Healthcare online Keeping you up-to-date
VOL. 12     ISSUE:  July 2014 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 features like

"C- Section Risk !", "Inactivity & Obesity !", "New Hope !", "Steroid & Back Pain !", "Vasectomy Risk !", "Dengue Fever Vaccine !".

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

Please send us your feedback !

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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.

 C- Section Risk !

C-Section May Raise Odds Of Failed Pregnancy Later : Study

A new study finds that a cesarean delivery might put women at a slightly increased risk for ectopic pregnancy and stillbirth in future pregnancies. However, the risk for either complication is still very low. The researchers analyzed data from nearly 833,000 first-time mothers in Denmark. Those whose baby was delivered by cesarean section had a 14 percent higher rate of stillbirth and were 9 percent more likely to have a future ectopic pregnancy in their next pregnancy than those who had a vaginal delivery. That works out to an absolute risk increase of 0.03 percent and 0.1 percent respectively. That means that for every 3,000 cesarean deliveries, there would be one extra stillbirth and for every 1,000 cesarean deliveries, there would be one extra ectopic pregnancy in subsequent pregnancies. The study author said, “The findings of the current study are particularly important for expectant mothers as well as health care professionals as cesarean section rates are increasing significantly worldwide.” While the study finds an association between C-sections and failed pregnancies, it does not prove a direct cause-and-effect relationship.

SOURCE: HealthDay News, July 2014

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 Inactivity & Obesity !

Inactivity May Be Main Culprit In Obesity Epidemic: Study

Lack of exercise -- and not a tendency to eat too much -- may explain why an increasing number of Americans are obese, a new study suggests. Researchers analyzed U.S. government data from the last 20 years and found that the number of women who reported no physical activity rose from about 19 percent in 1994 to nearly 52 percent in 2010. The number of men who said they didn't exercise increased from about 11 percent to about 43 percent. Black and Mexican-American women showed the greatest decreases in reported exercise, the study authors found. During the study period, there was an increase in adults' average body mass index (BMI), an estimate of body fat based on height and weight, with the most dramatic rise among women aged 18 to 39. The researchers also found increased rates of abdominal obesity, especially among women. At the same time, calorie intake among adults remained steady during the study period, according to the findings reported recently in the American Journal of Medicine. While the investigators found an association between inactivity and the obesity epidemic, the study did not prove a cause-and-effect relationship. "Our findings do not support the popular notion that the increase of obesity in the United States can be attributed primarily to sustained increase over time in the average daily caloric intake of Americans," lead investigator said. "Although the overall trends in obesity in the United States are well appreciated and obesity prevalence may be stabilizing, our analyses highlight troublesome trends in younger adults, in women, and in abdominal obesity prevalence, as well as persistent racial/ethnic disparities," lead investigator added. 

SOURCE: HealthDay News, July 2014

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 New Hope !

Breast Cancer Drug May Help Women Fight A Leading Cause Of Infertility: Study

A new study suggests women with PCOS (polycystic ovary syndrome) have a better chance of getting pregnant if they take a breast cancer drug instead of the currently preferred medication. PCOS affects 5 to 10 percent of reproductive-age women, according to background information in the study. Currently, typical prescription to boost fertility for women with PCOS is Clomiphene. However, this new study suggests the drug Letrozole results in better ovulation, conception and birth rates. "We found a simple and comparatively safe and vastly more effective treatment for polycystic ovary syndrome," said the lead researcher. Clomiphene, which works by stimulating ovulation, has been the standard treatment for years, but has a high rate of multiple births. Letrozole, a treatment for breast cancer in postmenopausal women, works by blocking estrogen production, tricking the ovaries into producing more of the hormone. Researchers found that almost 28% of the women taking Letrozole had babies after 5 cycles, compared with about 19% of those taking Clomiphene. Also, women taking Letrozole had fewer twin pregnancies, compared with those taking Clomiphene - about 3% versus 7%, the study found. "Clomiphene may be trumped," the researcher said. "To see a 40% improvement in birth rate is a huge difference." For the study, his team randomly assigned 750 women with PCOS to take Clomiphene or Letrozole. The drugs were given in five menstrual cycles with the dosage increased with each cycle. The overall ovulation rate was higher with Letrozole than with clomiphene – 62% compared to 48%. Clomiphene was associated with hot flashes, while some women using Letrozole reported fatigue and dizziness. For both drugs, birth defects were rare and rates were similar. “They were comparable with those seen in studies of women who conceive without treatment,” he claimed. “Whether Letrozole will cause more birth defects than other drug is not known,” the lead researcher stated, "we will need other studies to show that the rates of birth defects are actually low - lower than we would expect in an infertile population." Letrozole is relatively inexpensive, similar to the cost of clomiphene, so an affordable form of infertility treatment.

SOURCE: HealthDay News, July 2014

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 Steroid & Back Pain !

