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VOL.  15     ISSUE:  11    November  2017 Medical Services Department

SQUARE Pharmaceuticals Ltd.



Blood Thinner !





P G Dip. Business Management







Dear Doctor,

Welcome to this issue of 'e-SQUARE'.

In this issue, we focused on some interesting features like -

"Liposuction in CA Patients !", "Gene Therapy !", "Regenerated Organs !",       "Cancer Care !",  "Kidney Failure !", "Blood Thinner !".

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

We will appreciate 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.

Liposuction in CA Patients !

                                                Liposuction May Ease Limb Swelling in Carcinoma (CA) Patients

Liposuction may help people with lymphedema, a painful, disfiguring swelling of the arms, hands, legs or feet. Lead researchers used the surgical technique to remove fat from just underneath the skin in three people with the condition. Two of the patients had lymphedema as a side effect of CA treatment. The other one had a naturally developing form of lymphedema. In all three cases, there was improvement in the lymphedema after liposuction, the lead researcher said. And the improvement appears to be more effective and lasting than expected. One patient has had more than five years of follow-up. Liposuction is extremely effective at removing fat from underneath the skin, which makes the arm or leg smaller. And the new data show that the surgery improves lymphatic flow and increases quality of life. It actually allows the underlying lymphatic system to move the fluid, lead researcher added. This is not a cure. It improves lymphatic flow, but people still need to take conservative measures, such as wearing compression garments. The reason people get lymphedema after CA treatment is because when CA spreads to lymph nodes, those nodes need to be removed. In this process, part of the lymph vessels attached to the node are also removed. Lymph nodes and vessels are part of the body's immune system. When removed, the body's natural drainage system for lymph fluid is disrupted and fluid builds up, sometimes to extreme levels, according to the American CA Society. Radiation therapy also can damage nodes and vessels or cause scarring that blocks drainage. Lymphedema can be very uncomfortable and cause a feeling of heaviness. Skin can feel tight. Wounds may heal more slowly, and lymphedema can cause reduced flexibility. About 200 million people have lymphedema worldwide. Treatment typically includes wearing compression garments and getting a special type of massage that helps promote fluid drainage. The study patients who had liposuction only had the procedure on an affected limb. They didn't have liposuction on their hands or feet. However, the two patients who had liposuction on their arm also saw improvement in their hand, and the one who had liposuction on her leg had improvement in the lymphedema affecting her foot. According to lead researcher this was unexpected.

SOURCE: HealthDay News, November 2017

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Gene Therapy !

                                            Gene Therapy, New Drug Battle a Rare But Deadly Disease in Kids

Babies born with a previously untreatable degenerative nerve disease now have two fresh sources of hope for their future. Two innovative new therapies for spinal muscular atrophy (SMA) type 1 have proven highly effective in clinical trials. Babies with SMA are born without the gene that promotes production of survival motor neuron (SMN) protein. Without this protein, nerve cells in the spinal cord and brain stem stop working and start to die off. These babies slowly lose the ability to move their arms and legs. Those with the most severe form, SMA type 1, eventually lose the ability to breathe on their own and rarely survive beyond 2 years of age. Two research groups say they've produced breakthrough therapies for these children. First, a new genetic treatment employed a DNA-loaded virus to replace the missing SMN1 gene with a fresh, healthy copy of the gene. Second, an already-approved drug called nusinersen (Spinraza) was used to promote production of the crucial nerve protein by a backup gene called SMN2. Both approaches increased survival in babies with SMA and preserved or improved their motor function, the lead researcher said. Both therapies aim to increase production of SMN protein in the motor neurons and thereby improve the survival and function of motor neurons. This leads to better muscle and respiratory function and survival, added van der Ploeg, who wrote an editorial accompanying the two clinical trial reports. The gene therapy treatment was tested in 15 babies with SMA type 1. All received one intravenous dose of a genetically engineered virus containing the new copy of the SMN gene. The virus is named AVXS-101. This was a phase 1 trial to test safety. All 15 patients treated with AVXS-101 are still alive, Mendell said, and some are thriving. Higher doses produced better responses. Nusinersen amps up protein production by the SMN2 gene, potentially halting progression of nerve damage. In the trial, 41 percent of infants who received the earliest treatment with nusinersen and 51 percent of infants in the final analysis experienced stable or improved motor function, the lead researcher added. Babies treated with nusinersen also were more likely to survive. The risk of death was 63 percent lower in the nusinersen group compared with the control group, the findings showed. Results were so promising that the clinical trial was halted early so the control group could receive nusinersen, the lead author said.

