Healthcare online Keeping you up-to-date
VOL. 14  ISSUE:  4  April  2016 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management





Dear Doctor,

Welcome to our healthcare bulletin 'e-SQUARE'.

Our current issue focused on some interesting features like -

"Cow's Milk Alert !", "Lung Ultrasound !", "Loneliness Alert !", "Metformin & Heart",  "PPIs Alert !", "Psoriasis Risk !".

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.

 Cow's Milk  Alert !

                                              Cow's Milk Allergy in Childhood May Lead to Weaker Bones: Study

Children who are allergic to cow's milk may have weaker bones than kids with other food allergies, a small study suggests. Cow's milk allergy is the most common childhood food allergy in the United States, affecting up to 3 percent of children, the researchers said. The main treatment is elimination of cow's milk and dairy products -- which are major sources of the calcium kids need to build strong bones. This new study detected low bone density in 6 percent of 52 children with a long-term milk allergy. "Prepubertal children with persistent cow's milk allergy have a lower bone mineral density and calcium intake compared with similarly aged children with food allergies other than cow's milk," study co-author said. The study findings don't show a direct cause-and-effect link between milk allergy and low bone density. And the difference in bone density observed in the study wasn't significant enough, on average, to worry about fractures, said one pediatric expert not involved with the research. But the findings merit attention, he added. Most kids with cow's milk allergy -- up to 87 percent -- outgrow it by about 3 years of age. However, recent reports find it persists in about 15 percent of those affected until they are teens, the study authors noted. For the study, they recruited 81 pre-puberty-stage children with food allergies. Fifty-two had cow's milk allergy, while 29 had allergies to foods other than milk. The kids' average age was close to 7 years old. The researchers measured the kids' bone mineral density using standard testing. They also took blood samples to assess levels of vitamin D, crucial for bone health. In addition, they recorded calcium and vitamin D intake and tracked compliance in those advised to take supplements. While low bone mineral density was found in 6 percent of those with cow's milk allergies, none of those in the other group had low bone density, the researchers said. The children with cow's milk allergies also had lower average calcium intake -- 930 milligrams (mg) a day compared to 1,435 in the other group. Recommended daily intake is 1,000 mg. Vitamin D intake in both groups was well below the recommended 600 International Units (IUs) a day. Few with the cow's milk allergies took supplements -- 37 percent reported taking calcium and 44 percent reported taking vitamin D. However, those who did take a supplement averaged more than five days a week, which was termed good compliance, according to the study. The study is published online April 20 in the journal Pediatrics. Prior research has shown that children who don't reach peak bone mass have a higher risk of the bone-thinning disease osteoporosis in later life, the study authors noted. "Parents should encourage the intake of alternate sources of calcium in their children's diet," study author added, suggesting soy, almond or rice milk and orange juice fortified with calcium. Parents can also have a dietitian evaluate their child's diet, and find out how to increase calcium and vitamin D intake, she said. Also, a bone density scan could be considered if indicated, she said.   

SOURCE: HealthDay News, April 2016

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 Lung Ultrasound !

                                                   Lung Ultrasound May Be Best to Spot Pneumonia in Kids: Study

Lung ultrasounds may offer a safer, yet equally effective, alternative to chest X-rays for diagnosing pneumonia in children, researchers report. "Ultrasound is portable, cost-saving and safer for children than an X-ray because it does not expose them to radiation," study leader explained. The study included 191 emergency department patients aged 21 and younger who were randomly assigned to either an investigational group or a control group. Patients in the investigational group had lung ultrasound and, if additional verification was needed, a follow-up chest X-ray. Those in the control group had a chest X-ray followed by lung ultrasound. The patients in the investigational group had nearly 39 percent fewer chest X-rays, with no missed cases of pneumonia and no increase in complications. The reduction in chest X-rays led to overall cost savings of $9,200 and an average decrease in time spent in the emergency department of 26 minutes, according to the study published April 12 in the journal Chest. "Our study could have a profound impact in the developing world where access to radiography is limited," researcher said. Pneumonia is a leading cause of death among children worldwide. Chest X-ray is considered the best way to diagnose pneumonia in children, but about three-quarters of the world's population does not have access to X-rays, according to the World Health Organization. 

