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VOL.  12     ISSUE:  2  February   2014 Medical Services Department

SQUARE Pharmaceuticals Ltd.


Dear Doctor:

Welcome to 'e-SQUARE' .

Our current issue focused on some interesting features like

"'Fat Hormone' Risk !", "HIV Infection Higher !", "Iron Deficiency Alert !", "Lymph Node Test !", "Video Game Helps !", "Weight Loss & Sleep Apnea !".

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.

 'Fat Hormone' Risk !

'Fat Hormone' Tied to Higher Colon Cancer Risk in Obese Men

Obesity seems to increase the likelihood for developing precancerous growths called colorectal polyps, according to new research that offers fresh insight into colon cancer risk. Specifically, the study links polyp risk to several key characteristics of obesity, including having elevated levels of the fat hormone leptin, having a higher body mass index (BMI) and having a larger waistline. BMI is a measurement of body fat taking height and weight into account. However, investigators stressed that the current findings are not, as yet, definitive, and should not lead to any immediate revisions of current colorectal screening recommendations. Co-author said the study "cannot assume any cause, only association." In order to change the recommendations, which right now advise men to get screened starting at the age of 50, we'd have to find out if obese men are more likely to develop these polyps at an earlier age than their lean counterparts," she explained. "But we can't yet say that," she said. "For the moment, all we can say for sure is that obese men in this particular population were more likely to have polyps. We will need larger studies following a more generalized population over time to learn about timing." To explore a potential link between obesity and colon cancer risk, between mid-2009 and early 2011 the authors focused on 126 seemingly healthy men aged 48 to 65, all of whom were Michigan residents. All the men underwent colonoscopies. In addition, the team noted BMI scores, waist measurements and leptin levels for all participants. Roughly four in 10 of the men were found to be obese (with a BMI of 30 and up), with 78 percent falling into the category of either obese or overweight. And when focusing on the overweight/obese group, the team found that 30 percent had more than one polyp. After cross-referencing overall results, the investigators determined that men who were obese faced a 6.5 times greater risk for having three or more colorectal polyps than those who were lean (with a BMI under 25). Obese men were also found to face an almost eight times greater risk than lean men for having at least one polyp, as opposed to none. What's more, polyp risk seemed to rise incrementally with body fat status. Specifically, polyp risk was seen to rise by a factor of nearly three when lean men were compared to overweight men. And risk went up again by the same amount when comparing overweight men to obese men. Importantly, the team also found that having higher levels of the fat hormone leptin was similarly associated with having a higher risk for developing polyps. Co-author said that her previous work has already uncovered evidence for how the obesity-colon cancer connection might function. "We found that precancer cells, find in a polyp, are very sensitive to leptin," she said. "And leptin increases with fat cell size and number. So in a laboratory setting and with animals we've seen that leptin makes these early cancer cells grow," she explained. "So while we can't yet add obesity to the risk profile for colon cancer, we do think we understand the mechanism behind this," she noted. "And if this is confirmed in a larger population it could lead to a change in screening protocols."

SOURCE: HealthDay News, February 2014

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 HIV Infection Higher !

Higher HIV Infection Rates Seen in Mental Health Patients: Study

Americans seeking treatment for mental health disorders may be four to 16 times more likely to be infected with HIV than those in the general population, a new study reveals. The findings emphasize the need to provide testing for HIV -- the virus that causes AIDS -- in mental health care facilities, the researchers said. The study authors provided HIV testing to more than 1,000 people in Philadelphia and Baltimore who sought treatment for mental health problems such as depression, psychosis and substance abuse from January 2009 to August 2011. About 4.8 percent of these patients were infected with HIV. That's 16 times higher than the rate of 0.3 percent in the overall U.S. population, and about four times higher than the rates of 1.4 percent in Philadelphia and 1.3 percent in Baltimore. Both cities are HIV epicenters, the researchers noted. Thirteen of the 51 mental health patients found to have HIV did not know they were infected, according to the study. The findings showed that HIV infection was more common among people with more severe symptoms of mental illness and among groups of people most likely to be infected in the general population, including blacks, gay or bisexual men, and those with hepatitis C, which often indicates past injection drug use. "These findings paint a recent picture of HIV infection rates in the community, and reinforce how important it is to identify patients and get them into appropriate infectious disease care in a timely manner while being treated for mental illness," study lead author said. "With such a high-risk group, it's imperative to be routinely testing patients to improve care and reduce transmissions to others. Historically, though, HIV testing is often not implemented in mental health care," lead author added.