SOURCE: HealthDay News, November 2017

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Regenerated Organs !

                               FDA Seeks to Speed Development of 'Regenerated' Organs for Medical Use

Using stem cells to grow new heart tissue, and even whole organs, used to be the stuff of science fiction. But the field of "regenerative medicine" is a reality now -- and the U.S. Food and Drug Administration has its eye on it. In the last decade, we've seen improbable advances that hold out great hope for patients. They believe that with the ability to facilitate the regeneration of parts of the human body, bearing witness to the beginning of a paradigm shift in the practice of medicine. For example, over the past few years scientists and physicians have developed tissue-engineered skin for transplant; bladders grown from a patient's own cells; and tissues grown to repair ailing hearts or failing knees, according to the U.S. National Institutes of Health. But Lead researcher said that along with all this good comes the bad. Companies seeking to exploit consumers are already popping up across the United States stem cell "clinics" promising pricey cures that they can't deliver to desperate patients. The rapid growth and promise of this field has increasingly sowed the ground for the entry of some unscrupulous actors, who have opportunistically seized on the clinical potential of regenerative medicine to make deceptive claims to patients about unproven and, in some cases. By exploiting the lack of consumer understanding of this area, as well as the fear and uncertainties posed by the diseases these bad actors claim to treat, they're jeopardizing the legitimacy and advancement of the entire field. The new rules are in keeping with provisions from the 21st Century Cures Act, passed by Congress in December. That legislation earmarked $6.3 billion in funding, mostly for the U.S. National Institutes of Health, towards groundbreaking medical research. According to lead researcher, the bottom line is to allow patients access to safe and effective regenerative medicine products as efficiently as possible.

SOURCE: HealthDay News, November 2017

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Cancer Care !

                                                             Patients' Gut Bugs May Play Role in Cancer Care

The type of bacteria that cancer patients harbor in the gut might affect their odds of responding to certain treatments, two early studies hint. The research, in humans and mice, adds to evidence that gut bacteria play a key role in the immune system. But experts stressed it's too soon to make recommendations to cancer patients -- including whether they should take "probiotic" supplements. Both studies looked at whether there's a link between patients' gut bacteria and their responses to newer cancer drugs called PD-1 inhibitors. The drugs, which include Keytruda (pembrolizumab) and Opdivo (nivolumab), work by freeing up the immune system to attack cancer cells. The drugs are approved for several cancers, including advanced cases of melanoma, lung, bladder and stomach cancers. In one study, researchers focused on 112 patients with advanced melanoma, the deadliest form of skin cancer. The investigators found that those who'd responded to PD-1 therapy tended to have a gut microbiome that was distinct from those of patients who did not respond. Those who'd responded generally had more diversity in their bacteria, plus higher concentrations of common bacteria called Ruminococcus and Faecalibacterium. Still, the researchers said the findings do not prove that those bacteria improve the odds of doing well on PD-1 therapy. Only a clinical trial can show that. This needs to be tested. However, the findings build on evidence of a clear link between the gut microbiome and immune function, 0lead researcher added. Studies have found that the diversity of those bugs particularly in the gut is linked to the risks of various health conditions, including those related to immune function. In general, studies have found, the more diversity in the gut microbiome, the better.

SOURCE: HealthDay News, November 2017

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Kidney Failure !