SOURCE:  HealthDay News, April 2016

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 Loneliness Alert !

                                                    Lonely, Isolated People May Be Prone to Heart Disease, Stroke

Lonely and isolated people may face a higher risk of heart disease and stroke, researchers report. Social isolation raised that risk by about 30 percent, exerting the same level of influence on heart health as risk factors such as anxiety and job stress, the British review found. "Addressing loneliness and social isolation could have an important role in the prevention of two of the leading causes of ill health and mortality worldwide," lead researcher said. "We take risk factors like obesity and physical inactivity for granted, whereas we do not yet with social isolation and loneliness," she said. "The data from our study support us taking it seriously." But this analysis could not prove that loneliness and social isolation caused heart problems or strokes, only that an association existed, she added. "However, if we put the study findings into context, what we found is comparable in size to the effect of other psychosocial risk factors such as anxiety and job strain. Efforts to prevent heart disease and stroke could benefit from taking social isolation and loneliness into account," she said. The report was published online April 19 in the journal Heart. For the study, lead researcher and her colleagues analyzed data from 23 previously published studies that, in total, included over 180,000 adults, more than 4,600 of whom had heart attacks, angina or died and more than 3,000 who had suffered strokes. The pooled data showed that loneliness and social isolation were associated with a 29 percent increased risk of heart attack or angina attack and a 32 percent increased risk of stroke. Loneliness has been linked in past research to a weakened immune system, high blood pressure and premature death, the researchers explained.

SOURCE: HealthDay News, April 2016

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 Metformin & Heart !

                               Metformin Safer for Heart Than Other Common Type 2 Diabetes Drugs: Study

Metformin, the most frequently prescribed standalone drug for type 2 diabetes, is better for the heart than its closest competitors, a large analysis suggests. Metformin reduced the risk of dying from heart attack and stroke by about 30 percent to 40 percent compared with other commonly used drugs called sulfonylureas, such as glibenclamide, glimepiride, glipizide and tolbutamide, researchers report. "Pharmaceutical companies continue to make new drugs to reduce blood sugar and improve on safety concerns of the older drugs," senior study author said. But, "while adults with diabetes often need more than one medication to control blood sugar, the newer medications do not appear to be safer than the older drugs," she added. Metformin is still the safest and most effective type 2 diabetes medication, study author said. The analysis, which included 204 studies involving 1.4 million people, was published April 19 in the Annals of Internal Medicine. According to the researchers, although diabetes patients with uncontrolled blood sugar are at risk for dying from a heart attack or stroke, it hasn't been clear whether one diabetes drug is better than another in preventing these deaths. "The complications of untreated diabetes often outweigh these safety concerns, but consumers will need to weigh benefits and risks of the medications with their doctors when making diabetes treatment choices," she said. Metformin, which has been used since the late 1990s, is a relatively inexpensive generic drug compared to many newer, more expensive drugs, she added. In 2014, per-person spending was higher for diabetes drugs than for any other class of drugs, in part because more than half the prescriptions were for brand-name medications, she explained.

SOURCE: HealthDay News, April 2016

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 PPIs Alert !

