Healthcare online Keeping you up-to-date
VOL.  12     ISSUE:  3  March    2014 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management





Dear Doctor:

Welcome to "e- SQUARE" !

This issue features a variety of articles including "Aspirin & Heart !", "Autism Linked Pregnancy !", "Childbirth Alert !", "Drug & Cancer !", "Surgery & Diabetes !", "Vit-D & CAD !".

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

We welcome your feedback regarding "e-SQUARE" ! 

We always value 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.

 Aspirin & Heart !

Aspirin May Not Protect Heart After Non-Cardiac Surgeries: Study

Giving aspirin to patients around the time of surgery may do them more harm than good, a large new study finds. Surgery of any kind -- not just heart surgery -- may raise a person's risk for having a heart attack, research has shown. Doctors often start patients on a low dose of aspirin shortly before and after their procedures to help prevent those events. But the new study, which pitted aspirin against a dummy pill ("placebo") in over 10,000 patients who were having major surgeries that didn't involve their hearts, found that not only did aspirin fail to prevent heart attacks, it also significantly increased the risk of major bleeding. The authors pointed out that many patients were already taking other drugs meant to prevent blood clots. The most common surgeries in the study were orthopedic procedures like joint replacements. For the study, researchers recruited patients from 135 hospitals in 23 countries. Half were randomly assigned to take 200 milligrams of aspirin just before surgery and then to continue on 100 milligrams for up to a month after surgery. The other half took a placebo pill. Half of the patients were already taking a low-dose aspirin every day when they entered the study. Those patients were told to stop their daily aspirin at least three days before surgery and pick it up again seven days after. The average age of patients who participated in the study was 68, almost evenly divided between women and men. About a third of patients in both groups had a history of blood clots that had caused heart attacks, strokes, or peripheral vascular disease. And nearly two-thirds also got some kind of additional blood thinner, typically Enoxaparin or Rivaroxaban, to prevent clots. Nearly the same number of patients, about 7 percent, died or had a heart attack within 30 days of their surgeries, whether they took aspirin or the placebo -- 351 of 4,998 patients in the aspirin group compared with 355 of 5,012 patients who took the placebo. That was true even for patients who were already on a daily aspirin regimen before their operations. But significantly more patients in the aspirin group experienced major bleeding than those who took the placebo -- 230 patients versus 188 in the placebo group. The findings contradict previous studies that found that aspirin could help prevent heart attacks after surgery. But those studies were smaller, the researchers noted, or looked at surgical outcomes after treatments had already been assigned, making their results less definitive. Researchers say it could be that aspirin does prevent heart attacks caused by blood clots, but when it's given to patients in addition to other blood thinners, as is often the case, the bleeding risk cancels any benefit. Bleeding can also cause heart attacks, explained study author. A sharp drop in blood pressure can seriously stress the heart, sending it into cardiac arrest. "The perioperative period is a tricky period in terms of balancing these competing physical effects that are going on," he said. "We should stop aspirin during the perioperative period, because we're only putting patients at risk without an apparent benefit," he added. For patients who take a low dose of aspirin each day to prevent either first or second heart attacks, he said the study found that it's safest to resume that regimen eight to 10 days after surgery, since that's when bleeding risk subsides. 

SOURCE: HealthDay News, March 2014 

Return to top

 Autism Linked Pregnancy !

