Healthcare online Keeping you up-to-date
VOL.  20     ISSUE:  10    October  2022 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management








Dear Doctor,

Welcome to our healthcare bulletin 'e-SQUARE' !

In this issue, we focused on some interesting features like -

"Antidiabetic & Dementia !", "Hair Straighteners Alert !", "Fish Oil & Aging Brain !",  "Stress Tied Cancer !",  "Late Night Meal Alert !", "‘Trigger Finger’ & Diabetes !".

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.

Antidiabetic & Dementia !

 Certain Class of Diabetes Meds Could Cut Dementia Risk 

An older class of type 2 diabetes drugs known as thiazolidinediones, or TZDs, may protect from dementia down the road, according to new research. Exactly how these diabetes drugs lower risk for dementia is not fully understood, and the study wasn't designed to answer that question. Diabetes is a known risk factor for dementia, and glucose or blood sugar is the brain's main fuel for important functions, including thinking, understanding, and problem-solving, said study author. "With type 2 diabetes, the mechanism for driving glucose out of the blood and into the cells is less functional and this can affect cognition, which is one of the most energy-demanding functions," she said. For the study, researchers compared risk for dementia in older veterans with type 2 diabetes who were treated with either a sulfonylurea or a thiazolidinedione drug for diabetes to those treated with metformin alone between 2000 and 2019 in the U.S. Veterans Affairs Healthcare System. People aged 60 and older who were given a first prescription of metformin, a sulfonylurea or a thiazolidinedione between January 2001 and December 2017 were followed for about eight years. Those who took thiazolidinedione had an 11% lower risk of Alzheimer's disease and a 57% lower risk of vascular dementia, the study showed. Vascular dementia is typically caused by multiple strokes. The risk of dementia from any cause was 12% higher among folks who used a sulfonylurea drug alone for their diabetes, the study showed. "Thiazolidinediones were the most effective in reducing the chances of developing Alzheimer's disease later in life," she said. "Starting early and sustaining glucose metabolism without moving into taking insulin has long-lasting benefit," study author added. "There is pharmacotherapy and the things we are in charge of, like what we eat and how much we move," she said. "Sitting is the new smoking." "It remains unknown which class of anti-diabetic agents would be most beneficial in reducing dementia risk in diabetics," an Alzheimer’s expert said. It's also too early to recommend these drugs if you are at high risk for dementia but don't have diabetes, he added. "These observational studies, when combined with other epidemiological data, as well as preclinical data, might indicate benefit," he said. "However, at this time, it is certainly premature to promote or recommend widespread use of anti-diabetic agents of any class for the prevention of dementia, particularly Alzheimer's disease."

SOURCE: HealthDay News, October 2022

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Hair Straighteners Alert !

Use of Hair Straighteners Tied to Doubling of Risk for Uterine Cancer

Women who regularly use chemical hair straighteners may be more prone to developing uterine cancer, a new large government study suggests. The study, which followed nearly 34,000 U.S. women over a decade, found that those who frequently used hair straighteners were 2.5 times more likely to develop uterine cancer, versus non-users. "Frequent" was defined as more than four times in the past year. Experts cautioned that the findings do not prove cause and effect. And given that uterine cancer is relatively uncommon, even the increased risk linked to hair straighteners is small. Frequent users had a 4% chance of developing the cancer by age 70, versus a 1.6% chance among non-users, the investigators found. "The overall risk is not large, and chemical hair products are just one of many factors that may influence a woman's chances of getting uterine cancer," said senior researcher. Should women avoid the products? Researcher said that "more research is needed before firm recommendations can be made." But she also noted that women who used hair straighteners less frequently did not have an elevated risk of uterine cancer. So women could consider cutting down on the treatments. The findings come at a time when uterine cancer, while not common, is on the rise — particularly among Black women, federal data show. Black women also have death rates from the disease that are double those of any other racial or ethnic group. If hair straighteners do raise the risk of uterine cancer, research team said, Black women could be more affected, due to their greater use of the products. In this study, 60% of participants who used hair straighteners identified as Black. It's expected that nearly 66,000 U.S. women will be diagnosed with uterine cancer in 2022, according to the American Cancer Society. There are some established risk factors for the cancer, including obesity and some exposures that raise the body's estrogen levels — like taking estrogen (without progesterone) after menopause. That's why it's plausible that heavy exposure to chemical hair straighteners could affect a woman's risk of the disease, she said. Hair straighteners can contain chemicals that are considered endocrine-disruptors, meaning they might influence the body's hormones. Many other personal care products also contain those ingredients. But those in hair straighteners might be more concerning, the researchers noted, due to greater absorption through the scalp, which could be exacerbated by any burns or lesions the products cause. The researchers did not collect information on the brand or ingredients in the hair products women used, so it's unclear whether any particular chemicals are implicated. Women who used hair straighteners more than four times a year were at increased risk — even with factors like obesity and hormone use taken into account. No other hair products, including dyes and permanents, were linked to the disease. Taken together, she said, it suggests there is a relationship between the products and "hormonally mediated" health conditions.

