Healthcare online Keeping you up-to-date
VOL.  21     ISSUE:  5   May 2023 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management

Rezaul Hasan Khan


Rubyeat Adnan


Moshfiqur Rahman




Welcome to this edition of the online healthcare bulletin.

We hope you are enjoying this healthcare online !

Our current issue focused on some interesting features like -

"Peanut Allergies !", "Headache Pattern !", "ADHD Alert !", "Toxic Proteins !",  "Anticancer Therapy !", "CT Screening ! ".

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.

 Peanut Allergies !

New test safely and accurately diagnoses peanut allergies

Researcher developed a new laboratory test to diagnose peanut allergy. The test has 98 per cent specificity and, unlike current options, it doesn't run the risk of false-positives or causing allergic reactions such as anaphylactic shock. The simple blood test is five times more cost-efficient compared to the oral food challenge (OFC) the standard food allergy test and could be adapted to test for other food allergies. Peanut allergies are among the most common food allergies in children. Currently, peanut allergy using a skin-prick test or IgE test but this may result in over-diagnosis or false-positives and it cannot differentiate between sensitivity and true food allergy. When skin-prick and IgE test results are unclear, allergists rely on an OFC, which consists of feeding peanut in incrementally larger doses to a patient in a highly-controlled setting in hospital to confirm allergy to the food. While the test is the gold-standard for diagnosing food allergies, there is risk of causing severe allergic reactions. Now, the researchers have developed a safer, accurate blood test in the lab. The new test, called the mast activation test (MAT), could act as a second line tool when skin-prick test results are inconclusive and before referring children and their families to specialists for an OFC. The lead researcher said that the current tests are not ideal. The new test is specific in confirming the diagnosis so when it's positive. It reduce by two-thirds the number of expensive, stressful oral food challenges conducted, as well as saving children from experiencing allergic reactions. Food allergy symptoms are triggered when allergens interact with an antibody called immunoglobulin E (or IgE). The food allergens activate IgE antibodies, triggering symptoms such as skin reactions, itching or constricting of the mouth, throat and airways, and digestive problems (such as stomach cramps, nausea or vomiting). The current skin-prick test and IgE test, which have been in use for decades, measure the presence of IgE antibodies. The new test focuses on mast cells, which play a crucial role in triggering allergic reactions. Mast cells activate by recognising the IgE in plasma and, in allergic patients, produce biomarkers associated with allergic reactions, which can be detected in the lab. The MAT test is five times cheaper to conduct than the OFC, which requires an allergist and specialist nurses on hand to monitor for adverse reactions and provide medical support if symptoms arise. The researchers believe the MAT test may have other uses, for example, in the food industry to detect the presence of allergens in products. Pharmaceutical companies could use it to monitor patients' allergic response to drugs being evaluated during clinical trials. The scientists plan to transition the biomarker test out of the laboratory and into a clinical setting. They will be testing blood samples from patients with suspected allergies to further validate its utility.

SOURCE: Science Daily, May 2023

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 Headache Pattern !

Headaches happen at the same time of day

The meta-analysis included all available studies on cluster headache and migraine that included circadian features. This included information on the timing of headaches during the day and during the year as well as studies on whether genes associated with the circadian clock are more common in people with these headaches. The researchers also looked at studies on cluster headache and migraine and hormones related to the circadian system, including cortisol and melatonin. The data suggest that both of these headache disorders are highly circadian at multiple levels, especially cluster headache. This reinforces the importance of the hypothalamus the area of the brain that houses the primary biological clock and its role in cluster headache and migraine. It also raises the question of the genetics of triggers such as sleep changes that are known triggers for migraine and are cues for the body's circadian rhythm. For cluster headache, the meta-analysis found a circadian pattern of headache attacks in 71% of people. Attacks peaked in the late hours of the night to early hours of the morning. During the year, people had more attacks in the spring and fall. On the genetic level, cluster headache was associated with two main circadian genes, and five of the nine genes that increase the likelihood of having cluster headache are genes with a circadian pattern of expression. For migraine, the meta-analysis showed a circadian pattern of attacks in 50% of people. While the peak for attacks during the day was broad, ranging from late morning until early evening, there was a circadian low point during the night when few attacks happened. Migraine was also associated with two core circadian genes, and 110 of the 168 genes associated with migraine were genes with a circadian pattern of expression. A limitation of the study was that researchers did not have information on factors that could influence the circadian cycle, such as medications, other disorders such as bipolar disorder or circadian rhythm issues such as night shift work.