More Signs Autism May Originate During Pregnancy

Children with autism show key "patches of disorganization" in the outer layers of the brain, according to a new study said to offer more evidence that the developmental disorder begins in the womb. Experts have long believed autism involves disruptions in typical brain development, going back to pregnancy. For the study, researchers examined samples of brain tissue from 22 children after death -- 11 with autism and 11 without. They were able to spot tiny patches of disrupted development dotting the outer layers of the brain in the children with autism. Differences like that would take shape during prenatal development, lead researcher said. "This is pretty direct evidence of a prenatal origin," he added. In general, however, experts believe autism arises from genetic susceptibility and yet unknown environmental factors. "Ultimately, it's an interplay between genes and environment," researcher said. In the United States, an estimated one in 88 children has an autism spectrum disorder, which affects the ability to communicate and interact with others. Some kids are profoundly affected, speaking very little or not at all and focusing obsessively on just a few interests. Others have milder problems communicating and reading social cues, such as other people's gestures and facial expressions. Researchers have managed to find a few hundred genes that are linked to autism risk. And although there is no definite environmental culprit, studies have tied certain factors during pregnancy to an increased risk, including exposure to high levels of air pollution, low intake of the B vitamin folate and viral infections. For the new study, lead researcher and his colleagues examined small samples of the neocortex -- the outer surface of the brain. During fetal development, the neocortex forms six layers, each with its own specialized brain cells. As those cells develop, they take on a "genetic signature" that can be visualized in tissue samples, using sophisticated techniques. Overall, the study found, brain tissue from children with autism showed tiny patches where certain genetic signatures were absent from brain cells. What's more, those patches were concentrated in areas associated with higher order brain functions, such as understanding language and social cues. Lead researcher said the fact that the brain tissue showed small patches of disruption, rather than pervasive abnormalities, is "potentially good news." It suggests that much of the neocortex is actually typical in children with autism, he said. That might help explain why autistic toddlers who get early behavioral therapy often show significant improvements, he said. It's possible the brain is able to "rewire," to an extent, to get around some of the trouble spots seen in this study.

SOURCE: HealthDay News, March 2014

Return to top

 Childbirth Alert !

Cardiac Arrest During Childbirth More Common Than Thought: Study

Cardiac arrest in women during childbirth is rare, but it may be twice as common as previously believed, a new study suggests. Factors that can cause a woman's heart to stop beating during childbirth include a severe form of high blood pressure called preeclampsia, excessive bleeding, heart failure or heart attack, blood infection and the entry of amniotic fluid into the mother's bloodstream (amniotic fluid embolism). Researchers analyzed data from more than 56 million births in the United States, and found that more than one in 12,000 women had a cardiac arrest while they were in hospital for childbirth. Those who had cardiac arrests were more likely to be older, black or to be covered by Medicaid, according to the study. The main causes of cardiac arrest were bleeding (nearly 45 percent), heart failure (13 percent), amniotic fluid embolism (13 percent) and blood infection (11 percent), the investigators found. The researchers also reported that CPR was often successful in cases of cardiac arrest during childbirth, and that the survival rate rose from 52 percent in 1998 to 60 percent in 2011. "These are rare high-stakes events on obstetric units, and team preparation is critical to ensure that everyone is ready to act quickly and effectively," study author said. "Fortunately, physician anesthesiologists are experts in leading resuscitation teams for maternal cardiac arrest and other emergencies that happen on the labor floor," she added.

SOURCE: HealthDay News, March 2014 

Return to top

 Drug & Cancer !

Anti-Seizure Drug May Guard Against Some Cancers

A drug used to treat seizures may reduce the risk of head and neck cancers, a new study suggests. Valproic acid is prescribed to prevent seizures and also to control mood, but it is also being investigated for cancer prevention because it inhibits genetic changes that can lead to cancer. The new study included nearly 440,000 U.S. veterans, including about 27,000 who were taking valproic acid for bipolar disorder, post-traumatic stress disorder (PTSD), migraines and seizures. Overall, veterans who took the drug for at least one year were 34 percent less likely to develop head and neck cancers than those who didn't take the drug, the investigators found. The risk appeared to be even lower in those who took it in higher doses or for longer periods of time, according to the study. Veterans who took valproic acid did not have a reduced risk for lung, bladder, colon or prostate cancers, said team leader. "A 34 percent risk reduction for the development of head and neck cancer with [valproic acid] use could result in the prevention of up to approximately 16,000 new cases and 3,000 to 4,000 annual deaths in the U.S. alone," lead authorsaid. "Head and neck cancer is an important global health crisis, and low cost and low toxicity prevention strategies like [valproic acid] use have a high potential impact on pain, suffering, costs, and [death] associated with this disease," he added. Although the study found an association between valproic acid use and reduced risk of certain cancers, it did not prove cause-and-effect.  

SOURCE: HealthDay News, March 2014

Return to top

Surgery & Diabetes !

