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VOL.  15     ISSUE:  3  March    2017 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management







Dear Doctor:

Welcome to healthcare bulletin "e- SQUARE" !

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This issue features a variety of articles including "Warming Planet & Diabetes !", "Blood Test & Autism !", "Diet & Chronic Pain !", "Folic Acid & Pregnancy !", "Sickle Cell Trait !", "Sinus Trouble & Depression !".

In our regular feature, we have some 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.

 Warming Planet & Diabetes !

                                                      A Warming Planet Might Mean More Diabetes

The effects of climate change are far-reaching, but new research suggests a surprising linkage to a warming Earth -- more cases of type 2 diabetes. For every 1 degree rise in environmental temperature, the researchers calculated that there would be an increase of more than 100,000 new cases of type 2 diabetes in the United States alone. The lead researcher explained that during cold spells -- at least a few cold days in a row -- so-called brown fat is activated. Brown fat is different from white fat. When activated, it leads to an improvement in the body's sensitivity to insulin, a hormone that helps usher sugar from foods into cells for energy. The function of brown fat tissue is to burn fat to generate heat, which is important to prevent a drop in body temperature during cold exposure, explained by lead researcher. Before started to packing for colder climes, it's important to note that this study cannot prove a direct cause-and-effect relationship between warmer temperatures and the development of type 2 diabetes. The prevalence of type 2 diabetes is rising rapidly across the world. In 2015, about 415 million people worldwide had the disease, the researchers said. By 2040, that number is expected to be as high as 642 million. In those with pre-diabetes, the body can still keep up with demand by producing more and more insulin. But, eventually, the body can't keep pace and it doesn't make enough insulin to keep blood sugar levels from rising. This is when type 2 diabetes develops. A recent study reported that people with type 2 diabetes exposed to moderate cold for 10 days showed improved insulin resistance, which means they're using insulin more efficiently. This may have occurred due to an increase in brown fat activity. Other past research showed that brown fat is most active in the winter, when temperatures are coldest, the lead author noted. For the new study, investigators used information from adults in 50 U.S. states, along with Guam, Puerto Rico and the U.S. Virgin Islands. The data covered from 1996 to 2009. The lead researcher also looked at data from the World Health Organization on fasting blood sugar levels and obesity rates for 190 countries. 

SOURCE: HealthDay News, March 2017 

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 Blood Test & Autism !

                                                       Could a Blood Test Spot Autism in Childhood?

Researchers say an experimental blood test has shown promise as a novel way to diagnose autism in children. The test appears to be nearly 98 percent accurate in kids between the ages of 3 and 10, the lead researcher claimed. The test was able to predict autism, regardless of where on the spectrum an individual was, referring to varying degrees of autism severity. Additionally, the test indicates with very good accuracy the severity of certain autism-related conditions," added by lead researcher. The study was small, involving just 83 children with autism and 76 children without the disorder. More follow-up research is planned, the lead researcher said. And a senior official with a leading autism advocacy group said he had some concerns about the new study. In the United States, it's estimated that 1 in 68 children has an autism spectrum disorder. This is the term for a range of conditions that may involve problems with social skills, speech and nonverbal communication, and repetitive behaviors, according to Autism Speaks. Boys seem at higher risk than girls. The current standard approach to diagnosing autism typically entails a consensus drawn from a group of medical professionals, including pediatricians, psychologists, occupational therapists, and speech and language experts. But the new blood test takes a different approach, focusing instead on identifying the presence of key metabolism markers. To test the idea, the study authors collected blood samples from all 159 children. The analysis turned out to be nearly flawless in diagnosing autism cases, the researchers said. It was also more than 96 percent accurate in identifying those children who did not have autism, the top researcher added.

SOURCE: HealthDay News, March 2017

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 Diet & Chronic Pain !

                                                                   Mediterranean Diet May Ease Chronic Pain of Obesity

People who are overweight and plagued by chronic pain may find relief in a Mediterranean diet, new research suggests. The study of 98 men and women between the ages of 20 and 78 builds on growing evidence that a diet heavy on fish, fruits, vegetables, nuts and beans provides significant health benefits. It also sheds new light on why eating these foods might reduce pain associated with obesity. Because obese people with chronic pain usually also have a high degree of inflammation, lead researcher suspects the foods' anti-inflammatory properties might explain the reduced pain levels. Although the relationship of body fat and pain has been well-documented in prior studies, the mechanism is not known," said by lead researcher. One possibility is the stress of body weight on joints. A second possible mechanism is via inflammatory factors in the bloodstream, because both body fat and pain are known to be associated with elevated inflammation. Slightly more than 70 percent of American adults are overweight, with 38 percent considered obese (at least 30 pounds overweight), according to the U.S. Centers for Disease Control and Prevention. No matter what they weighed, those who ate more fish and plant-based proteins such as nuts and beans had less pain, the lead researcher added. While adjusting their findings to account for age-related pain among older participants, the researchers found that a Mediterranean diet benefited men and women of all ages. Also, only an association was seen between diet and pain, not a cause-and-effect link. The next step is to conduct a study with blood markers of inflammation, and then it would be ideal to conduct an intervention study to evaluate change in body fat, inflammation and pain.

