Healthcare online Keeping you up-to-date
VOL. 16  ISSUE:  4  April  2018 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 -

"Antidepressants in Pregnancy !", "Parkinson's Risk !", "Nasal Spray !", "Pancreatic Cancer !,  "Genetic Testing !", "Hope in Progeria !".

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.

 Antidepressants in Pregnancy !

                               Common Antidepressants in Pregnancy May Alter Fetal Brain Development

Pregnant women who take certain antidepressants may unknowingly compromise the brain development of their child, lead researcher suggests. The concern is based on a new analysis of brain scans involving nearly 100 newborns, some of whom were born to mothers who took selective serotonin reuptake inhibitors (SSRIs) while pregnant. The scans indicated that SSRI exposure in the womb was associated with an increase in the size of gray matter found in two parts of the brain: the amygdala and the insula. Maternal SSRI use was also linked to an increase in white matter connections between the two regions Animal research has linked such increases to a higher risk for developing anxiety and depression, explained by lead researcher. Gray matter facilitates most of the brain's signaling and is central to sensory perceptions, while white matter is largely nerve fiber bundles that enable communication between brain regions. The specific brain regions in question are critical to the processing of emotions. All the mothers in the study were between the ages of 18 and 45 while pregnant between 2011 and 2016. Nearly a third were white, a quarter Hispanic, and a quarter black. Most of the mothers had been examined for depression before, during and after pregnancy, and those prescribed an SSRI during their pregnancy were assigned to the, SSRI group. All of the newborns had brain scans at an average age of just 1.5 weeks. The scans revealed that babies in the SSRI group had significant increases in the size of amygdala and insula gray matter, compared with those born to mothers who had been diagnosed with depression but not given an SSRI and those born to moms without depression. SSRI group infants also had a significant increase in white matter connections between those two regions, relative to the other groups. The lad researcher noted that while maternal depression (with or without SSRI treatment) was accounted for, the study did not examine other critical factors that could affect fetal development, including a family history of depression.

SOURCE: HealthDay News, April 2018

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 Parkinson's Risk !

                        Just One Concussion Could Raise Parkinson's Risk

If you've ever had a mild concussion, your risk of developing Parkinson's disease goes up by 56 percent, a new study of more than 300,000 U.S. veterans suggests. Upwards of 40 percent of adults have had a traumatic brain injury, so these findings are definitely concerning, said by lead researcher. Findings don't mean everyone who has ever had a concussion is doomed to develop the degenerative neurological disorder that affects coordination of movement. Top researcher pointed out the lifetime risk of Parkinson's is probably about 1 to 2 percent, so a greater than 50 percent increase in that risk isn't as alarming as it sounds. But these findings do lend credence to the idea that some professional athletes have developed Parkinson's disease as a result of their athletic careers. The most famous is probably boxer Muhammad Ali. Previous research has linked TBI and Parkinson's disease, but the new study's design and large size makes it among the most definitive. The lead researcher said it's possible that traumatic brain injuries could cause abnormal proteins to accumulate in the brain. It's also possible that a brain injury might make the brain less resilient to aging. Head injury might cause damage to dopamine-producing cells. The new study identified more than 325,000 veterans from three U.S. Veterans Health Administration databases. Half of this group had experienced a traumatic brain injury at some point in their lives. The TBIs were mild, moderate or severe. The other half of participants had never had a TBI. Some of their injuries were due to combat, but some were from falls or motor vehicle accidents. Study volunteers were aged 31 to 65, and were followed for up to 12 years. None of the vets had a diagnosis of Parkinson's when the study began. During the study, almost 1,500 were diagnosed with Parkinson's disease. Of those, 949 had previously had a traumatic brain injury. The overall risk of developing Parkinson's in this group was slightly more than a half of 1 percent for those with a traumatic brain injury. For those without brain injuries, the risk of Parkinson's was just under one-third of 1 percent. When the researchers compared those who had brain injuries to those who didn't, and controlled the data for other risk factors -- such as age, sex, race, education and other health conditions -- the overall risk of Parkinson's disease was 71 percent higher for people who had any type of TBI. The risk for those with a mild TBI was 56 percent higher, and for those with moderate to severe TBIs, the risk was 83 percent greater.

