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VOL.  15     ISSUE:  6  June  2017 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management







Dear Doctor:

Welcome to 'e-SQUARE' !

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This issue features the articles including "Cirrhosis & Stroke !", "Genes Behind IBD !", "Gene Sequencing Alert !", "Superburst !", "'Plaques' & Alzheimer's !", "Brain Stimulation Alert !".

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

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The views expressed in this publication do not necessarily reflect those of its editor or SQUARE PHARMACEUTICALS LTD.

 Cirrhosis & Stroke !

                                                                                           Cirrhosis Could Raise Stroke Risk

Cirrhosis often tied to excessive drinking of alcohol may also raise an older person's odds for a stroke, a new study suggests. In a nationally representative sample of elderly patients with vascular risk factors, cirrhosis was associated with an increased risk of stroke, particularly hemorrhagic stroke, said by lead researcher. Hemorrhagic or "bleeding" stroke comprises about 13 percent of strokes and occurs when a blood vessel ruptures, according to the American Stroke Association. The majority of strokes (87 percent) are ischemic. In the new study, lead researcher tracked 2008-2014 data for more than 1.6 million Medicare patients older than 66. The research showed that while just over 1 percent of people who did not have cirrhosis suffered a stroke during the average year, that number jumped to just over 2 percent for people with the liver disease. The study couldn't prove that the cirrhosis actually caused any of the strokes. According to the authors, possible explanations for the association between cirrhosis and increased stroke risk include impaired clotting ability. Or, patients' heart risk factors may be exacerbated by cirrhosis and the underlying causes of cirrhosis, such as alcohol abuse, hepatitis C infection and metabolic disease, the lead researcher said. In the past, doctors had thought that cirrhosis somehow helped lower a person's risk for clot-linked, ischemic stroke, but the new study dispels that myth.

SOURCE: HealthDay News, June 2017

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 Genes Behind IBD ! 

                                     Scientists Spot Genes Behind Crohn's, Ulcerative Colitis

Researchers say they've come closer to pinpointing genes linked with inflammatory bowel diseases such as Crohn's and ulcerative colitis. For the study, the lead investigator examined the genomes of nearly 68,000 people. Of the regions of the genome associated with inflammatory bowel disease (IBD), 18 could be traced to a single genetic variant with more than 95 percent certainty. They took the biggest ever data set for IBD and applied careful statistics to narrow down to the individual genetic variants involved. "Now we have a clearer picture of which genes do and do not play a role in the disease. We are zooming in on the genetic culprits of IBD," he lead researcher quoted. The findings could lead to improved effectiveness of current treatments for IBD, as well as the discovery of new drug targets. In diseases such as Crohn's and ulcerative colitis, the body's immune system attacks parts of the digestive tract. Symptoms can include abdominal pain, cramping, diarrhea, rectal bleeding and extreme fatigue. The causes of the disease are unclear, and there is currently no cure. For patients with inflammatory bowel disease, medications -- including steroids, immunosuppressants or anti-inflammatory drugs -- are used to slow the progression of the disease. If these aren't effective, surgery may be needed. Inflammatory bowel diseases affect as many as 1.6 million Americans, most of whom are diagnosed before age 35, according to the Crohn's and Colitis Foundation.

SOURCE: HealthDay News, June 2017

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 Gene Sequencing Alert !

Gene Sequencing May Reveal Risks for Rare Diseases

Genome sequencing of healthy people reveals that some are at risk for rare genetic diseases. And doctors need to be sensitive when revealing that information, the lead researchers said. Sequencing healthy individuals will inevitably reveal new findings for that individual, only some of which will have actual health implications. Patients who receive their results are not likely to experience anxiety connected to those results, the lead researcher said. Whole genome sequencing entails analysis of the 3 billion pairs of letters in someone's DNA. Scientists anticipate the technology will usher in a new era of predicting and preventing disease, but how people will react to this personal information is a big question mark. For this study, the top researcher analyzed nearly 5,000 genes associated with rare genetic conditions in 50 healthy people. The investigators found that 11 of the people almost one-quarter had gene variants predicted to cause previously undiagnosed rare disease. Two of those 11 patients had signs or symptoms of the underlying conditions. One had variants linked to an eye disease called fundus albipunctatus, which impairs night vision. The second had a variant associated with variegate porphyria, which explained the patient's mysterious rashes and sun sensitivity. The other nine patients had no evidence of the diseases predicted by the genetic testing. For example, two patients had gene variants associated with heart rhythm abnormalities, but their hearts showed no signs of problems. It's possible, but not certain, that they could develop heart problems in the future, the lead researcher said. As part of the study, the patients' primary care doctors were taught how to interpret a one-page report of their patients' genome testing results. They also had access to genetic specialists for consultation. The doctors then used their own judgment in deciding how to handle their patients' test results. While the findings appear promising, continued research on the outcomes of sequencing will be needed before the routine use of genome sequencing in the primary care of generally healthy adults can be medically justified, the lead researcher said.

SOURCE: HealthDay News, June 2017

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 Superburst !

