measures because they confirm that exposure to road traffic noise is harmful to our blood pressure. Policymaking may alleviate the adverse impacts of road traffic noise as a societal effort, such as setting stricter noise guideline and enforcement, improving road conditions and urban design, and investing advanced technology on quieter vehicles. This is the first large-sized prospective study directly addressing the effect of road traffic noise on the incidence of newly-diagnosed hypertension. The data demonstrated in this article provides a higher quality of evidence to justify the potential to modify road traffic noise and air pollution from both individual and societal levels in improving cardiovascular health. As a follow-up, researchers said field studies are underway to better understand the pathophysiological mechanisms through which road noise affects hypertension.

SOURCE: Science Daily News, March 2023 

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ADHD in Kids  !

                             ADHD in Kids Who Start School Earlier

The rate of ADHD diagnoses among children has risen dramatically over the past 20 years. In 2016 alone, more than 5 percent of U.S. children were being actively treated with medication for ADHD. Experts believe the rise is fueled by a combination of factors, including a greater recognition of the disorder, a true rise in the incidence of the condition and, in some cases, improper diagnosis. The results of the new study underscore the notion that at least in a subset of elementary school students, the diagnosis may be a factor of earlier school enrollment, the research team said. Researcher suggest the possibility that large numbers of kids are being over-diagnosed and over treated for ADHD because they happen to be relatively immature compared to their older classmates in the early years of elementary school. The researchers said, what may be normal behavior in a boisterous 6-year-old could seem relatively abnormal relative to the behavior of older peers in the same classroom. This dynamic may be particularly true among younger children given that an 11- or 12-month difference in age could lead to significant differences in behavior. As children grow older, small differences in age equalize and dissipate over time, but behaviorally speaking, the difference between a 6-year-old and a 7-year-old could be quite. Research has shown wide variations in ADHD diagnosis and treatment across different regions in the United States. The diagnosis of this condition is not just related to the symptoms, it's related to the context. The relative age of the kids in class, laws and regulations, and other circumstances all come together. It is important to look at all of these factors before making a diagnosis and prescribing treatment.

SOURCE: Science Daily, March 2023

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Migraines During Menstruation !

                                                                   Low Estrogen Levels Paired with Higher CGRP Levels

Researcher said that the elevated level of CGRP (calcitonin gene-related peptide) following hormonal fluctuations could help to explain why migraine attacks are more likely during menstruation and why migraine attacks gradually decline after menopause. The study involved three groups of female participants with episodic migraine. All had at least three days with migraine in the month before the study. The groups were those with a regular menstrual cycle, those taking oral contraceptives, and those who had gone through menopause. Each group was compared to a group of female participants of similar ages who did not have migraine. Each group had 30 people, for a total of 180. Researchers collected blood and tear fluid to determine CGRP levels. In those with regular menstrual cycles, the samples were taken during menstruation when estrogen levels are low and around the time of ovulation, when levels are the highest. In those taking oral contraceptives, samples were taken during the hormone-free time and the hormone-intake time. Samples were taken once from postmenopausal participants at a random time. The study found that female participants with migraine and a regular menstrual cycle had higher CGRP concentrations during menstruation than those without migraine. Those with migraine had blood levels of 5.95 picograms per milliliter (pg/ml) compared to 4.61 pg/ml for those without migraine. For tear fluid, those with migraine had 1.20 nanograms per milliliter (ng/ml) compared to 0.4 ng/ml for those without migraine. The study also suggests that measuring CGRP levels through tear fluid is feasible and warrants further investigation. Researcher said that this method is still exploratory, but it is non-invasive and also noted that while hormone levels were taken around the time of ovulation, they may not have been taken exactly on the day of ovulation, so the fluctuations in estrogen levels may not be fully reflected.

SOURCE: Science Daily, March 2023

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 Anxiety Biomarker !

                                                                                   Researchers Develop Blood Test for Anxiety

Many people are suffering from anxiety, which can be very disabling and interfere with daily life. The current approach is to talk to people about how they feel to see if they could be on medications, but some medications can be addictive and create more problems. Researcher wanted to see if approach to identify blood biomarkers could help the match people to existing medications that will work better and could be a non-addictive choice. Researcher has led to the development of blood tests for pain, depression/bipolar disorder and post-traumatic stress disorder. The study included three independent cohorts - discovery, validation and testing. Participants would complete a blood test every 3-6 months or whenever a new psychiatric hospitalization occurred. By examining the RNA biomarkers in the blood, researchers could identify a patient's current state of anxiety and matches them with medications and nutraceuticals, showing how effective different options could be for them based on their biology. In addition to medications, there are other methods to treat anxiety, such as cognitive behavioral therapy or lifestyle changes. But having something objective like this where we can know what someone's current state is as well as their future risk and what treatment options match their profile is very powerful in helping people. A person's biomarkers can also change over time. Researcher said the test can help evaluate a person's risk of developing higher levels of anxiety in the future as well as how other factors might impact their anxiety. Researchers said this new test could also be used in combination with the other blood tests his research has led to, providing a more comprehensive view of a patient's mental health and risk of future mental health concerns. Researchers can also use the test to develop new treatments for anxiety that are more targeted to individual biomarkers.