SOURCE:  HealthDay News, April 2018

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  Nasal Spray !

                                              Ketamine Nasal Spray Shows Promise Against Depression, Suicide

In a small, early study, a nasal spray containing the club drug ketamine appears to quickly help ease depression and even curb thoughts of suicide. Psychiatrists were cautiously optimistic about the anesthetic's potential for treating the mood disorder. This study only had 68 people enrolled, which is a limitation, so there really needs to be larger-scale studies before being able to confidently recommend ketamine as a first-line choice, said by lead researcher. Longer-term studies also need to be done but still ketamine is certainly an exciting option that holds a lot of promise, especially when traditional medications have failed. Ketamine has a checkered history, and is perhaps best known as the recreational club drug in easing signs of depression. The lead researcher conducted a study involving 68 people diagnosed with major depression. The participants were randomly assigned to receive either a dummy placebo nasal spray, or ketamine in a nasal spray form called esketamine. All of the participants were deemed to have such severe depression that they were at imminent suicide risk. They were already using standard antidepressants and continued to do so throughout the study. The lead researcher tracked the effects of esketamine at four hours after use, 24 hours later and 25 days later. The study was double-blind, meaning that neither the researchers nor the participants knew which people were taking esketamine and which were taking the placebo. At the four-hour and 24-hour mark, there was a significantly greater improvement between 30 and 40 percent reductions in depression scores and a lowering of suicidal thoughts for those taking the esketamine nasal spray. The effect did not last to the 25-day mark, however. Still, the study is proof o concept that intranasal esketamine may be an efficacious treatment for rapid reduction of depressive symptoms, including suicidal ideation in patients assessed to be at imminent risk for suicide. The lead researchers noted that assessments of depression level and suicide risk were made by both the patients and their physicians. Side effects did occur for some participants and included nausea, dizziness, and headache, the lead researcher added.

SOURCE: HealthDay News, April 2018

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 Pancreatic Cancer !

                               Some Blood Pressure Meds Tied to Pancreatic Cancer Risk in Women

Certain drugs prescribed to treat high blood pressure may boost a woman's risk for developing pancreatic cancer after menopause. In a large study of postmenopausal women, those who had ever taken a short-acting calcium channel blocker (CCB) saw their pancreatic cancer risk shoot up by 66 percent. And women who had used a short-acting CCB for three years or more faced more than double the risk for pancreatic cancer, compared with those who had taken other types of blood pressure drugs. This class of drugs includes short-acting nifedipine, nicardipine and diltiazem. The short-acting CCBs were the only blood pressure drugs linked to higher pancreatic cancer risk, according to lead researcher. However, people taking this class of drugs shouldn't panic, because their absolute risk of developing pancreatic cancer still remains very low. According to the U.S. National Cancer Institute, just 1.6 percent of Americans will develop the cancer during their lifetime. That means that even after accounting for a bump up in risk from taking a CCB an individual's odds for the disease remains minimal. Still, the new finding was unexpected. Prior investigations had hinted that CCBs might even protect against pancreatic cancer by boosting levels of a protein (sRAGE) known to keep inflammation in check. Reduced inflammation is typically associated with a lower risk for a range of cancers. The lead researcher noted that short-acting CCBs are the least effective blood pressure drug available. That could mean many of the women in the study had not achieved good blood pressure control to begin with, which could have boosted their risk for diabetes. And diabetes is a known risk factor for pancreatic cancer. Blood samples taken from more than half the pancreatic cancer patients revealed that those who had ever taken a short-acting CCB also had notably lower levels of the sRAGE protein, compared with women who had taken other types of blood pressure drugs. That would mean less inflammation control and, therefore, potentially higher cancer risk. Finally, he hypothesized that women who are prescribed short-acting CCBs might differ in some way from patients prescribed other types of blood pressure control. CCBs tamp down blood pressure by preventing calcium from entering cells in the heart and blood vessel walls, thereby decreasing cardiac stress and workload.

