Healthcare online Keeping you up-to-date
VOL.  12     ISSUE:  5   May 2014 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management





We hope that you are enjoying this online healthcare bulletin.

Our current issue focused on some interesting features like -

"Asthma & Bone Loss !", "Early Menopause Risk !", "Kids' Diabetes !", "Migraine Alert !",  "New Drug & LDL !", "Walking & CKD !".

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

We will appreciate your feedback !

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Editorial Team

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

 Asthma & Bone Loss !

Asthma Linked to Bone Loss in Study

People with asthma could be at higher risk of bone loss, new research suggests. But it's not clear how the two conditions might be related. "We know prolonged use of corticosteroids in the treatment of asthma is a risk factor of osteoporosis, but we haven't had definite data showing the relationship between asthma itself and bone loss," study author said . "This study has shown a meaningful association between the two conditions, even in the absence of previous oral corticosteroid use," study author noted. The researchers studied more than 7,000 people, including 433 with asthma. They found that bone density in the lumbar spine and femur was significantly lower in those with asthma. "It is difficult to pinpoint the cause of bone loss in this subset of patients," said an allergist. "Reasons can include corticosteroid use, low levels of vitamin D or even race. This research has unveiled findings that need be further studied," he said. Although steroid treatments for asthma may be a possible link to bone loss, no one should stop taking these drugs without talking to their doctor. "Asthma is a serious disease that can be life-threatening," allergist said. "It is important that those with asthma and other breathing problems continue their prescribed treatment. It is also imperative that allergists discuss the potential of the disease itself or as a consequence of therapy in asthma sufferers." Side effects from corticosteroid treatment are generally more evident with oral forms of the drugs instead of inhaled, though oral steroids are more effective. Doctors prescribe inhaled corticosteroids whenever possible. If oral corticosteroids are necessary, doctors will prescribe the lowest effective dose to help avoid side effects, according to the study. 

SOURCE: HealthDay News, May 2014

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 Early Menopause Risk !

Early Menopause Linked to Heart Failure Risk in Swedish Study

Early menopause may increase a woman's risk for heart failure later in life, especially if she is a smoker, a new study suggests. Researchers analyzed data from more than 22,000 older women in Sweden. Those who experienced early menopause (ages 40 to 45) were 40 percent more likely to suffer heart failure than those who went through menopause in the normal age range of 50 to 54, the investigators found. For every one-year increase in the age a woman began menopause, there was a 2 percent lower risk of heart failure, according to the study. The risk of heart failure was highest in current or former smokers who had early menopause, the researchers found. Current or former smokers who went through menopause only somewhat early -- ages 46 to 49 -- also had an increased risk of heart failure. However, while the study found an association between age at menopause and heart failure risk, it did not prove a cause-and-effect relationship.

SOURCE: HealthDay News, May 2014

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 Kids' Diabetes !

