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VOL.  11     ISSUE:  3    March 2013 Medical Services Department

SQUARE Pharmaceuticals Ltd.


Dear Doctor:

Welcome to this edition of "e- SQUARE" healthcare bulletin !

This issue features a variety of articles including "Aspirin & Melanoma !", "B Vitamins & Schizophrenia !", "Brain 'Pacemaker' !", "'Chemo Bath' !", "Secondhand Smoke Risk !", "Tooth Loss Risk !".

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

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 Aspirin & Melanoma !

Study Found Up To 30 Percent Reduced Odds Of Developing Melanoma

Older women who take an aspirin regularly may be lowering their risk of developing the deadly skin cancer melanoma, a new study suggests. And the longer postmenopausal women take aspirin, the more melanoma risk appears to diminish. The effect is only seen with aspirin, not with other pain relievers such as acetaminophen, the researchers noted. For the study, the research team collected data on nearly 60,000 white women who were part of the Women's Health Initiative, a long-term national study. The women, aged between 50 and 79, were asked about what medications they took and other lifestyle preferences. Over 12 years of follow-up, the investigators found that women who took aspirin had a 21 percent lower risk of developing melanoma compared to women who didn't take aspirin. But it's too soon to make firm conclusions, a researcher cautioned. "Aspirin could be potentially used to prevent melanoma, but a clinical trial is needed," said lead author. This type of population-based study can only show an association between aspirin and the reduced risk for melanoma, not that aspirin actually helps prevent it. It is possible that aspirin's anti-inflammatory properties might be responsible for lowering the risk of melanoma, the author suggested. "Aspirin may also promote cell death of melanoma cells," she added. The study found that women who took aspirin for at least five years had their melanoma risk drop by 30 percent, compared to women who didn't take aspirin.

SOURCE: HealthDay News, March 2013 

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 B Vitamins & Schizophrenia !

B Vitamins Might Help Some With Schizophrenia

Possessing one or another version of a gene key to metabolizing the B vitamin folate may make a big difference in who responds to vitamin supplements intended to treat negative symptoms of schizophrenia, according to a new study. Researchers tracked 140 people with schizophrenia for 16 weeks and found that those with the so-called high-functioning FOLH1 gene variant had a greater response to folic acid and B12 supplements, compared to those with the low-functioning FOLH1 variant. "That's a gene that actually controls the digestion of folate (or folic acid) into the bloodstream," said the study's lead author. Folate, one of the B vitamins, is used in the manufacturing of neurotransmitters, which send signals throughout the brain and body, and it's found in leafy vegetables, citrus fruits, beans and fortified grain products. Since the 1960s, folate deficiencies have been tied to the development of schizophrenia, and researchers have observed spikes in cases of the mental disorder after famines in China and the Netherlands, for example. But this new study, researcher said, is the first to look at the effects of folate supplements in a large population of people with the condition - at several medical centers in Massachusetts, New York and Michigan. The researchers, who published their findings in JAMA Psychiatry, were targeting so-called negative symptoms in schizophrenia patients, which include apathy, withdrawal and an inability to display emotion. Those are less severe than the more well-know symptoms of schizophrenia - including hallucinations, delusions and paranoia - but still lead to significant impairment, because they are unaffected by traditional antipsychotic drugs, experts said. For the new study, the researchers recruited 140 schizophrenia patients and randomly assigned them into two groups. One group received 2 milligrams of folic acid and 400 micrograms of vitamin B12, which increases folic acid's effect, per day for 16 weeks. The other group took placebo pills for comparison, but all patients also continued their normal medications. At the beginning, each group scored in the mid-30s on a scale that measures the severity of their negative symptoms from 0 to 100 - with higher scores being more severe. Researcher  said the participants all had moderate to severe symptoms. Overall, those taking the supplements improved on the scale after the 16 weeks, but it wasn't until the researchers looked at each person's FOLH1 gene type that they identified who benefited the most. Specifically, those with the high-functioning version of the FOLH1gene seemed to be able to process the supplements best, and saw their negative symptom score drop by about 5 points, compared to no significant change in the placebo group members with high-functioning FOLH1 genes. Folate levels in people with the low-functioning variant who took the supplements eventually caught up to those with the high-functioning variant, according to the study. And those participants might have improved on the symptom scale if the study had gone longer than 16 weeks.