SOURCE: Science Daily, May 2023

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 ADHD  Alert !

Attention deficit hyperactivity disorder (ADHD) can make life disorganized

Attention deficit hyperactivity disorder (ADHD) is a mental health condition that can cause unusual levels of hyperactivity and impulsive behaviors. People with ADHD may also have trouble focusing their attention on a single task or sitting still for long periods of time. Many people experience inattention and changes in energy levels. For a person with ADHD, this happens more often and to a greater extent compared with people who donít have the condition. It can have a significant effect on their studies, work, and home life. Both adults and children can have ADHD. A wide range of behaviors are associated with ADHD. Some of the more common ones include having trouble focusing or concentrating on tasks, being forgetful about completing tasks, being easily distracted, having difficulty sitting still, interrupting people while theyíre talking. Signs and symptoms can be specific to different aspects of ADHD, such as hyperactivity, impulsivity, or difficulty focusing. To make ADHD diagnoses more consistent, the American Psychological Association (APA) has grouped the condition into three types. These types are predominantly inattentive, predominantly hyperactivity-impulsive, and a combination of both. Predominantly inattentive type of ADHD has extreme difficulty in focusing, finishing tasks, and following any instructions. People with Predominantly hyperactive-impulsive type of ADHD primarily show hyperactive and impulsive behavior. This can include fidgeting, interrupting people while theyíre talking, not being able to wait their turn. Combined hyperactive-impulsive and inattentive type is the most common type of ADHD. People with this combined type of ADHD display both inattentive and hyperactive symptoms. These include an inability to pay attention, a tendency toward impulsiveness, and above-average levels of activity and energy. Despite how common ADHD is, doctors and researchers still arenít sure what causes the condition. Itís believed to have neurological origins. Genetics may also play a role. Research suggests that a reduction in dopamine is a factor in ADHD. Dopamine plays a role in triggering emotional responses and movements. Other research suggests a structural difference in the brain. Findings indicate that people with ADHD have less gray matter volume. Thereís no single test that can tell if someone has ADHD. A study highlighted the benefits of a new test to diagnose adult ADHD, but many clinicians believe an ADHD diagnosis canít be made based on one test. Treatment for ADHD typically includes behavioral therapies, medication, or both. Types of therapy include psychotherapy, or talk therapy. Another therapy type is behavioral therapy. This therapy can help someone to learn how to monitor and manage your behavior. Medication can also be very helpful when people living with ADHD. ADHD medications are designed to affect brain chemicals in a way that enables a patient to better control his or her impulses and actions. Central nervous system (CNS) stimulants are the most commonly prescribed ADHD medications. These drugs work by increasing the amounts of the brain chemicals dopamine and norepinephrine.

SOURCE: Healthline, May 2023 News

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 Toxic Proteins  !

                              Toxic proteins spread through brain

Researchers have discovered that synapses, which send essential signals through the brain, are also transporting toxic proteins known as tau around the brain. Large clumps of the protein tau called tangles form in brain cells and are one of the defining features of Alzheimer's disease. As these tangles spread through the brain during the disease there is a decline in brain function. The study focused on synapses, connections which allow the flow of chemical and electrical messages between brain cells and are vital to healthy brain function. Alzheimer's disease attacks synapses and their loss strongly predicts reduced memory and thinking abilities. In the study, scientists examined more than one million synapses from 42 people using powerful microscopy techniques to visualise proteins within individual synapses. The team discovered that small clumps of the protein tau known as tau oligomers are found within the synapses of people who died of Alzheimer's disease. Tangles of tau oligomers were seen inside both ends of the synapse from the brain cell sending signals and the brain cell receiving signals. In a mouse model of the disease, the oligomers jumped from one side of the synapse to the other, spreading the toxic tau through the brain. Alzheimer's disease is the most common form of dementia, with currently around 900,000 people with the condition in the UK. This figure is projected to rise to nearly 1.6 million in 2040. It can cause severe memory loss and there is currently no cure. We have known for over 30 years that tangles spread through the brain during Alzheimer's disease, but how they spread has remained a mystery. Wherever tangles appear in the brain, neuron death follows, contributing to the decline in cognitive ability. Stopping the spread of toxic tau is a promising strategy to stop the disease in its tracks.