                                              Kidney Failure Declining Among U.S. Diabetics: CDC

While diabetes cases continue to rise in the United States, one potential outcome, kidney failure has decreased by one-third, health officials report. The rate of kidney failure requiring dialysis or transplantation among people with diabetes fell 33 percent from 2000 to 2014, a new report from the U.S. Centers for Disease Control and Prevention shows. This continued a trend begun in the 1990s. Continued awareness of risk factors for kidney failure and interventions to improve diabetes care might sustain and improve these trends, said by lead researcher. The survey data reflects all 50 states, the District of Columbia and Puerto Rico. It's likely that people with diabetes have better control of blood pressure and blood sugar, two risk factors for kidney failure, the lead researcher suggested. For example, treatment with so-called ACE inhibitors or angiotensin-receptor blockers can slow the decline in kidney function while lowering blood pressure. We can conclude that the measures that physicians take to delay progression is working to some degree, the lead researcher said. However caution should be maintained about the data as some of it was from self-reporting. In addition, there has been a significant increase in those patients undergoing preemptive kidney transplant, thus not technically reaching and therefore not being captured on federal forms. According to the report, about 1 in 3 adults with diabetes has kidney damage or reduced kidney function. But most are unaware of it. The lead researchers said earlier screening for kidney disease in people with diabetes is important. And better treatment can prevent complications. More than 9 percent of Americans are estimated to have diabetes, according to recent CDC figures. The overwhelming majority have type 2, which is linked to overeating and a sedentary lifestyle. Preventing type 2 diabetes is one way to lower the odds of chronic kidney disease. Lifestyle changes, including healthy eating and weight management, can help in that regard. Despite improving numbers with regard to kidney failure, doctors and patients with diabetes should not become complacent.

SOURCE: HealthDay News, November 2017

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Blood Thinner !

                                                                   Could a Common Blood Thinner Lower Cancer Risk?

A pill widely taken to prevent heart attack and stroke may also guard against cancer; new research suggests.Warfarin is an inexpensive blood thinner. It's typically prescribed for patients whose leg arteries are prone to clots and for patients with the abnormal heartbeat or atrial fibrillation. Now, Norwegian investigators say it may also protect against any type of cancer and from prostate, lung and breast cancer, in particular. Lower colon cancer risk was also reported, but only in people taking warfarin for A-fib, according to the study. The findings don't prove that warfarin reduces the risk of cancer, cautioned by lead researcher. This is an observational study using data on more than 1.25 million people 50 and older from Norwegian national registries, and cannot prove a cause-and-effect relationship. Among adults taking warfarin, however, fewer developed cancer compared with those not taking the drug. This study suggests there is something about warfarin that might reduce the risk of cancer. However, the study does not suggest that we should be prescribing warfarin to reduce cancer risk and no one should be taking warfarin as a cancer prevention measure. Lead researcher added that a healthy diet and exercise are better ways to prevent cancer than taking warfarin. Experimental cancer models have found that warfarin blocks a receptor called AXL on tumor cells, which might explain why it could prevent cancers. As many as 10 percent of adults in Western countries take warfarin, according to background notes with the study. As a blood thinner, warfarin works by blocking vitamin K, which is essential for clotting. But the drug is difficult to regulate, and frequent blood tests are needed to ensure the dose is high enough to prevent clotting, but not so high as to cause major bleeding. New drugs that don't need such careful monitoring, such as Xarelto (rivaroxaban) and Eliquis (apixaban), have started to replace warfarin. Because these new drugs have a different mechanism of action. The next step is to demonstrate that a low dose of warfarin is safe and effective in preventing a return of cancer.

SOURCE: HealthDay News, November 2017

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Perkidopa TM
Generic Name Levodopa + Carbidopa

110 mg

  Dosage form Tablet
Therapeutic Category Anti-Parkinson drugs
  Product Perkidopa TM
Generic Name

Levodopa + Carbidopa

Strength 275 mg
Dosage form Tablet
Therapeutic Category Anti-Parkinson drugs
  Product Giloba  
  Generic Name Ginkgo biloba
  Strength 60 mg
  Dosage form Capsule
  Therapeutic Category Herbal & Nutraceuticals

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