Healthcare online Keeping you up-to-date
VOL.  11     ISSUE:  10    October  2013 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management





Dear Doctor,

Welcome to our healthcare bulletin 'e-SQUARE'.

In this issue, we focused on some interesting features like -"Alzheimer's Risk !", "Flat Feet Alert !", "New Drug !",  "Psoriasis & CKD !",  "Tanning Gene Alert !", "Vit-D Safety !".

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

We always value your feedback !

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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.

Alzheimer’s Risk !

Alzheimer's have double the rate of debilitating brain-tissue loss

People who carry a certain genetic mutation associated with Alzheimer's disease have double the rate of debilitating brain-tissue loss, a new study finds. People with this mutation, known as the TREM2 gene variant, may also develop the disease three years earlier than expected, the researchers said. "Our lab studies the rate of brain-tissue loss in elderly people, trying to discover factors that protect people as they age. We have never seen such a dramatic effect as with this genetic varian" -study lead author said. "If one carry this genetic mutation, we've found that there is this wildfire of tissue loss in the brain," he added. In the study, the researchers mapped the effects of the gene mutation on the living brain using MRI scans. "This is the first study to use brain scans to show what this gene variant does, and it's very surprising," lead author said. The research involved nearly 500 adults from North America, averaging 76 years of age. One hundred had Alzheimer's disease, 221 had some impairment in memory or thinking, and 157 were healthy. People with the gene mutation lost 1.4 percent to 3.3 percent more of their brain tissue than those who did not carry the mutation. This more extensive brain loss, which took place primarily in areas of the brain responsible for memory, also proceeded twice as quickly in those with the mutation. "This gene speeds up brain loss at a terrific pace," he said. "Carriers of this genetic mutation, who comprise about 1 percent of the population, lose about 3 percent of their brain tissue per year. This is a silent time bomb in 1 percent of the world." Although healthy people usually lose less than 1 percent of their brain tissue per year, this loss is offset by the creation of new normal tissue from mental stimulation. For those with Alzheimer's, however, symptoms typically appear once about 10 percent of their brain tissue has been destroyed. Research team said the findings might have real importance in speeding research into effective Alzheimer's treatments because if studies targeted people who carry this mutation, answers to vital questions might become apparent more quickly. "Enrolling those people who carry the mutation in clinical trials for Alzheimer's treatments could help us reach quicker and more meaningful results," lead author said.

SOURCE: HealthDay News, October 2013

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Flat Feet Alert !

Low Back Pain Tied To Flat Feet: Study

Women who walk with flat feet are 50 percent more likely than those with normal or high arches to have low back pain, a new study suggests. "The key takeaway from the study is that if women have low back pain, it may not be just the back," said senior author. "It turns out that feet are important for the back." Past research has hinted that low back pain, which affects roughly one in five people worldwide, could be related to the shape of the foot's arch in the standing position. Among 1,930 men and women recruited from Framingham, Massachusetts, pronated feet - which tend to roll inward as a person walks - were linked to lower back pain in women only. For their study, research team measured each person's arch in the standing position. Then participants walked across a mat with embedded sensors to measure pressure from the heel to the tip of the foot while walking. Women in the study were in their 60s, on average. About 38 percent overall reported having low back pain. Senior author said the body may use other muscles to help make up for flat feet when a person walks, which could explain the link to back pain. Standing and walking use the foot in different ways. Both a flat foot in standing position and a pronated foot walking could be something to consider during a doctor's visit, she said. She and her team suggested reasons why women could be more affected by flat feet while walking than men. For example, women's pelvic bones are wider and not as flexible as men's. In general, women rotate their hips more than men while walking. Women also move their upper bodies more than men when they walk. "Women probably don't know if their foot function contributes to low back pain, but they can find out about it," she added. She suggested people with low back pain visit a doctor or physical therapist. One simple trick to strengthen muscles in the feet is to lay a towel on a flat surface and then scrunch the toes together in order to pick up the towel and lower it back down. Foot orthotics are another option.

SOURCE:  Reuters Health, October 2013

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New Drug !