SOURCE: Reuters Health, March 2013

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 Brain 'Pacemaker' !

Deep Brain Stimulation Helped Women Regain Weight, Curb Problem Behaviors

People suffering from severe, tough-to-treat anorexia, having a biological "pacemaker" implanted in their brain may help ease the disorder, a new study suggests. The researchers noted that anorexia is the psychiatric disorder with the highest mortality rate and, although therapies exist, not everyone benefits in the long term. The disorder is among the most common psychiatric ills diagnosed among teenage women. Up to 20 percent of patients do not respond to available treatments, which usually focus on behavioral change. The new study examined the effectiveness of an approach called deep brain stimulation (DBS), sometimes called a brain pacemaker. The procedure requires surgery, but is minimally invasive and reversible, the researchers said. The authors of the new study said the treatment could be effective for people with anorexia who fail to respond to other forms of treatment. In this pilot study, involving six female patients, at least half of the women with anorexia -- who did not respond to other forms of treatment -- showed improvements in both their mood and their body-mass index . The women were between 24 and 57 years old and had suffered from anorexia for between four and 37 years. Using MRI, researchers based at the Krembil Neuroscience Centre and University Health Network in Canada, identified a thick bundle of nerve fibers that divides the left and right sides of the brain. Electrodes were then implanted into the area and connected to a pulse generator placed under the women's skin. Ten days after the device was implanted, the researchers activated it and recorded any changes in the patients' mood and anxiety levels, compulsive behavior and eating patterns. The study found that the procedure was safe. Only one patient experienced a serious adverse reaction, which was related to a metabolic disorder resulting from her anorexia. Three months after the DBS procedure, however, this pattern began to reverse. The researchers found that five of the six women were either maintaining or gaining weight. Nine months later, three of the patients had a higher weight than before treatment began. Half of the patients also experienced better moods and less compulsive behavior.

SOURCE: HealthDay News, March 2013 

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 'Chemo Bath' !

Women Who Received 'Intraperitoneal' Treatment Lived About A Year Longer

Women with advanced ovarian cancer who receive intense chemotherapy directly into their stomach area may live at least one year longer than women who receive standard intravenous chemotherapy, a new study says. But this survival edge may come at the expense of more side effects. "The long-term benefits are pretty significant," said study author . "There is no study of ovarian cancer treatments that has shown a greater survival advantage. "Intraperitoneal chemotherapy involves bathing the abdominal area with chemotherapy agents. By contrast, intravenous (IV) chemotherapy is delivered throughout the body via the bloodstream. The U.S. National Cancer Institute currently recommends intraperitoneal therapy for women with ovarian cancer who have had successful surgery to remove the tumor. In 2013, more than 22,000 American women will be diagnosed with ovarian cancer, and more than 14,000 will die from the disease, according to the U.S. National Cancer Institute. There are no early screening tests for ovarian cancer, which is why it is often diagnosed when the cancer has already spread outside of the ovaries. For this reason, survival rates tend to be very low. In the new study, women who received the intraperitoneal treatment were 17 percent more likely to survive longer than those who got IV chemotherapy. On average, women in the intraperitoneal group survived for more than five years, while those who received IV chemotherapy survived for about four years, the study found. But survival benefits aside, intraperitoneal chemotherapy does confer a greater risk of side effects -- such as abdominal pain and numbness in the hands and feet -- and not all women can tolerate this high concentration of cancer-killing drugs. The drugs are also absorbed more slowly, providing more exposure to the medicine. The same properties that make the intraperitoneal therapy more effective likely play a role in causing more side effects, the researchers said. 