More Evidence Weight-Loss Surgery Helps People With Diabetes

Weight-loss surgery might do more than help people shed pounds. For some who have the surgery, it may also put type 2 diabetes into remission for several years, a new study suggests. The success rate in controlling diabetes depended on the type of weight-loss surgery, the researchers said. Patients who had the more involved gastric-bypass surgery were more likely to achieve control of their type 2 diabetes without the use of medications, compared to those who had a procedure known as sleeve gastrectomy, according to the new research. "This study is a three-year follow-up. Initially, we showed that people lost a lot of weight after surgery, and for some people, that caused their type 2 diabetes to come to an end," said study co-author. "But no one knew how lasting that would be." "One-third [of patients] in the gastric bypass group had remission of diabetes -- meaning they had normal blood sugar control -- and a quarter of the people in the sleeve gastrectomy group had remission of type 2 diabetes," she said. "These effects are real, and they're persistent for at least three years. Essentially, these patients have had a vacation from diabetes for three years." Even when people weren't able to achieve a full remission from type 2 diabetes, weight-loss surgeries still helped many participants take less medication to control their blood sugar, according to the study. Co-author also said quality of life was improved for people who had the weight-loss surgery compared to those who received standard type 2 diabetes management. Quality-of-life measures included bodily pain, physical functioning, energy levels and emotional well-being. The current study included 150 people with type 2 diabetes. Their average age was 49, and two-thirds were female. At the start of the study, the patients' average body-mass index (BMI) -- a rough estimate of a person's body fat -- was nearly 37. Below 25 is considered normal weight and over 30 is considered obese. One-third of the study volunteers were randomly selected to receive standard medical management of their type 2 diabetes, while another third was given gastric-bypass surgery and medical management. The final third received sleeve gastrectomy plus medical management of their diabetes. Gastric-bypass surgery routes food directly to the small intestine, which means it bypasses the stomach, duodenum and large intestines. Sleeve gastrectomy reduces the size of the stomach. Co-author of the study said the biggest benefits of the surgeries likely stem from the amount of weight lost. "When someone taking drugs to manage diabetes, it's hard to lose significant amounts of weight," she said. "A lot of diabetes medications make weight loss hard."

SOURCE: HealthDay News, March 2014

Return to top

 Vit-D & CAD !

Vitamin-D Deficiency May Be Linked To Heart Disease

New research suggests people with lower levels of vitamin D are more likely to suffer from coronary artery disease and to have more severe forms of the illness. While the findings aren't definitive, they add to recent research that indicates vitamin D -- the so-called sunshine vitamin -- may play a role in preventing heart disease. The results "suggest vitamin D deficiency to be the cause rather than the consequence of atherosclerosis," said study investigator. Clogged arteries, or atherosclerosis, can lead to heart attack. While the study showed an association between vitamin D levels and heart disease risk, it did not prove a cause-and-effect link. Researchers who examined nearly 1,500 patients found that 70 percent of those undergoing angiography, a test used to detect blockages in the arteries, had deficient levels of vitamin D. Patients with levels low enough to be considered deficient had a 32 percent greater risk of coronary artery disease and an almost 20 percent greater risk of the most severe level of disease, the researchers said. Also, those with the lowest levels of vitamin D were almost twice as likely to suffer from clogged arteries compared to those with normal levels. Vitamin D is absorbed through the skin from sunlight. It is also found in fatty fish, fortified dairy products and supplements. Study investigator recommended a diet rich in vitamin D and moderate exercise outdoors for people with and without cardiovascular disease. "Although evidence of benefits with vitamin D supplementation in cardiovascular outcomes are still lacking, strategies to raise [natural] vitamin D should probably be advised in the prevention of cardiovascular disease," she said.

SOURCE: HealthDay News, March 2014

Return to top


New Products of SQUARE Pharmaceuticals Ltd.

  Product Duolax Oral Emulsion
  Generic Name Magnesium Hydroxide+ Liquid Paraffin
  Strength (0.3 gm+ 1.075 gm)/5ml
  Dosage form Oral Emulsion
  Therapeutic Category Laxative
  Product Urocure Suspension
Generic Name



25 mg/5ml

Dosage form Suspension
Therapeutic Category Furantoin Antibiotic
  Product Urocure100 SR
  Generic Name Nitrofurantoin
  Strength 100 mg
  Dosage form Sustained Release Capsule
  Therapeutic Category Furantoin Antibiotic

Return to top


Copyright 2014 SQUARE Pharmaceuticals Ltd. All rights reserved.