                                                                          Shifting Weather Can Unleash Pollen 'Superburst'

The changeable weather that many areas of the United States experiences may lead to a pollen "superburst"-and for allergy sufferers that may mean misery, a sinus specialist cautions. About 60 million Americans suffer from pollen allergies. Symptoms can include nasal stuffiness and discharge, headaches, cough, sore throat, swollen glands, hoarseness, bad breath, mouth breathing, chapped lips, decreased sense of smell or taste, facial and dental pain, general fatigue, ear pressure, hearing loss, and dizziness.Allergies left untreated can cause sinus swelling leading to chronic sinusitis. Allergies can also affect your digestive tract. Gastroesophageal reflux disease can be a direct response to the allergic response. So allergies can seriously affect the quality of life. Getting medications into the system during that time will help to protect when the season hits. Remain indoors as much as possible between 10 a.m. and 4 p.m. when pollen counts are highest. Take a shower after being outside to rid of the pollen that may have attached to skin and hair.As soon as get home, take off clothes and wash them immediately. Keep clothes that have been exposed to pollen separate from clean clothes. Keep home's windows and doors closed and use air conditioning whenever possible because it cleans and dries the air. Make sure to change air-conditioning filters often. Consider using an air purifier, especially in the bedroom.

SOURCE: HealthDay News, June 2017

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 'Plaques' & Alzheimer's !

Sticky Brain 'Plaques' Implicated in Alzheimer's Again  

Older adults with evidence of "plaques" in the brain are more likely to see their memory and thinking skills wane over the next few years. The buildup of abnormal proteins in the brain signals an early stage of Alzheimer's disease. It's been known for years that in people with Alzheimer's, the brain accumulates abnormal protein deposits dubbed "plaques" and "tangles." But even people with no outward signs of dementia can have abnormal beta-amyloid levels in the brain. The lead researcher quoted that people with increased beta-amyloid may have a heightened risk of eventually developing Alzheimer's. It's a critical distinction, lead researcher said, because the ultimate hope is to spot people in the earliest stages of Alzheimer's, when it might be possible to prevent or slow the progression. A biomarker is something that can be measured to reliably indicate that a disease is present, even if there are no outward symptoms. The new findings add to evidence that the buildup of beta-amyloid is not a benign process and can instead serve as a biomarker. Researchers are developing a number of experimental drugs aimed at slowing Alzheimer's -- including medications that target beta-amyloid proteins. Overall, the study found, people with elevated beta-amyloid showed a steeper decline in their memory and other mental skills over the next three years.

SOURCE: HealthDay News, June 2017

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 Brain Stimulation Risk !

                                          Electric Brain Stimulation No Better Than Meds For Depression: Study

For people who battle depression and can't find relief, stimulating the brain with electric impulses may help. But a new study by Brazilian researchers says it's still no better than antidepressant medication. In a trial that pitted transcranial, direct-current stimulation against the antidepressant escitalopram, the lead researcher found that lessening of depression was about the same for either treatment. The lead researcher found that antidepressants are better than tDCS and should be the treatment of choice. In circumstances that antidepressant drugs cannot be used, tDCS can be considered, as it was more effective than placebo. The researchers used the Hamilton Depression Rating Scale. This test has a score range of zero to 52, with higher scores indicating more depression. People who received brain stimulation lowered their depression score by 9 points. Those taking Lexapro had depression scores drop by 11 points. Patients receiving placebo experienced a drop of 6 points in their depression score, the lead researchers found. To get a better idea of how well brain stimulation worked for depression, the lead researcher randomly assigned 245 patients suffering from depression to one of four groups. One group had brain stimulation plus a placebo pill, another had fake brain stimulation plus Lexapro. The third group had brain stimulation plus Lexapro, and the final group had fake brain stimulation plus a placebo. Brain stimulation involved wearing sponge-covered electrodes on the head. The treatment was given for 15 consecutive days at 30 minutes each, then once a week for seven weeks. Lexapro was taken daily for three weeks, after which the daily dose was increased from 10 milligrams (mg) to 20 mg for the next seven weeks. After 10 weeks, patients receiving brain stimulation fared no better than those taking Lexapro. Patients receiving brain stimulation, however, suffered from more side effects, the lead researcher found. Specifically, patients receiving brain stimulation had higher rates of skin redness, ringing in the ears and nervousness than those receiving fake brain stimulation. In addition, two patients receiving brain stimulation developed new cases of mania. That condition can include elevated mood, inflated self-esteem, decreased need for sleep, racing thoughts, difficulty maintaining attention and excessive involvement in pleasurable activities. Patients taking Lexapro reported more frequent sleepiness and constipation.

SOURCE: HealthDay News, June 2017

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New Products of SQUARE Pharmaceuticals Ltd.

  Product CholenakTM IV Infusion 500 ml
Generic Name Sodium Chloride 0.5% w/v, Potassium Chloride 0.1% w/v and Sodium Acetate 0.393% w/v
  Strength 500 ml
  Dosage form Pareteral
  Therapeutic Category Standard Electrolyte Solution
  Product RivaxaTM 10 Tablet
Generic Name



10 mg

Dosage form Tablet
Therapeutic Category Anticoagulant
  Product Prolert Oral Soluton
  Generic Name Fluoxetine HCl
  Strength 50 ml
  Dosage form Oral Solution
  Therapeutic Category Antidepressants  

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