Healthcare online Keeping you up-to-date
VOL.  20     ISSUE:  9    September  2022 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management








Dear Doctor,

Hope you are well !

Welcome to our online publication  'e-SQUARE' !

Our current issue focused on some interesting features like-

"COVID triggers A Fib !", "Best COVID Drug !", "Cancer Alert !", "Meal Time & Mood !", "Artificial Sweeteners Risk !", "Vitamin & Brain !".

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

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The views expressed in this publication do not necessarily reflect those of its editor or SQUARE PHARMACEUTICALS LTD.

COVID triggers A Fib !

COVID may help trigger A-Fib in some patients

About 1 in 20 patients hospitalized with COVID-19 develop the heart rhythm disorder atrial fibrillation (A-Fib), according to data from an American Heart Association (AHA) registry. Having a new case of a-fib in the hospital was associated with major heart events, the study found, as well as longer hospital stays and greater need for intensive care and intubation. About 45% of those patients died while in the hospital. "In 2001, experts predicted the number of Americans living with a-fib would double by 2050 -- the situation may be more dire following the COVID-19 pandemic," said the researcher. "Research suggests a-fib is likely to influence more Americans and could put more people at greater risk of stroke and heart failure than previously expected," he said in an AHA news release. At least 2.7 million Americans have a-fib, which is a quivering or irregular heartbeat. It can lead to blood clots, stroke, heart failure and other heart-related complications. The findings, which accounted for underlying health conditions and factors in the hospital, suggest new-onset a-fib in COVID patients is a marker of adverse clinical factors, according to the heart association. A study published in July also pointed to increased risk of heart problems in COVID patients.

SOURCE: HealthDay News, September, 2022

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Best COVID Drug !

   Which drugs fight COVID best? WHO updates treatment guidelines

In updated guidance, the World Health Organization now recommends against using the antibody drugs sotrovimab and casirivimab-imdevimab for patients with COVID-19. This recommendation replaces previous conditional recommendation for these antibody drugs. The change in guidance was based on emerging evidence that the medications which work by binding to the SARS-CoV-2 spike protein, preventing the virus from infecting cells are not likely to work on the Omicron variants that are spreading now. In the United States, both antibody drugs are no longer recommended to treat COVID-19 because of emerging variants. The panel also made a conditional recommendation for using the antiviral drug remdesivir in patients with severe COVID, while simultaneously recommending against its use in patients with critical COVID, which is even more serious than severe COVID. This recommendation was prompted by results from five randomized trials of 7,643 patients, which found 13 fewer deaths per 1,000 patients in those with severe COVID taking remdesivir. Meanwhile, they have found 34 more deaths per 1,000 patients among those taking the medication who had critical COVID. Patients with severe and critical COVID can receive a combined therapy using three drugs meant to treat arthritis, along with corticosteroids. The WHO advised combining the IL-6 receptor blockers tocilizumab or sarilumab and the JAK inhibitor baricitinib. High-certainty trial evidence showed a survival benefit with baricitinib when combined with corticosteroids and IL-6 receptor blockers. However, their high price may worsen health inequities, the organization noted. Past guidance has included a strong recommendation for using nirmatrelvir/ritonavir for high-risk patients with non-severe covid-19. WHO does not advise using ivermectin and hydroxychloroquine in patients with COVID-19, regardless of disease severity.

SOURCE: HealthDay News, September 2022

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Cancer Alert !