SOURCE: HealthDay News, February 2014

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 Iron Deficiency Alert !

Iron Deficiency May Raise Stroke Risk

Low iron levels can raise risk of stroke by making blood more sticky, a new study indicates. Investigators looked at data from nearly 500 people with a rare hereditary disease that causes them to have enlarged blood vessels in the lungs. Typically, blood vessels in the lungs don't allow clots to enter the arteries. But in these patients, clots can escape the lungs, travel to the brain and cause a stroke. Those who had an iron deficiency had stickier platelets -- which are small blood cells that trigger clotting when they stick together -- and were more likely to suffer a stroke, according to the researchers. Even those with moderately low iron levels were about twice as likely to suffer a stroke as those with iron levels in the middle of the normal range, according to the study. The researchers noted that many people have other types of conditions that let blood clots bypass the lung's filtering system, and they added that their findings could eventually help with stroke prevention. Iron deficiency affects about 2 billion people worldwide, and recent research has shown that it may be a risk factor for stroke, but how iron deficiency could boost stroke risk was unknown. "Since platelets in the blood stick together more if iron is short, we think this may explain why being short of iron can lead to strokes, though much more research will be needed to prove this link," researcher said. "The next step is to test whether we can reduce high-risk patients' chances of having a stroke by treating their iron deficiency. We will be able to look at whether their platelets become less sticky," she said. "There are many additional steps from a clot blocking a blood vessel to the final stroke developing, so it is still unclear just how important sticky platelets are to the overall process," she added. "We would certainly encourage more studies to investigate this link."

SOURCE: HealthDay News, February 2014

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 Lymph Node Test !

Lymph Node Test a Good Strategy for Melanoma: Study

Testing a key lymph node in patients with the most dangerous form of skin cancer is the best approach to determine if the cancer has spread, new late-stage clinical research indicates. The test could significantly improve survival among those whose affected lymph nodes are then removed, the researchers said. Culminating nearly two decades of international research, the study provides the first long-term evidence affirming the value of a procedure known as "sentinel node biopsy" for intermediate and thick melanoma lesions, the study authors said. The study compared melanoma patients during a 10-year period. Among people with intermediate-thickness lesions, those whose lymph nodes were removed after their sentinel node biopsy tested positive for cancer were 44 percent more likely to survive their melanoma, said study author. The other "watchful waiting" group of patients didn't have their nodes removed until the disease was later found to have spread. "It makes sense: Those who were not treated up front had their melanoma spread from the sentinel lymph node to other lymph nodes in the area, [which can facilitate] a spread throughout the body," study author said. "This study provides concrete evidence that everything we had assumed about the sentinel node procedure ... and lymph node treatment is true." Initiated in 1994, the study randomly assigned about 2,000 patients with melanoma to two groups. The observation group had their lesion removed and their lymph nodes observed for recurrence, at which time they were removed. The biopsy group underwent lesion removal and a sentinel node biopsy, with immediate lymph node removal for patients whose cancer had spread to the sentinel node. In melanoma, a sentinel node biopsy removes the lymph node nearest a lesion and tests it for evidence of cancer. If the sentinel node is unaffected, the cancer is highly unlikely to have spread to surrounding lymph nodes or distant sites in the body. The biopsy procedure is also used in other malignancies, particularly breast cancer. In the new study's biopsy group, sentinel node results were the most important predictor for 10-year survival of melanoma among patients with lesions considered intermediate or thick. Disease-free survival rates over 10 years were significantly better in the biopsy group among patients with intermediate melanoma (about 71 percent compared with 65 percent) and thick melanoma (nearly 51 percent versus about 41 percent).