SOURCE: HealthDay News, March 2017 

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 Folic Acid & Pregnancy !

                                     More Folic Acid in Pregnancy May Protect Kids from High Blood Pressure

Higher folic acid levels during pregnancy may reduce the risk of high blood pressure in children if their mothers have heart disease risk factors, a new study suggests. This study adds further evidence on the early life origins of high blood pressure, said lead researcher. Findings raise the possibility that early risk assessment and intervention before conception and during pregnancy may lead to new ways to prevent high blood pressure and its consequences across life span and generations. Researcher looked at data from almost 1,300 mother-child pairs from births at Boston Medical Center. The moms and kids were followed from 2003 to 2014. Two-thirds of this group were black, and nearly 20 percent were Hispanic. The lead researcher wanted to see if a woman's folic acid levels and heart disease risk factors -- including high blood pressure, diabetes and obesity -- during pregnancy individually and jointly had an impact on a child's blood pressure. Nearly 29 percent of the children had elevated systolic blood pressure from ages 3 to 9 years. Kids with higher blood pressure were more likely to have mothers with pre-pregnancy obesity, high blood pressure and diabetes. Those children were also more likely to have lower birth weight, lower gestational age and a higher body mass index. Higher levels of folic acid during pregnancy were associated with a 40 percent lower risk of high blood pressure among children of mothers with heart disease risk factors. However, a mother's folic acid levels alone were not linked with a child's blood pressure.

SOURCE: HealthDay News, March 2017

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 Sickle Cell Trait !

                                                        Sickle Cell Trait Tied to Higher Kidney Failure Risk for Blacks

Black people with a trait for sickle cell anemia appear to have doubled the risk of kidney failure that requires dialysis, new research suggests. Although you cannot change the genes you are born with, doctors can use this information to start screening for kidney disease earlier and to aggressively treat any other risk factors you may have such as diabetes or high blood pressure, quoted by lead researcher. Sickle cell anemia is an inherited disorder that affects hemoglobin -- the substance in red blood cells that carries oxygen through the blood. This disease causes the hemoglobin to form in a sickle shape instead of the normal rounded disc shape. To have sickle cell anemia, a person must inherit the gene from both parents. Someone who only has the gene from one parent is said to have a trait for sickle cell, but they won't have symptoms of the disease. Hemoglobin variants, such as the sickle cell trait and another one called the hemoglobin C trait, are more common in black people. The lead researcher evaluated data on almost 10,000 black people. More than 700 had sickle cell trait and almost 250 had the hemoglobin C trait. In 6.5 years of follow-up, kidney failure requiring dialysis developed in about 5 percent of study participants with sickle cell trait. In people with the hemoglobin C trait, just 2.5 percent developed kidney failure serious enough for dialysis. In those who didn't have a gene variant, 2.6 percent had kidney failure needing dialysis, the research showed. But the study didn't prove a cause-and-effect relationship. It only showed an association between this gene variant and the need for dialysis.

SOURCE: HealthDay News, March 2017

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 Sinus Trouble & Depression !

                                                                          Sinus Trouble Can Lead to Depression, Lost Work

People who are depressed due to chronic sinus infections are less productive, according to a new study. They're more likely to miss work or school than those with chronic rhinosinusitis (CRS) who aren't depressed, lead researcher found. Scientists said their findings could lead to targeted therapy to help improve patients' overall quality of life. Top researcher found that all symptoms related to CRS -- sinus, nasal or otherwise -- the severity of depressed mood and depression symptomatology was the predominant factor associated with how often our CRS patients missed work or school due to their CRS. CRS is a common illness that interferes with breathing and sleeping. The study author identified three other issues that lower the quality of life for people with CRS: nasal blockages, ear and facial pain, and emotional function. The lead researcher asked 107 people with CRS to complete surveys about their symptoms and their attendance at school and on the job. On average, the participants said they missed three days of work or school over three months, or 12 in one year. Emotional issues -- particularly depression symptoms -- were the main reason for missed days, the study found. The top researcher said they were surprised to find that poor sleep and nasal congestion did not lead to missed days. These findings really point to the fact that specific elements of CRS may be driving specific disease manifestations or consequences of the disease.

SOURCE: HealthDay News, March 2017

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Products of SQUARE Pharmaceuticals Ltd.

  Product LamicetTM 50 Tablet
  Generic Name Lamotrigine
  Strength 50 mg
  Dosage form Tablet
  Therapeutic Category Antiepileptic
  Product Canaglif
Generic Name



100 mg

Dosage form Tablet
Therapeutic Category Antidiabetic
  Product Viodin Solution 1 Litre
Generic Name Povidone Iodine
Strength 10%
  Dosage form Solution
Therapeutic Category Antiseptic Disinfectant

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