                                                                                            Steroid Shots May Not Help Back Pain

People who have lower back pain caused by spinal stenosis -- a condition that narrows the open space in the spinal canal -- are unlikely to get relief from steroid shots, a new study finds. "Steroid injections are a common treatment for spinal stenosis, and we were surprised by the finding," said lead author. "These steroid injections aren't helpful," she said. "There is no added benefit to the steroid itself, so if people are considering these injections, I would recommend that they consider an alternative." Spinal stenosis causes pain by putting pressure on the spinal nerves. The condition is common in men and women over 60, according to the American Academy of Orthopaedic Surgeons. Spinal stenosis is often treated with injections of local anesthetics plus steroids. More than 2 million of these injections are done each year among people on Medicare. Steroid injections are believed to relieve pain by reducing swelling and inflammation around the compressed spinal nerves, the researchers said. Alternative treatments include exercise and surgery, she added. For the study, lead author and colleagues randomly assigned 400 people with back and leg pain caused by spinal stenosis to injections of either a local anesthetic (lidocaine) alone or in combination with steroids. The drugs were injected into the outermost space of the spinal canal. Symptoms improved initially in both groups, the researchers found. Three weeks after the injections, those who received the steroid said they had slightly less leg pain and slightly better function. At six weeks, however, there were no significant differences between the two groups in either pain or function, her team found. Most people who got the steroid injection said they were satisfied with their treatment -- 67 percent said they were "very" or "somewhat" satisfied, compared with 54 percent of those given lidocaine alone. Those given the steroid also showed improvement in symptoms of depression, the researchers added. Lead author thinks the increased satisfaction reported may be due to early benefit seen in the first three weeks. Steroids are also known to improve mood and reduce fatigue. These effects may have contributed to feelings of satisfaction. People given steroids, however, had lower levels of the hormone cortisol, a steroid made by the body. That suggests the whole body was using the steroid from the injection. The side effects of steroids include reduced bone mineral density, increased risk of bone fractures and weakening of the immune system. The researchers found that people who got steroid injections did see some pain relief over four years. But they did not fare as well as folks who went with other conservative treatments or with surgery right away. And if people who got steroids eventually opted for surgery, they did not improve as much as people who had surgery, but who hadn't had steroid shots.

SOURCE: HealthDay News, July 2014

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 Vasectomy Risk !

 Study Links Vasectomy To Aggressive Prostate Cancer

Men who have a vasectomy may be at increased risk for aggressive prostate cancer, a new study suggests. But the risk is comparatively small, the researchers acknowledged. And several urologists not involved with the study said more research is needed to determine if the study findings are truly accurate. For the study, Harvard researchers analyzed data from more than 49,400 American men who were followed for 24 years, starting in 1986. During that time, 6,023 cases of prostate cancer were diagnosed among the men, including 811 fatal cases. The 25 percent of the men in the study who'd had a vasectomy had a 10 percent increased risk of developing prostate cancer, according to the study. Vasectomy was not linked with an increased risk of low-grade prostate cancer. But it was associated with a 20 percent higher risk of advanced prostate cancer and a 19 percent greater risk of fatal prostate cancer, respectively, the study authors said. Even among men who had regular prostate-specific antigen (PSA) screening tests for prostate cancer, those who had a vasectomy were 56 percent more likely to develop fatal prostate cancer. This link was strongest among men who had a vasectomy at a younger age. However, the absolute risk of developing deadly prostate cancer was small, the study authors noted -- 16 of every 1,000 men. "This study follows our initial publication on vasectomy and prostate cancer in 1993, with 19 additional years of follow-up and tenfold greater number of cases. The results support the hypothesis that vasectomy is associated with an increased risk of advanced or lethal prostate cancer," study co-author said. About 15 percent of men in the United States have a vasectomy. Prostate cancer is the second leading cause of death among American men, although most men diagnosed with the disease don't die from it. "The decision to opt for a vasectomy as a form of birth control is a highly personal one and a man should discuss the risks and benefits with his physician," study co-author said. The Harvard researchers said they were able to compensate for factors such as more frequent visits to doctors before reaching their conclusions.

SOURCE: HealthDay News, July 2014

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 Dengue Fever Vaccine !

Dengue Fever Vaccine Shows Some Promise In Trial

A potential vaccine to protect children from the worldwide scourge of dengue fever was somewhat successful in a trial among Asian children. While the vaccine only prevented dengue fever in 56 percent of the 10,000 kids who got the full series of three shots, it protected more than 88 percent of them from severe disease. In the worst-case scenarios, dengue fever can lead to hospitalization, and sometimes death. "This vaccine has already proven to be safe," said an epidemiologist in the dengue branch of the U.S. Centers for Disease Control and Prevention, who had no role in the trial. "We know that this vaccine does not lead to a risk of developing severe dengue -- that is a huge step forward." However, "the 56 percent is not as high as we would like to see it. It's still a big step forward, but we have a way to go before we get a vaccine that is both safe and as efficacious as we would need it to be," epidemiologist added. The trial focused on children aged 2 to 14. They were randomly assigned to receive three injections of the CYD-TDV vaccine or a placebo vaccine. After the first vaccination, the second was given six months later and the third six months after that. The children were followed for up to two years. More than 28 days after the third vaccination, 117 children who received the vaccine developed dengue, compared with 133 who were given placebo. That works out to a vaccine effectiveness rate of 56.5 percent, the researchers noted. In addition, after three doses, the vaccine was 88.5 percent effective against severe disease, which often leads to hospitalization for over 500,000 people -- mostly children -- every year. "One of the difficulties in making a dengue vaccine is that you have to cover for four different viruses at the same time," epidemiologist explained. "If you are not able to do that, you risk increasing the chances of developing severe dengue." The vaccine wasn't equally effective against all four dengue viruses. It was only 35 percent effective against type 2, more than 75 percent effective against types 3 and 4, and 50 percent effective against type 1. The vaccine was well tolerated, the researchers reported. A total of 402 serious adverse events were reported in the vaccine group and 245 were reported in the placebo group.

SOURCE: HealthDay News, July 2014

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Nebita®
  Generic Name Nebivolol
  Strength 2.5 mg
  Dosage form Tablet
  Therapeutic Category Antihypertensive
  Product Mirakof®  
Generic Name Butamirate Citrate
Strength 7.5 mg/5ml
Dosage form Syrup
Therapeutic Category Antitussive
  Product Linita®
  Generic Name Linagliptin
  Strength 5 mg
  Dosage form Tablet
  Therapeutic Category Antidiabetic

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