Healthcare online Keeping you up-to-date
VOL.  15     ISSUE: 8  August  2017 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management






Dear Doctor,

Welcome to this edition of 'e-SQUARE'.

Our current issue focused on some interesting features like -
Mutation Repair !", "Deadly diseases !", "Bypass Surgery !", "CKD & Infection !",  "Pregnancy Interval & Diabetes !", "Novel Approach !".

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

We will appreciate your feedback !

Click on to reply mode.

Yours sincerely,


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.

 Mutation Repair !

Geneticists Repair Mutation in Human Embryo

In a first-ever experiment, geneticists have successfully modified a human embryo to remove a mutation that causes a life-threatening heart condition. This is the first study to demonstrate that a gene-editing technique can be used in human embryos to convert mutant genes back to their normal version, the lead researcher added. The new procedure tackled a genetic mutation in human embryos that causes hypertrophic cardiomyopathy, an inherited condition in which the heart muscle becomes abnormally thick. The mutation was successfully repaired in 72 percent of 18 embryos that were created in a lab using sperm from a male donor who carries the hereditary heart condition. The procedure also might work in other genetic diseases caused when a person has one good copy and one mutated copy of a gene. These include cystic fibrosis and cancers caused by mutated BRCA genes. This embryo gene correction method, if proven safe, can potentially be used to prevent transmission of genetic disease to future generations. But while the procedure is considered to be the first of its kind, human trials are not currently allowed in the United States. Hereditary hypertrophic cardiomyopathy occurs in about one out of every 500 adults, and is passed along when a person winds up with one good copy and one mutated copy of a gene called MYBPC3, the lead researchers said. There's a 50 percent chance that the children of a parent with the disease will inherit the genetic mutation for the disease. People with hypertrophic cardiomyopathy are at increased risk of heart failure and sudden heart death. The condition is the most common cause of sudden death in otherwise healthy young athletes. To repair the problem, the lead researcher "broke" the mutated version of the MYPBC3 gene inside human embryos, using technology that allows scientists to snip a specific target sequence on a mutant gene. DNA repair process employed within human embryos activates to fix the broken gene, using the normal copy of the gene as a template. The result: an embryo with two healthy copies of the gene that, if implanted in a woman and allowed to gestate, should result in a baby free from risk of hereditary cardiomyopathy. Further, any children descended from that baby should also be free from this genetic risk. The lead researcher found that when they performed this procedure, all the cells in corrected embryos wound up containing two normal copies of the gene. The lead researcher said, every generation on, would carry this repair because we've removed the disease-causing gene variant from that family's lineage. By using this technique, it's possible to reduce the burden of this heritable disease on the family and eventually the human population. The lead researcher broke the mutated gene using a technology called CRISPR-Cas9. Essentially, the process uses genetic techniques to target sequences of DNA inside the mutant gene. Those targeted sequences are then snipped using Cas9, an enzyme that functions like a pair of molecular scissors. Until now, CRISPR-Cas9 has been used as a lab tool to help scientists understand the impact that a mutation has on disease. The process was tested on 18 lab-created embryos using sperm from the male donor and eggs donated by 12 healthy young women. These embryos all carried one good copy and one mutant copy of MYPBC3.Used in conjunction with pre-implantation genetic diagnosis, this procedure could improve the efficiency and success of in-vitro fertilization by requiring fewer IVF cycles to produce a genetically healthy embryo. The lead researcher will next focus on testing the safety and improving the efficiency of the CRISPR-Cas9 process, possibly by using other genetic tools in combination with it. After that, they could proceed to human trials, in which the corrected embryos would be implanted with the goal of establishing pregnancy.

SOURCE: HealthDay News, August 2017

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 Deadly diseases !