SOURCE: HealthDay News, February 2014

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 Video Game Helps !

Video Games Might Help People With Dyslexia Learn to Read, Study Suggests

Video games might help people with dyslexia improve their ability to read, a new study suggests. Dyslexia, which affects between 5 percent and 10 percent of people, is a learning disorder that causes problems with reading and writing. Standard methods of reading instruction might be counterproductive for people with dyslexia, according to the study. The researchers tested people with dyslexia and discovered that they have difficulty managing competing sights and sounds. "Imagine you are having a conversation with someone when suddenly you hear your name uttered behind you," study author said. "Your attention shifts from the person you are talking to -- the visual -- to the sound behind you," she said. "This is an example of a cross-sensory shift of attention. We found that shifting attention from visual to auditory stimuli is particularly difficult for people who have dyslexia compared to good readers." Study author and her colleagues said programs to help people with dyslexia might need to take these findings into account. In traditional approaches to reading, letters are first seen and then heard, they said. "We think that people with dyslexia might learn associations between letters and their sounds faster if they first hear the sound and then see the corresponding letter or word," she said. The researchers also suggested that video games might prove useful in helping people with dyslexia improve their reading and writing skills. "We propose that training people with dyslexia to shift attention quickly from visual to auditory stimuli and back -- such as with a video game, where attention is constantly shifting focus -- might also improve literacy," study author said. "Action video games have been shown to improve multitasking skills and might also be beneficial in improving the speed with which people with dyslexia shift attention from one task, or sense, to another," she said.

SOURCE: HealthDay News, February 2014

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 Weight Loss & Sleep Apnea !

A Little Weight Loss May Ease Sleep Apnea

A small amount of weight loss might help combat sleep apnea, a new study suggests. Finnish researchers said losing as little as 5 percent of body weight seems to lead to significant improvement in the condition -- in which breathing pauses frequently while people are asleep, resulting in disrupted sleep and daytime fatigue. "Being overweight is considered the most important risk factor for obstructive sleep apnea," said lead researcher Dr. Henri Tuomilehto, an adjunct professor at the University of Eastern Finland's Oivauni Sleep Clinic, in Kuopio. Being moderately overweight increases the risk for obstructive sleep apnea by 10 times, he added. "It has been estimated that around 70 percent of all patients with obstructive sleep apnea are obese," he said. Based on this and other studies, lead vresearcher said, a weight-reduction program with lifestyle counseling should be a part of the routine treatment for all obstructive sleep apnea patients who are obese. "We believe it represents the first-line treatment in the early phases of the disease and has a good chance of curing the disease or at least preventing the progression," he said. For the study, his team randomly assigned 57 moderately obese people with mild sleep apnea to a yearlong supervised program of diet and exercise designed to get them to lose weight. Others in the study were given general information on diet and exercise. During four years of follow-up, those who lost at least 5 percent of their body weight (an average of 11 pounds) saw dramatic improvement in their sleep apnea, the researchers found. Those who maintained their weight loss saw an 80 percent reduction in progression of their condition, compared to those who didn't lose weight. He said many people who suffer from the condition don't know they have it. "Obstructive sleep apnea is a highly prevalent disease and untreated it is a major burden for our health care systems," he said. "Unfortunately, 80 percent to 90 percent of those with obstructive sleep apnea are undiagnosed and do not know or even suspect that they have it." "If daytime performance and vitality is not what you would expect, do not blame your age first," he said. "Suspect something else, such as obstructive sleep apnea, until proven otherwise."

SOURCE: HealthDay News, February 2014

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Iprex HFA Inhaler
  Generic Name Ipratropium Bromide
  Strength 20mcg/puff
  Dosage form MDI
Therapeutic Category Antiasthma
  Product Locular Plus Eye Drop 
Generic Name

Brimonidine Tartrate + Timolol



Dosage form Eye Drops
Therapeutic Category Antiglaucoma
  Product Olistat
  Generic Name Orlistat
  Strength 120 mg
  Dosage form Capsule
  Therapeutic Category Antiobesity

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