Kids' Diabetes Rates Up Dramatically in 8 Years, Study Finds

Rates of diabetes in U.S. children have jumped sharply in just eight years, according to new research.The prevalence of type 1 diabetes increased 21 percent between 2001 and 2009. At the same time, rates of type 2 diabetes rose 30.5 percent, the study found. These increases affected both boys and girls, and nearly all racial groups, the researchers noted. The reasons behind the increases aren't entirely clear, said lead researcher. "While we do not completely understand the reasons for this increase, since the causes of type 1 diabetes are still unclear, it is likely that something has changed in our environment, both in the U.S. and elsewhere in the world, causing more youth to develop the disease, maybe at increasingly younger ages," she said. Several reasons for the increase in type 2 diabetes are possible, she said. "Most likely is the obesity epidemic, but also the long-term effects of diabetes and obesity during pregnancy, which have also increased over time," she noted. This report shows the increasingly important public health burden that pediatric diabetes represents, she pointed out. "It also highlights the facts that all racial/ethnic groups are affected by both major forms of diabetes," she said. In type 1 diabetes, the body does not produce insulin, the hormone needed to convert sugar, starches and other food into energy. In type 2 diabetes, the body does not use insulin properly. This is called insulin resistance. At first, the pancreas makes extra insulin to make up for it. But over time, it isn't able to keep up and can't make enough insulin to keep blood sugar at normal levels. For the study, research team collected data on more than 3 million children and adolescents. When looking for type 1 diabetes, the researchers included people aged 19 years and younger. For type 2, the researchers limited the age range to 10 through 19 years. The incidence of type 2 in children younger than 10 was too low to provide statistically significant numbers, according to the report. The data came from five centers located in California, Colorado, Ohio, South Carolina, and Washington state, as well as from some American Indian reservations in Arizona and New Mexico. In 2001, type 1 diabetes had been diagnosed in just under 5,000 youngsters from a group of more than 3 million youth. By 2009, that number rose to almost 6,700, an increase of 21 percent, according to the study authors. The only groups that didn't see an increase in type 1 diabetes were children from 0 to 4 years old, and American Indian children, the study revealed. For type 2, the researchers looked at a group of almost 2 million children. In 2001, 588 children and teens had been diagnosed with type 2 diabetes. By 2009, 819 kids and teens had type 2, a jump of 30.5 percent, the researchers found. The only ethnic groups that didn't see an increase in type 2 were American Indians and Asian Pacific Islanders. "Historically, type 1 diabetes has been considered a disease that affects primarily white youth; however, our findings highlight the increasing burden of type 1 diabetes experienced by youth of minority racial/ethnic groups as well," the authors wrote. The increase for both types of diabetes was seen among boys and girls and among whites, blacks and Hispanics. The biggest increase in both types of diabetes was among those 15 through 19 years of age, the researchers noted.

SOURCE: HealthDay News, May 2014

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 Migraine Alert !

Migraines Linked to Increased Risk of 'Silent Strokes'

Older people who have migraines may be twice as likely to have "silent strokes," according to a new study. Silent strokes are symptomless brain injuries caused by a blood clot that disrupts blood flow to the brain. Researchers cautioned that these brain injuries are a risk factor for future strokes. "I do not believe migraine sufferers should worry, as the risk of ischemic stroke in people with migraine is considered small," the study's lead author, Dr. Teshamae Monteith, said in a news release from the American Heart Association. Monteith is an assistant professor of clinical neurology and chief of the headache division at the University of Miami Miller School of Medicine. "However, those with migraine and vascular risk factors may want to pay even greater attention to lifestyle changes that can reduce stroke risk, such as exercising and eating a low-fat diet with plenty of fruits and vegetables," noted Monteith. The study, published online May 15 in the journal Stroke, involved a multi-ethnic group of older people in New York City. Just over 100 of the study participants had a history of migraines and nearly 450 didn't experience migraines. Of these adults, 41 percent were men with an average age of 71 years. Because Hispanics and blacks are at greater risk for stroke, the researchers noted that roughly 65 percent of the participants were Hispanic. Using MRI scans, the researchers compared the brains of those with migraine and those without. Even after taking other risk factors for stroke into account, the evidence showed there were twice as many silent strokes among the participants with migraines. This risk of silent stroke was increased both in people who had migraines with auras (or changes in vision), and those who had migraines without visual symptoms, according to the study. Although previous research has linked migraine with abnormalities in the small blood vessels in the brain, the current study didn't find an increase in blood vessel changes. The study authors noted that their findings suggest treating migraines might help lower the risk of stroke. "We still don't know if treatment for migraines will have an impact on stroke risk reduction, but it may be a good idea to seek treatment from a migraine specialist if your headaches are out of control," said Monteith. While the current study found an association between migraine and stroke, it wasn't designed to prove that migraines cause stroke. The researchers also pointed out that more studies are needed to confirm their findings.

SOURCE: HealthDay News, May 2014

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 New Drug & LDL !