SOURCE: HealthDay News, April 2018

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 Genetic Testing !

                                                         Busting Myths Surrounding Cancer and Genetic Testing

While only 5 percent to 10 percent of cancers are caused by an inherited gene mutation, genetic testing may benefit people with a strong history of family cancer, the lead researcher suggests. This is especially true in families with a history of breast, ovarian, prostate or pancreatic cancers, as well as colon and uterine cancers. Lead researcher said there are many myths about inherited cancers and genetic testing. The first misconception is that a negative test for a BRCA1 or BRCA2 mutation means a person does not have hereditary cancer syndrome. In the general population, about one person in 500 has a BRCA1 or BRCA2 mutation. While these mutations are the most common cause of hereditary breast or ovarian cancer, a negative genetic test does not mean there is no hereditary cancer risk, the lead researcher explained. There are a number of other genes that are associated with hereditary cancer syndromes. Another myth is that having an inherited genetic mutation guarantees a person will develop cancer. While most hereditary cancer syndromes have moderate-to-high risk levels, the risk can be reduced with guided management. Signs of hereditary cancer syndrome include cancers found before age 50 the same type of cancer in three or more members on the same side of the family and one or more family members with multiple cancers. People with rare cancers like medullary thyroid cancer and male breast cancer, or a history of more than 10 colon polyps, may also have hereditary cancer syndrome. Some people think a woman can't get a genetic mutation from her father. Nearly all hereditary cancer syndrome mutations can be passed down by either mother or father. But inherited mutations in these genes increase female carriers' risk of breast and ovarian cancers. Another misconception believes that if you've already had cancer, there's no need to find out whether you have an inherited gene mutation. People with such mutations are at increased risk for multiple cancers over a lifetime, so it's important to know about these mutations.

SOURCE: HealthDay News, April 2018

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 Hope in Progeria !

                                                         New Hope Against Disease That Prematurely Ages Children

Many people at the age of just 10 months, can be diagnosed with the rare and fatal premature aging disease known as progeria. Affecting just 1 in every 20 million people, progeria is driven by a genetic mutation that results in a vast surplus of a protein known as progerin. This surplus triggers rapidly progressive cellular damage, culminating in irreversible heart disease. There is no known cure or treatment. But the lead researchers have some good news. The results of a small study that represents a major breakthrough for clinical investigation in progeria. Originally developed to fight cancer, the drug is known to inhibit the activities of an enzyme that is critical to progerin production. Specifically, the drug blocks the enzyme from hooking up with the progerin protein. In so doing, it stops progerin from attaching itself to the patient's cell membranes, where damage takes place. In the new study, 27 progeria patients were put on a daily two-dose regimen of lonafarnib pills. On average, treatment continued for a little over two years, during which time just one patient died. In the same time frame, 9 of 27 progeria patients not treated with lonafarnib died. Side effects typically occurred during the first few months of treatment, and included diarrhea, nausea and appetite loss. A second group of 36 patients are continuing to take lonafarnib. So far, just four of the total of 63 lonafarnib patients has died, compared with 17 deaths among 63 untreated patients. Lonafarnib is a treatment, not a cure, stressed the lead researcher. But this is the first support we have for a single medication influencing the life spans of the children with progeria. However, the lead researcher said that drug's manufacturer, Merck, provided it for free to the study patients and that foundation intends to advocate for a situation where the patient families would receive the drug at no cost to them. According to the foundation, there are currently 144 registered cases of progeria across 45 countries.

SOURCE: HealthDay News, April 2018

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Efaxim TM
  Generic Name Rifaximin
  Strength 200 mg
  Dosage form Tablet
Therapeutic Category Antidiarrheal
  Product Alice TM
Generic Name




Dosage form Lotion
Therapeutic Category Antilice
  Product Cefopen TM
  Generic Name Cefoperazone Sodium

1 gm

  Dosage form IM/IV Injection
  Therapeutic Category Cephalosporin Antibiotic

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