SOURCE:  HealthDay News, October 2022                                           

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Fish Oil & Aging Brain !

Fish Oil Could Strengthen Aging Brain 

Fish has been dubbed "brain food," and a new study suggests that may really be true for middle-aged adults. Researchers found that among more than 2,000 middle-aged people, those with higher blood levels of omega-3 fatty acids performed better on tests of certain thinking skills. They also had thicker tissue in a brain area related to memory - one that typically thins when older adults develop dementia. Omega-3 fatty acids -- particularly two known as DHA and EPA -- are most abundant in fatty fish like salmon, bluefin tuna, mackerel, herring and sardines. They can also be taken via fish oil supplements. The new study focused on middle-aged adults who were mentally intact. The idea was to see whether even at that age, omega-3s might make a difference in brain structure or function. Middle age is when the earliest indicators of abnormal brain aging may start to appear, noted lead researcher. "So we need to think about what things we can do in middle-age to support our brain health," she said. Her team looked at data on 2,183 people in the research project on risk factors for heart disease and stroke. The participants, who were 46 years old on average, underwent MRI brain scans and standard tests of memory and thinking skills. Their blood levels of DHA and EPA were also measured. Overall, the researchers found, the 75% of study participants with higher omega-3 levels fared better, brain-wise, than the bottom 25%. That former group showed greater tissue volume in the brain's hippocampus -- an area involved in memory, and among the first brain regions to show damage when people develop dementia. People with higher omega-3 levels also outperformed their peers in tests of abstract reasoning. That's a kind of higher-order thinking that, for example, allows a person to solve new, unfamiliar problems. Of course, people who consume more omega-3s, from food or supplements, may differ in many ways from those who do not. The researchers accounted for as many of those differences as they could -- including age, weight, smoking habits, and whether people had health conditions like high blood pressure or diabetes. Even then, omega-3 levels were tied to brain volume and test scores. That is not enough to prove cause-and-effect, lead researcher said. But, she added, other studies have linked omega-3s to greater mental prowess, and basic research points to potential reasons: In lab animals, the fatty acids have been shown to reduce inflammation, and protect cells in the hippocampus from dying, while fostering the generation of new ones, among other benefits. Based on the findings, though, it does not take a lot of EPA/DHA to benefit the brain: People in the top 75% had blood levels that would reflect moderate omega-3 intake, the researchers said.

SOURCE: HealthDay News, October 2022

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Stress Tied Cancer !

Lifetime of Stress Tied to Big Rise in Cancer Risk 

Over time, men and women under chronic stress face a significantly higher risk that they will die as a result of cancer, a new study warns. The finding comes from an analysis of more than three decades of U.S. data from a federal health and nutrition survey. After adjusting for a number of influential factors — including race, gender and prior medical history — the researchers found that lifelong stress appears to trigger a 14% rise in risk of cancer death. But why? Lead author explained that the link owes to a concept known as "allostatic load." That's a measure of cumulative stress, or wear and tear on the body, due to what described as "life course stressors." Study author noted that allostatic load levels can be measured in hard numbers. To do so, experts look at several key biological indicators that together show precisely how stress affects the body. To see how such indicators and allostatic load as a whole might impact cancer deaths, Research team looked over nationwide health survey data collected between 1988 and 2019. Collectively, the surveys included more than 41,000 adults. More than seven in 10 were white, about 13% were Black and roughly 9% were Hispanic. Allostatic load levels of all participants were tallied on a 0-to-9 scale, with scores of 3 or more defined as indicative of a "high allostatic load." In all, just under half of the participants (nearly 20,000) were pegged as having a high allostatic load. These respondents were more likely to be Black people, older, less well educated and less affluent compared with the low allostatic load group. The investigators then gauged the link between high allostatic load and cancer death risk in several ways. For example, after eliminating age as a consideration, a high allostatic load was linked to a 28% higher risk of death due to cancer. When looking solely at Black and Hispanic respondents, the link was weaker, but the researchers said the relatively low numbers of non-white respondents may have affected that part of the analysis. Still, when gender, race, age and educational background were also removed from the equation, a higher risk of cancer death was pegged at 21%. And that dropped to a 14% increase in risk after investigators also accounted for patients' history of smoking, prior heart attack or previous history of either cancer or congestive heart failure. Without adjusting for any potential confounders (such as age, race, gender, income and educational level), those with a high allostatic load were 2.4 times more likely to die from cancer than those with low allostatic loads, the researchers reported. "Cumulative stress is associated with risk of cancer death" across the board, he said. He added that more research is needed to clarify cancer-specific risks and explore the role of stress in cancer outcomes.