Nearly 4 Million Worldwide Die Each Year From Asthma, COPD

Two major chronic lung diseases asthma and COPD kill nearly 4 million people worldwide annually. Lead researcher calculates that 3.2 million people died in 2015 from .Asthma caused another 400,000 deaths. While asthma is more common, COPD is much more deadly. And while both conditions can be treated, many people remain undiagnosed or misdiagnosed. In addition, in many countries, treatment, if it exists at all may be at insufficient levels. Although much of the burden is either preventable or treatable with affordable interventions, these diseases have received less attention than other prominent non-communicable diseases like cardiovascular disease, cancer or diabetes, said report lead researcher. Smoking and air pollution are the leading causes of COPD, the lead researcher noted. The causes of asthma are less certain but are thought to include allergens and smoking. One expert in respiratory health agreed that both diseases take a heavy, but treatable, toll on health. Asthma may be fairly easily controlled and even reversed with medications, while COPD is also treatable. Lung damage is permanent and the natural aging process of the lung is the progressive or accelerated loss of alveoli. So the decline in lung function is life-long, whereas asthma does not have this issue. Overall, the diseases have become less common and less deadly since 1990 when judged by rates. But absolute case numbers worldwide have gone up because there are more people in the world and more elderly people, too. The lead researcher found that COPD hit these countries the hardest: India, Lesotho, Nepal and Papua New Guinea. Asthma was an especially high burden in these countries: Afghanistan, Central African Republic, Fiji, Kiribati, Lesotho, Papua New Guinea, and Swaziland. Indoor cooking fuels like "biomass" materials, such wood and coal, for example remain a major source of respiratory illness in poorer nations. The use of these cooking fuels is one of the greatest causes of air pollution  resulting in a high burden of morbidity and mortality. To reduce household air pollution, a switch to cleaner fuels would be desirable. However, this change is not always possible due to financial or logistical constraints, especially in urban slums. Interventions aimed at replacing smoke-generating cook stoves with cheap, cleaner-burning devices would go a long way toward cutting the burden of asthma and COPD worldwide.

SOURCE: HealthDay News, August 2017

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 Bypass Surgery !

Which Heart Bypass Surgery Works Best?

Five years after heart bypass surgery, patients whose operation was done using a heart-lung pump lived longer than those whose surgeons didn't use the device. Since the 1990s, two different approaches have been commonly used by heart surgeons to perform coronary artery bypass graft operations. Coronary artery bypass creates new routes for blood to flow to the heart because old routes are blocked by plaque in the artery. A piece of blood vessel is taken from another area of the body and used to "bypass" a blocked vessel going to the heart, according to the U.S. National Heart, Lung, and Blood Institute. The two different ways to do this surgery have been referred to as "on-pump," assisted by a heart-lung machine, or "off-pump." Which procedure produces better results has been controversial, the lead researcher added. The heart-lung machine allows you to stop the heart so you can sew the grafts with no blood flowing through it. This enables the surgeon to work on a heart that is fully exposed and not moving. When operations are done on-pump, surgeons are able to do more grafts. In off-pump surgery, the heart is a moving target as it continues to pump blood. This report looks at the five-year outcomes of patients who had heart surgery as part of the U.S. Veterans Affairs trial of on-pump versus off-pump operations done from February 2002 through June 2007. In this trial, more than 2,200 patients from 18 VA centers were randomly selected to receive either on-pump or off-pump heart surgery. They were assessed a year after their operation and then at five years .Specifically, the lead researcher looked for major cardiac problems, including death from any cause, the need for new heart procedures or nonfatal heart attacks. After a year, more patients who had an off-pump operation died or needed new procedures than patients who had on-pump surgery. Five years after surgery, the rate of death among those in the off-pump group was a little over 15 percent, compared with nearly 12 percent among those who had on-pump surgery, the researchers found. That's a 28 percent higher risk of dying five years after surgery for the off-pump group .In addition, more people who had off-pump surgery had major cardiovascular problems than those who had on-pump operations -- 31 percent versus 27 percent. Overall, "Off-pump did not look as good as on-pump. Off-pump is not indicated except for certain patients who have issues, such as a heavily calcified aorta. That means there's a lot of plaque build-up in the artery. And, when a pump is used, the aorta has to be clamped. Clamping can cause plaque in the artery to break off and result in a blockage of the heart or brain. Other reasons to use off-pump include patients suffering from liver failure. Surgery is a technical thing, and a lot of the outcomes depend on how good your surgeon is, particularly, how experienced and technically able the surgeon is with the procedure they are doing .Off-pump surgery is technically demanding, so one should have an experienced surgeon. If you select the patients properly, and the surgery is done by an experienced surgeon, then the results can be good. Elderly patients who may have had a stroke and only need two or three grafts probably do better off-pump. Both are very good procedures. The key is to have a surgeon experienced with both so that they can choose the right one for you.

SOURCE: HealthDay News, August 2017

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 CKD & Infection !