                                                         Common Heartburn Drugs Linked to Kidney Disease in Study

People who use certain drugs for chronic heartburn may be at increased risk of developing kidney disease, a new study suggests. The research is the latest to highlight potential risks from drugs called proton pump inhibitors (PPIs). But prolonged use of PPIs has been linked to certain nutrient deficiencies and bone-density loss. According to the U.S. Food and Drug Administration, bone fractures are considered a safety concern when people use PPIs for a year or more. More recently, research has hinted at additional hazards. Last year, for example, a study tied the medications to a slight increase in heart attack risk. However, neither that study nor this new one prove that PPIs are directly to blame for these problems. "I cannot say for certain that this is cause-and-effect," researcher said. His team found that PPI users were more likely than people on other heartburn medications to develop chronic kidney disease or kidney failure over five years. The researchers did try to rule out other possible explanations, such as PPI users being older or in poorer health. But, researcher said, there could still be other factors that account for the higher kidney risk. Despite the uncertainty, he said the findings underscore an important point: People should use PPIs only when it's medically necessary, and for the shortest time possible. "I think people see these medications at the drug store and assume they're completely safe," he added. "But there's growing evidence they're not as safe as we've thought." The new study findings are based on medical records from over 173,000 VA patients who were prescribed a PPI and over 20,000 other patients prescribed another class of heartburn drug called H2-blockers. Over five years, 15 percent of PPI users were diagnosed with chronic kidney disease, versus 11 percent of those on H2-blockers. After the researchers weighed other factors, PPI users still had a 28 percent greater risk. Few study patients -- less than 0.2 percent -- developed end-stage kidney failure. But the odds were almost doubled among PPI users, the study found. And, researcher said, the risk increased the longer people used the medications: Patients on PPIs for one to two years had a threefold higher risk of kidney failure than those who used the drugs for a month or less. Researcher said he could only speculate on how PPIs could contribute to kidney disease. But past research has linked the drugs to cases of acute kidney inflammation, he said. It's possible, he added, that some PPI users develop cases that go undiagnosed and eventually lead to chronic kidney disease. Deficiency in the mineral magnesium could also play a role, according to researcher. Because PPIs block stomach acids, they can lower the body's absorption of certain nutrients, including magnesium. The study was released online April 14 in the Journal of the American Society of Nephrology. 

SOURCE: HealthDay News, April 2016

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 Psoriasis Risk !

                                                          Psoriasis May Raise Risk for Aneurysms in Abdomen: Study

Psoriasis patients may face a higher risk of an abdominal aortic aneurysm, though the overall odds of experiencing this potentially deadly blood vessel rupture are small, new research shows. The Danish scientists also found that the more severe the psoriasis -- a chronic autoimmune condition characterized by scaly, red patches of skin -- the more likely a person will develop an abdominal aortic aneurysm. They believe the two conditions share overlapping inflammatory processes in the body. "The association between [abdominal aortic aneurysm] and psoriasis has not been examined before, but we are not surprised by seeing a heightened risk in our study lead researcher said. "Our results add to the evidence that there is an increased risk of various cardiovascular diseases in patients with psoriasis," he added. The study is published April 14 in the journal Arteriosclerosis, Thrombosis and Vascular Biology. About 7.5 million people in the United States are affected by psoriasis, an incurable condition that occurs when the immune system attacks healthy skin cells, causing them to shed more quickly, according to the American Academy of Dermatology. Abdominal aortic aneurysms occur when the main blood vessel supplying blood from the heart to the abdomen becomes enlarged. Often, there are no symptoms until there is a rupture, which can often prove fatal. Their prevalence increases with age and affects about 2 percent of people 65 and older, typically men, according to the study. Researcher and his team analyzed more than 59,000 patients with mild psoriasis and 11,000 patients with severe psoriasis using 14 years of data from nationwide registries in Denmark. The patients were tracked until they were diagnosed with an abdominal aortic aneurysm, died, moved or the study ended. The researchers found that patients with mild psoriasis were 20 percent more likely to develop an abdominal aneurysm than people without psoriasis. And those with severe psoriasis were 67 percent more likely to develop an aneurysm. However, the study did not prove that psoriasis causes these aneurysms, merely that an association exists between the two conditions. "More research is needed to explain the causal mechanisms," he said. "Nonetheless, our findings not only stress the need to treat the symptoms of the skin disorder, but also a regular evaluation of the risk factors that are associated with cardiovascular disease outcomes. "Also, patients with psoriasis must be encouraged to change unhealthy lifestyle and adhere to a daily program that will minimize the risk of cardiovascular problems," he added.

SOURCE: HealthDay News, April 2016

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Fusitop  HC
  Generic Name Fusidic Acid+Hydrocortisone
  Strength 2%+1% 
  Dosage form Cream
Therapeutic Category Topical Corticosteroid Combination
  Product Femastin
Generic Name




Dosage form Cream
Therapeutic Category Hormone Replacement Therapy
  Product Redclov
  Generic Name Redclover Isoflavone

40 mg

  Dosage form Capsule
  Therapeutic Category Hormone (Natural Estrogen) 

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