SOURCE: Science Daily, May 2023

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 Anticancer Therapy !

   Function of mitochondria in cancer cells

Researchers examined two main subtypes of non-small cell lung cancer (NSCLC) -adenocarcinomas and squamous-cell carcinomas and found distinct subpopulations of mitochondrial networks within these tumors & discovered that the mitochondria frequently organize themselves with organelles such as lipid droplets to create unique subcellular structures that support tumor cell metabolism and mitochondrial activity. The investigators say these findings provide key information about the function of mitochondria in cancer cells and could lead to new approaches to cancer treatment. Study represents a first step towards generating highly detailed 3-dimensional maps of lung tumors using genetically engineered mouse models. Using these maps, researcher begun to create a structural and functional atlas of lung tumors, which has provided valuable insight into how tumor cells structurally organize their cellular architecture in response to the high metabolic demands of tumor growth. Researcher findings hold promise to inform and improve current treatment strategies while illuminating new directions from which to target lung cancer. Study has uncovered a novel finding in the metabolic flux of lung tumors, revealing that their nutrient preference may be determined by the compartmentalization of their mitochondria with other organelles, either relying on glucose ("sugar") or free fatty acids ("fat"). This discovery has important implications for developing effective anti-cancer therapies that target tumor-specific nutrient preferences. Multi-modality imaging approach has enabled to uncover this previously unknown aspect of cancer metabolism, and researcher believe that it can be applied to other types of cancer, paving the way for further research in this area.

SOURCE: Science Daily, May 2023

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 CT Screening !

             CT scan best at predicting heart disease risk in middle age

Finding the best way to identify who is at risk for developing heart disease can help determine what needs to be done to lower their risk. This finding can help doctors and patients in managing risk for heart disease. Currently, conventional measures of risk-factor levels, such as blood pressure and cholesterol, are used by doctors to determine a person's likelihood of developing coronary heart disease or blockages of the arteries in the heart. But some people may experience a heart attack, or related heart problem, without one of those conventional factors picking it up.Because the risk for heart disease can be inherited, scientists were optimistic that a person's genetics can inform who is at greatest risk. It was posited that polygenic risk scores - a compilation of more than 6 million commonly occurring genetic variants associated with heart disease could be used as a potential breakthrough for personalized medicine. Findings support recommendations to consider CT screening to calculate risk for heart disease in middle-aged patients when their degree of risk is uncertain or in the intermediate range. Investigators used data on risk factors for heart disease (smoking status, cholesterol levels, blood pressure), genetics and CT scan data to estimate the risk of developing heart disease. The study follow-up of up to 17 years. The investigators looked at how using either CT scans or polygenic risk scores affected the risk predicted of individuals based on conventional risk factors blood pressure and cholesterol, and whether the addition of either of these markers (CT or genetics) put them in a different risk category. Low risk means someone has less than a 7.5% risk of developing heart disease in the next 10 years. If it's above 7.5%, statins are recommended. Using genetic data did not affect a person's risk category based on their conventional risk factors (blood pressure and cholesterol.) But only when considering CT scan, half the study participants moved into high-risk group.

SOURCE: Science Daily, May 2023

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Products of SQUARE Pharmaceuticals Ltd.

  Product Nafodil TM
  Generic Name Naftidrofuryl

100 mg

Dosage form Capsule
Therapeutic Category Cardiovascular Preparation
Product Aclitol TM
Generic Name

Aclidinium Bromide + Formoterol Fumarate Dihydrate Anticholinergic + Beta-2 stimulant

Dosage form Cozycap
Therapeutic Category Antiasthma
  Product Fliban TM
Generic Name Flibanserin
  Strength 100mg
Dosage form Tablet
  Therapeutic Category HSDD (Hypoactive Sexual Desire Disorder)

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