                                            Cancers in people under 50 are rising worldwide

Cancers among younger adults are a growing global problem and are likely related to factors like poor diet, obesity and inactivity, a new research review finds. Since the 1990s, researchers say, rates of various cancers have been rising in many countries among people under 50. And while the reasons are not fully clear, it's likely that changes in lifestyle and environment starting early in life are playing a role. The review found that in recent decades, rates of 14 cancers have been inching up annually among younger adults in a diverse range of countries from the United States and Canada, to Sweden and England and to Ecuador, Uganda and South Korea. The cancers, similarly, run the gamut, and include those of the breast, colon, esophagus, kidneys, liver, stomach and pancreas. For certain cancers, increased screening may partly explain the rising incidence, according to researcher. Screening tests for diseases like breast and colon cancers can detect more cases, at an earlier point in time. But for the most part, he said, the growing cancer incidence among younger adults is beyond what would be expected from heightened detection. And many of the cancers that are increasing arise along the digestive tract "anywhere from the mouth to the anus," he said. That, he added, points to a potential role for the microbiome. The microbiome refers to the vast array of bacteria that normally dwell in the body, largely the digestive tract. Research in recent years has been revealing how important the microbiome is to overall health, playing a role in immunity, fighting chronic inflammation and other vital functions. For any one person, makeup of the microbiome depends partly on genes. But he noted that environmental factors are critical, too including diet, alcohol intake, smoking, exercise and antibiotic use. And many of those environmental exposures have shifted substantially in recent decades. The spread of the "westernized" diet is a clear example, he said. It's high in heavily processed foods, added sugar and red meat, but low in fruits, vegetables, fiber and "good" fats qualities that have been linked to increased risks of certain cancers, like colon cancer. The rise in colon cancers among younger adults has been gaining particular attention. According to the U.S. National Cancer Institute, the incidence of that disease among Americans younger than 50 has more than doubled since the 1990s in sharp contrast to a decrease among people older than 65. In fact, the trend spurred experts to lower the recommended starting age for colon cancer screening. It's now age 45 for people at average risk of the disease. Obesity among children and younger adults has, of course, skyrocketed in recent years. And on the opulation level, researcher said, there is a relationship between obesity and colon cancer risk. But many younger people who are diagnosed with the disease are not obese, and the reasons behind the rising incidence would appear to go beyond a single factor. Much more research is needed to understand what's driving the rise in various early-onset cancers, researcher said.

SOURCE: HealthDay News, September 2022

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Meal Time & Mood !

                                            Timing of meals could alter mood

The time of day or especially night that you eat may affect your mental health, according to a small new study. Researchers created a simulated shift-work schedule and found increases in depression and anxiety for those eating at odd hours. "Our findings provide evidence for the timing of food intake as a novel strategy to potentially minimize mood vulnerability in individuals experiencing circadian misalignment, such as people engaged in shift work, experiencing jet lag, or suffering from circadian rhythm disorders," said co-author. About 20% of the workforce in industrial societies does shift work in places like factories and hospitals. These workers often experience a misalignment between their central "circadian clock" in the brain and daily behaviors, including sleep/wake and fasting/eating cycles, according to the study. They also have about a 25% to 40% higher risk of depression and anxiety. The study enrolled 12 men and seven women in a randomized, controlled study. Participants underwent a "forced desynchrony" protocol in dim light for four 28-hour "days" instead of 24-hour days. By the fourth "day," their behavioral cycles were inverted by 12 hours, which simulated night work and caused circadian misalignment, researchers said. Participants were then randomly assigned to one of two meal timing groups. In the control group, meals were eaten on a 28-hour cycle, which meant folks were eating both during the night and day. This is a typical schedule for night workers. In the daytime-only meal intervention group, participants ate meals on a 24-hour cycle, which meant they were eating only during the day. While this was ongoing, the research team assessed mood levels every hour. By day 4, for those in the daytime/nighttime meal group, their depression-like mood levels had increased by 26% and anxiety-like mood levels by 16%. The daytime-only group had no mood changes. The participants with a greater degree of circadian misalignment experienced more mood changes, the authors said. "Shift workers -- as well as individuals experiencing circadian disruption, including jet lag -- may benefit from our meal timing intervention," said co-author. "Our findings open the door for a novel sleep/circadian behavioral strategy that might also benefit individuals experiencing mental health disorders," she said in the release. "Our study adds to a growing body of evidence finding that strategies that optimize sleep and circadian rhythms may help promote mental health." Further studies will be needed to establish if changes in meal timing can help people with depressive- and anxiety-related disorders, she said.

SOURCE: HealthDay News, September, 2022

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Artificial Sweeteners Risk !
Could Artificial Sweeteners Be Bad for Heart ?