SOURCE: HealthDay News, March 2013

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 Secondhand Smoke Risk !

The Greater The Exposure, The Higher The Odds Of Calcium Build Up In Coronary Arteries

 The more you're exposed to secondhand tobacco smoke, the more likely you are to develop early signs of heart disease, a new study indicates. The findings suggest that exposure to secondhand smoke may be more dangerous than previously thought, according to the researchers. For the study, the investigators looked at nearly 3,100 healthy people, aged 40 to 80, who had never smoked and found that 26 percent of those exposed to varying levels of secondhand smoke -- as an adult or child, at work or at home -- had signs of coronary artery calcification, compared to 18.5 percent of the general population. Those who reported higher levels of secondhand smoke exposure had the greatest evidence of calcification, a build-up of calcium in the artery walls. After taking other heart risk factors into account, the researchers concluded that people exposed to low, moderate or high levels of secondhand smoke were 50, 60 and 90 percent, respectively, more likely to have evidence of calcification than those who had minimal exposure. The health effects of secondhand smoke on coronary artery calcification remained whether the exposure was during childhood or adulthood, the results showed. "This research provides additional evidence that secondhand smoke is harmful and may be even more dangerous than we previously thought," study author said. "We actually found the risk of secondhand smoke exposure to be an equivalent or stronger risk factor for coronary artery calcification than other well-established ones such as high cholesterol, hypertension and diabetes. Passive exposure to smoke seems to independently predict both the likelihood and extent of calcification," he added. The findings provide yet more evidence of the need for enforceable public smoking bans and other measures to protect people from secondhand smoke, he said. "Tobacco smoke can damage the coronary arteries of nonsmokers through many different ways, which can lead to plaque formation and then to heart attacks, so this lends more credence to enforcing smoking bans," the author says. To aid prevention of heart disease, discussion of secondhand smoke exposure should be included as a routine part of medical exams, he suggested. 

SOURCE: Health Day News, March 2013

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 Tooth Loss Risk !

Reason For Link Between Teeth, Gums And Heart Health Is Still Unclear

For adults, losing teeth is bad enough, but tooth loss is also associated with several risk factors for heart disease, a large international study suggests. These heart disease-related risk factors include diabetes, obesity, high blood pressure and smoking. For the study, researchers analyzed data from nearly 16,000 people in 39 countries who provided information about their remaining number of teeth and the frequency of gum bleeds. About 40 percent of the participants had fewer than 15 teeth and 16 percent had no teeth, while 25 percent reported gum bleeds. For every decrease in the number of teeth, there was an increase in the levels of a harmful enzyme that promotes inflammation and hardening of the arteries. The study authors also noted that along with fewer teeth came increases in other heart disease risk markers, including "bad" LDL cholesterol levels and higher blood sugar, blood pressure and waist size. People with fewer teeth were also more likely to have diabetes, with the risk increasing 11 percent for every significant decrease in the number of teeth, the investigators found. Being a current or former smoker was also linked to tooth loss, according to the study. Gum bleeds were associated with higher levels of bad cholesterol and blood pressure. The researchers added that it is still unclear what is behind the association between tooth loss, gum health and heart health.

SOURCE: Health Day News, March 2013

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Ranolin XR
  Generic Name Ranolazine
  Strength 500 mg, 1 gm
  Dosage form Tablet
  Therapeutic Category Antianginal
  Product Tazocil
Generic Name

Piperacillin +Tazobactam


4.5 (Piperacillin 4 gm + Tazobactam 0.5 gm)

Dosage form IV Injection
Therapeutic Category Penicillin
  Product Pivalo2
  Generic Name Pitavastatin
  Strength 2 mg
  Dosage form Tablet
  Therapeutic Category Lipid Lowering Agent

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