Kidney Disease May Boost Odds of Infection

Infections facing people with advanced kidney disease include lower respiratory tract disease, urinary tract infections and blood poisoning. Chronic kidney disease (CKD) remains underdiagnosed and unrecognized in most societies, our findings may help patients and clinicians become more aware of chronic kidney disease and its complications. This in turn may be useful to identify patients at increased risk of infection and inform discussions about prevention strategies, such as vaccination and health service planning. The lead researcher tracked 12 months of data from 1.1 million Swedes who took part in a study examining measures of kidney function .The lead researcher found that infection rates grew almost six fold in people with stage 4 or higher chronic kidney disease, compared to people with normal kidney function. Several types of infection like lower respiratory tract infections, urinary tract infections and sepsis, made up a larger proportion of infections as kidney function worsened. The lead researcher focused on infections that people develop in the community, not hospitals and other health care settings.

SOURCE: HealthDay News, August 2017

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 Pregnancy Interval & Diabetes !

Women Who Gain Weight between Babies at Higher Risk for Diabetes

Women who gain weight after having a baby may be more likely to develop diabetes during their next pregnancy. Women's weight before conception and how much they gain during pregnancy are known risk factors for gestational diabetes, the lead researcher explained. Gestational diabetes can cause complications for both mother and baby. Lead researcher investigated the diabetes risk among women who had been pregnant once or twice before. The study involved about 24,200 women who gave birth between 2006 and 2014. The researchers considered the women's previous history of gestational diabetes and body mass index (BMI) when they got pregnant again. BMI is an estimate of body fat based on weight and height. A BMI of 30 is considered obese. About 36 percent of the women gained more than 1 BMI unit of weight between the start of their first pregnancy and their second, the lead researcher found. These women were more likely than women whose weight was stable to develop diabetes during a second pregnancy. Women who gained twice as much weight had double the risk for gestational diabetes. And the risk rose fivefold for women who had the greatest weight gain. These risks were most striking among women whose weights were normal before their first pregnancy. The study showed, however, that overweight women who lost weight after delivery reduced their risk of diabetes during another pregnancy.

SOURCE: HealthDay News, August 2017

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 Novel Approach !

Novel Procedure Improves Kidney Transplant Success

A new treatment might open the door for more patients with advanced kidney disease to get a transplant, a preliminary study suggests. Of the 100,000-plus Americans waiting for a donor kidney, about one-third are "sensitized," said by lead researcher. Those patients face a tough situation: They harbor immune system antibodies that are primed to attack a donor organ. The antibodies can form when a person is exposed to foreign tissue, lead researcher explained. So a patient who's had a prior kidney transplant may be highly sensitized, meaning they have a large number of the offending antibodies. It can also happen to patients who've had blood transfusion or ever been pregnant. It's almost impossible to find a compatible donor for those patients. But they might be able to receive a kidney from an incompatible donor if they first undergo an extensive "desensitization" process. That involves various treatments -including IV drugs called immune globulin and rituximab that try to quash the antibodies that would attack the donor organ. Now the new research suggests a simple approach an infusion of a particular enzyme hours before the transplant -- could offer a better alternative. Lead researcher found that the treatment quickly wiped out the dangerous antibodies, allowing all but one of 25 patients to have a successful transplant. Critically, the enzyme does not banish the antibodies forever. They come back and the results of that comeback vary from patient to patient. In the study, 10 patients had an episode of antibody-mediated rejection anywhere from two weeks to five months after their transplant. That means antibodies started to attack the new kidney. Those patients were all successfully treated with standard anti-rejection drugs, according to the top researcher. Still, it's not yet clear how the patients will fare in the long term. But the findings mark another step forward for patients like these. Traditionally, highly sensitized patients in need of a kidney have languished on waiting lists because it's so hard to find a compatible donor. But in the past 15 years or so, desensitization has emerged as an alternative. Last year, a landmark study proved that patients who receive transplants after desensitization live significantly longer than those who stay on dialysis.

SOURCE: HealthDay News, August 2017

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New Products of SQUARE Pharmaceuticals Ltd.

Product Larsulin InjectionTM
Generic Name Insulin Glargine
  Strength 300 IU/3ml
  Dosage form Injection
  Therapeutic Category Anti-diabetic
Product Larsulin Pen CartridgeTM
Generic Name

Insulin Glargine

Strength 300 IU/3ml
Dosage form Injection
Therapeutic Category Anti-diabetic
Product Oxifun 1% LotionTM
  Generic Name Oxiconazole
  Strength 1%
  Dosage form Lotion
  Therapeutic Category Topical Antifungal

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