SOURCE: HealthDay News, October 2022

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Late Night Meal Alert !
Late Night Meals Especially Bad for Weight Gain: Study 

Midnight snacks has caused to pack on the pounds over the years – a study revealed. While late-night eating has long been linked with an increased risk for obesity, researchers weren't sure exactly how it caused weight gain until now. "When meals are delayed by four hours and everything else stays the same, it burns fewer calories, have an increased drive for food, and experience changes in fat tissue that would promote weight gain," said study author. The solution? Eat earlier in the day, he said. "The new data suggest, together with the literature, eating earlier in the waking day results in changes in physiology that would promote weight loss and limit weight gain," study author said. For the study, 16 people who were overweight or obese stuck to a strict early and late meal schedule for one day each in a lab. In the weeks before each experiment, folks maintained fixed sleep schedules. They also ate identical diets and stuck to the same meal times at home. The participants reported on their hunger and appetite, provided blood samples throughout the day, and had their body temperature and calorie use measured. Researchers also collected samples of fat tissue. In addition to feeling hungrier, burning fewer calories, and showing changes in fat tissue, eating later also affected the hunger and appetite-regulating hormones, leptin and ghrelin. Ghrelin is the "go" hormone that tells when to eat, and leptin is the hormone that tells to stop. Leptin dropped by 16% when folks ate four hours later, the study showed. Due to the study's design, researchers were able to tightly control for exercise, sleep and light exposure, which could affect how many calories participants burned. More research is needed to see if these findings hold in real life, he said. "In the real world, when people change meal times, they may also change other behaviors such as timing or quality or time of sleep or how much they exercise, which could affect weight," he added.

SOURCE: HealthDay News, October 2022

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‘Trigger Finger’ & Diabetes !

Permanently Bent 'Trigger Finger' Can Be Hallmark of Diabetes

A finger that "locks" can be a telltale sign of another condition: Diabetes. Researchers suspected that this trigger finger, often in the ring finger or thumb, might indicate diabetes after frequently finding the condition in patients who had or developed diabetes. It's characterized by thickening of tendons that are used to bend the finger and their connective tissue sheath. "At the hand surgery clinic, we have noted for a long time that people with diabetes, both type 1 and type 2, are more often affected by trigger finger," said researcher. A painful condition, this thickening causes the finger to become fixed in a bent position toward the palm. It can often be treated with cortisone injections, but sometimes requires surgery. In the new study, researchers examined two Swedish health databases, including the national diabetes registry, to study whether high blood sugar increased the risk of trigger finger. In all, between 1% and 1.5% of the population is affected by trigger finger, the study found. In people with diabetes, the rate was 10% to 15%. Trigger finger was especially notable in people with type 1 diabetes. High blood sugar was linked to an increased risk of trigger finger in both men and women with type 1 and type 2 diabetes, according to the report. However, the study could not prove a cause-and-effect relationship. Blood sugar is measured in HbA1C, or long-term blood glucose. Men with the worst blood sugar levels had a risk for trigger finger up to five times higher compared to men with a well-regulated HbA1C level, the study found. "However, we can't know for certain if any of the groups seek health care more often than others which could be a factor that affects the results," he said. Why diabetes might create this increased risk isn't known. A theory is that high blood sugar thickens both the flexor tendons and their connective tissue sheaths, causing them to lock more easily. People with unregulated blood sugar are more prone to nerve entrapments in the hand. The researchers now aim to learn how effective it is to operate on patients with diabetes who are affected by trigger finger. Study author said, "From our experience at the clinic, surgery goes well and there are few complications, but it takes a little longer for patients with type 1 and type 2 diabetes to regain full movement and function." He said it would also be interesting to study whether trigger finger could be a warning signal for type 2 diabetes.

SOURCE: HealthDay News, October 2022

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Products of SQUARE Pharmaceuticals Ltd.

  Product Magnide™
  Generic Name Magnesium Oxide
  Strength 365 mg
  Dosage form Tablet
  Therapeutic Category Mineral
  Product Livacol™
Generic Name

Obeticholic Acid


5 mg & 10 mg

Dosage form Tablet
Therapeutic Category Bile Therapy (Hepatobilliary Disorder)
Product Peranel TabletTM
  Generic Name Perampanel
Strength 2 mg & 4 mg
  Dosage form Tablet
  Therapeutic Category Antiepileptic

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