SOURCE: Science Daily News, March 2023

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Teens Screen time  !

                                               Screen Time Plus Snacking: A Risk for Metabolic Disorder in Teens

Teens who sit for hours watching TV, using the computer or playing video games while eating unhealthy snacks are at increased risk for a group of risk factors for heart disease and diabetes. The study found these teens are at risk of developing metabolic syndrome -- a cluster of risk factors including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels -- that elevate the risk of heart disease, stroke and diabetes. Metabolic syndrome affects near 25 percent of the adult population and approximately 5.4 percent of children and adolescents. The research was part of the Study on Cardiovascular Risks in Adolescents (ERICA), a nationwide school-based survey of Brazilian teens. The study included data on 33,900 teens ages 12 to 17. The researchers measured the teens' waists and blood pressure, and took blood samples to measure blood glucose, HDL-cholesterol, and triglycerides. Almost 60 percent of the teens were female, and the average age was 14.6. Half of the teens were physically active; 85 percent said they usually eat snacks in front of the TV, while 64 percent usually ate snacks while using the computer or playing video games. There was no association between screen time and metabolic syndrome among teens who reported no snacking in front of screens. Among teens who reported habitually eating snacks in front of the TV or computer, the risk for metabolic syndrome rose the longer teens spent in front of screens.

SOURCE: Science Daily News, March 2023

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Alcohol Use Disorder !

                                                    How Heavy Alcohol Consumption Increases Brain Inflammation

For people with alcohol use disorder (AUD), there is a constant, vicious cycle between changes to the brain and changes to behavior. AUD can alter signaling pathways in the brain; in turn, those changes can exacerbate drinking. Researchers have uncovered new details about the immune system's role in this cycle that the immune signaling molecule interleukin 1 (IL-1) is present at higher levels in the brains of mice with alcohol dependence. In addition, the IL-1 pathway takes on a different role in these animals, causing inflammation in critical areas of the brain known to be involved in decision-making. These inflammatory changes to the brain could explain some of the risky decision-making and impulsivity we see in people with alcohol use disorder. AUD is characterized by uncontrolled and compulsive drinking, and it encompasses a range of conditions including alcohol abuse, dependence and binge drinking. Researchers have previously discovered numerous links between the immune system and AUD many of them centered around IL-1. People with certain mutations in the gene that codes for the IL-1 molecule, for instance, are more prone to developing AUD. In addition, autopsies of people who had AUD have found higher levels of IL-1 in the brain. The team then went on to show that IL-1 signaling in the alcohol-dependent group was not only increased, but also fundamentally different. In mice that had not been exposed to alcohol, as well as in mice that had drunk moderate amounts of alcohol, IL-1 activated an anti-inflammatory signaling pathway. In turn, this lowered levels of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), a signaling molecule known to regulate neural activity in the brain. However, in alcohol-dependent mice, IL-1 instead activated pro-inflammatory signaling and boosted levels of GABA, likely contributing to some of the changes in brain activity associated with AUD. Notably, these changes in IL-1 signaling in the alcohol-dependent mice persisted even during alcohol withdrawal.

SOURCE: Science Daily News, March 2023

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Products of SQUARE Pharmaceuticals Ltd.

  Product Dulamet TM
  Generic Name Mometasone & Formoterol
  Strength Mometasone 100 mcg + Formoterol 5 mcg/puff
Mometasone 200 mcg + Formoterol 5 mcg/puff
  Dosage form Metered Dose Inhaler
  Therapeutic Category Inhaled corticosteroid + Beta-2 agonist
  Product Vertina-DXTM
Generic Name

Doxylamine Succinate + Pyridoxine Hydrochloride


20 mg + 20 mg

Dosage form Extended Release Tablet
Therapeutic Category Antiemetic + Antinauseant
  Product DarborenTM
Generic Name Darbepoetin alfa 
Strength 25 mcg/0.42 ml, 40 mcg/0.40 ml &
60 mcg/0.30 ml
  Dosage form Pre-filled Syringe (IV/Subcutaneous Injection)
Therapeutic Category Erythropoietin Products

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