New Drug May Help Lower 'Bad' Cholesterol Beyond Statins

A new injectable drug can further knock down cholesterol levels in people who take cholesterol-busting statin medications, according to the results of a global trial. People taking the new therapy alongside statins enjoyed a 63 percent to 75 percent decrease in their "bad" (LDL) cholesterol levels, on top of the reduction caused by the traditional statin medications, researchers reported. "This drug enhances the body's natural way of reducing LDL levels in the bloodstream," said lead author. "It lets us get cholesterol really well-treated in people with genetic cholesterol disorders or people who can't take large amounts of statins." Evolocumab is a so-called "human monoclonal antibody" that, in a roundabout way, improves the body's ability to remove cholesterol from the bloodstream. Cells primarily located in the liver contain receptors that target LDL cholesterol and remove it from the bloodstream. But the liver also produces a regulatory protein called PCSK9 that binds to and breaks down these receptors, she said. The antibodies in evolocumab are designed to intercept PCSK9, preventing the protein from breaking down the cells' LDL receptors, which allows them to stay in circulation longer to remove LDL cholesterol, she explained. The phase 3 clinical trial was conducted at 198 sites in 17 countries. Over the course of 12 weeks, just over 2,000 people taking moderate to high doses of statins were randomly assigned to also take evolocumab, or another cholesterol-lowering drug called ezetimibe, or an inactive placebo. Compared with the placebo, evolocumab taken every two weeks reduced LDL cholesterol levels an additional 66 percent to 75 percent, and taken monthly cut the level by 63 percent to 75 percent. By comparison, ezetimibe provided an additional cholesterol reduction of up to 24 percent, the investigators found. According to the findings, evolocumab had adverse events and side effects comparable to those experienced by people taking either statins or ezetimibe. "Because it's a very specific antibody, it seems to be very well-tolerated without any drug interactions or any side effects," she said. Evolocumab will be mostly helpful in treating people with a genetic disorder that causes them to have high cholesterol, lead author said. About 1 in 500 people have this disorder, according to the U.S. National Institutes of Health. It also could help people with high cholesterol who can't take large doses of statins, she added, estimating that as many as 10 percent of people with heart disease or diabetes can't tolerate the recommended dose of statins. Lead author said a follow-up study is underway to evaluate the drug's longer-term outcomes and safety. But if it does gain U.S. Food and Drug Administration approval, she noted, the drug will be expensive. "It's not going to be for everybody, but it's going to be very important for certain people," those with genetic cholesterol disorders and those who can't take large doses of statins, she added.

SOURCE: HealthDay News, May 2014

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 Walking  & CKD !

Walking Could Be Key Step Against Kidney Disease

Kidney patients may make real strides against death or disability by routinely walking, a new study shows. "A minimal amount of walking -- just once a week for less than 30 minutes -- appears to be beneficial, but more frequent and longer walking may provide a more beneficial effect," study co-author said. His team tracked outcomes for more than 6,300 Taiwanese people with chronic kidney disease (CKD), who averaged 70 years of age. The patients were followed for an average of 1.3 years, and about 21 percent of them called walking their most common form of exercise. Overall, patients who walked cut their risk of dying within the study time frame by a third, and they were 21 percent less likely to need dialysis or a kidney transplant, compared to those who did not walk. And the more that patients walked, the greater the benefits. Compared to non-walkers, those who walked 1-2, 3-4, 5-6 and 7 or more times a week were 17 percent, 28 percent, 58 percent, and 59 percent less likely to die, respectively, the researchers said. They were also 19 percent, 27 percent, 43 percent, and 44 percent less likely to need dialysis or a kidney transplant, respectively. The difference wasn't pinned to the walkers being healthier than the non-walkers -- The researchers note that walkers and non-walkers were equally likely to have other health problems, such as heart disease and diabetes. Even with other health issues, many kidney patients "were able to walk if they wanted to, and walking for exercise is associated with improved patient survival and a lower risk of dialysis," he said.

SOURCE: HealthDay News, May 2014

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Duolax
  Generic Name Magnesium Hydroxide+ Liquid Paraffin

(0.3 gm+ 1.075 gm)/5ml

  Dosage form Oral Emulsion
  Therapeutic Category Laxative
  Product Urocure        
Generic Name


Strength 25 mg/5ml, 100 mg
Dosage form Suspension, Sustained Release Capsule
Therapeutic Category Furantoin Antibiotic
  Product Tulip
  Generic Name Ulipristal Acetate
  Strength 30 mg
  Dosage form Tablet
  Therapeutic Category Emergency Contraceptive

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