Artificial sweeteners are a popular way to try to keep slim, but French researchers suggest they may also increase your risk for a heart attack or stroke. The finding stems from tracking heart health among more than 103,000 men and women in France for close to a decade. "We observed that a higher intake of artificial sweeteners was associated with an increased risk of cardiovascular diseases," said study author. Roughly 80% of participants in the cohort were women (average age: 42). The study began in 2009 to investigate links between nutrition and health. At the outset, nearly four out of 10 participants reported they regularly used artificial sweeteners. They added them to food or beverages and also consumed them in processed products. Those who said they used sweeteners were generally younger; less active; more likely to be overweight or obese; more likely to smoke; and more likely to be dieting. They also tended to consume more red meat, dairy, salt, and sugar-free drinks. They drank less alcohol and ate fewer fruits and vegetables, less carbs and fats, and fewer calories overall, dietary records showed. Participants' heart health was then tracked and compared for an average nine years. During that time, more than 1,500 heart problems occurred, including heart attacks, strokes, severe chest tightness or angina, and/or the need for surgery (angioplasty). After stacking artificial sweetener consumption up against heart trouble, the researchers concluded that the former was associated with the risk for the latter. Researcher and her team stressed that their work does not definitively prove that sweeteners directly undermine heart health, only that there's a link between the two. Lead author suggested a number of possibilities: One, she said, is the promotion of metabolic syndrome, which encompasses an array of conditions that raise the risk for heart attack and stroke. Among those are high blood pressure, high blood sugar, excess waist fat and high cholesterol. "Another potential pathway could involve the interaction of artificial sweeteners with intestinal sweet taste receptors," which can affect both insulin levels and sugar absorption, she said. Artificial sweeteners may also alter the makeup of microbes found in the gut, drive up systemwide inflammation and trigger vascular malfunction, she added. "But these are hypotheses, notably from experimental studies, that need to be confirmed," she said. "Focus on an overall healthful eating plan," she advised. "More plant foods, leaner or low fat animal foods, and if you enjoy something sweet, think about portions, frequency of consumption, and try to vary the types of sweeteners. No single food or ingredient is the 'bad guy.' It is how all of this comes together into your day in, and day out, eating plan."

SOURCE: HealthDay News, September 2022

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Vitamin & Brain !

                              Multivitamins Linked to Healthier Brains in Old Age

A daily multivitamin might help keep brain free from any decline in thinking skills, a new study suggests. In a trial of more than 21,000 men and women, the study authors reported that cocoa had no benefit on thinking skills but taking a multivitamin every day did improve cognition among the 2,000 participants. All were aged 65 and older. "Our results are promising as they point to a potentially highly accessible, safe and inexpensive intervention that may provide a layer of protection against thinking declines in older adults. But more work is needed before widespread recommendations about regular use can be made," said lead researcher Research team found that taking a multivitamin over the course of three years reduced thinking declines by about 60%. The benefits were greater among people with heart disease, which is important because they are already at risk for thinking declines, the researchers noted. Cocoa's effect on brain power was a main focus of the study, but it flopped. On the other hand, the multivitamin was associated with better cognition. These results were not what the investigators were expecting, and it's not clear why a multivitamin might have this effect, she said. The researchers assumed that older adults were well-nourished, but they didn't take into account the other medical conditions older people can suffer from or the medications they take. Also, researcher noted that Americans in general don't eat a healthy diet, so they may be missing some important nutrients that multivitamins help replace. She noted that they plan to test their findings in a larger trial among a diverse population. "We're really going to work hard to reach far away from the hospitals and get into rural communities and get a better representation so that we can make a general statement about all people, not just people who are white," she said. But she also isn't recommending that people start taking a multivitamin in hopes of preventing thinking declines just yet. "We're not in a position where this work is ready for a general recommendation, because there's a lot of things that are unknown at this point," she added.

SOURCE: HealthDay News, September, 2022

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Products of SQUARE Pharmaceuticals Ltd.

  Product AntiscarTM
  Generic Name Extractum Cepae +Heparin +Allantoin
Strength 100 mg+ 0.278 mg+10 mg
  Dosage form Gel
  Therapeutic Category Antiscar
  Product MagnideTM
Generic Name Magnesium Oxide
Strength 365 mg
Dosage form Tablet
Therapeutic Category Mineral
  Product BolardiTM
  Generic Name Saccharomyces boulardii
  Strength 250 mg & 500 mg
  Dosage form Capsule
  Therapeutic Category Antibiotic Associated Illness

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