FDA Approves New Drug To Treat Major Depressive Disorder

The U.S. Food and Drug Administration today approved vortioxetine to treat adults with major depressive disorder. Major depressive disorder (MDD), commonly referred to as depression, is a mental disorder characterized by mood changes and other symptoms that interfere with a person's ability to work, sleep, study, eat and enjoy once-pleasurable activities. Episodes of depression often recur throughout a person's lifetime, although some may experience a single occurrence. Other signs and symptoms of MDD include loss of interest in usual activities, significant change in weight or appetite, insomnia or excessive sleeping (hypersomnia), restlessness/pacing (psychomotor agitation), increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, and suicide attempts or thoughts of suicide. Not all people with MDD experience the same symptoms. “Major depressive disorder can be disabling and can keep a person from functioning normally,” said acting director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research. “Since medications affect everyone differently, it is important to have a variety of treatment options available for patients who suffer from depression.” Six clinical studies in which adults with MDD were randomly assigned to receive vortioxetine or placebo demonstrated that vortioxetine is effective in treating depression. An additional study showed vortioxetine decreased the likelihood of participants becoming depressed again after treatment of their MDD episode. These studies were conducted in the United States and other countries. The most common side effects reported by participants taking vortioxetine in clinical trials included nausea, constipation and vomiting. Vortioxetine will be available in 5 mg, 10 mg, 15 mg and 20 mg tablets. Vortioxetine and other antidepressant drugs have a Boxed Warning and a Medication Guide alerting patients and healthcare professionals that antidepressants can increase the risk of suicidal thoughts and behavior in children, adolescents and young adults ages 18 to 24 during initial treatment. Studies show adults older than 24 years of age do not appear to have an increased risk of suicidal thoughts and behavior, while adults ages 65 and older appear to have a reduced risk. Patients starting antidepressant therapy should be closely monitored for worsening of their depression and the emergence of suicidal thoughts and behavior.

SOURCE: FDA, September 2013

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Psoriasis & CKD !

Study Sees Link Between Psoriasis, Kidney Problems

People with moderate to severe psoriasis are at increased risk for chronic kidney disease and need to be closely monitored for kidney problems, a large new study suggests. Researchers analyzed data from nearly 144,000 people, aged 19 to 90, with psoriasis, and a comparison (control) group of nearly 690,000 adults without the condition. During seven years of follow-up, people with psoriasis were more likely to develop chronic kidney disease than those in the control group. Those with severe psoriasis had a nearly two-fold higher risk of developing kidney disease and a more than fourfold higher risk of developing kidney failure requiring dialysis, according to research. Further investigation that focused on the amount of skin area affected by psoriasis showed that people with moderate to severe psoriasis were at greater risk of developing chronic kidney disease. People with moderate psoriasis have 3 percent to 10 percent of skin area affected, while those with severe psoriasis have more than 10 percent of skin area affected. Moderate and severe psoriasis affect more than 20 percent of patients worldwide, according to the study. Although the study found an association between having psoriasis and a higher risk of kidney problems, it did not establish a cause-and-effect relationship. The researchers also found that the risk of chronic kidney disease linked to psoriasis increases with age. In patients aged 40 to 50 with severe disease, psoriasis accounted for one extra case of chronic kidney disease per 134 patients yearly. In those aged 50 to 60, it accounted for one extra case yearly per 62 patients. Further research is needed to confirm the study findings, determine how psoriasis can cause kidney disease and examine how psoriasis treatment affects the risk for kidney disease, the researchers concluded.

SOURCE: HealthDay News, October 2013

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Tanning Gene Alert !

Tanning Gene Linked To Increased Risk Of Testicular Cancer : Study

A gene important in skin tanning has been linked to higher risk for testicular cancer in white men, according to a study. Nearly 80 percent of white men carry a variant form of this gene, which increased risk of testicular cancer up to threefold in the study.  The team suspected that variations in a gene pathway controlled by the tumor suppressor gene p53 could have both positive and negative effects on human health.  “Gene variations occur naturally, and may become common in a population if they convey a health benefit,” said the author  “It appears that this particular variant could help protect light-skinned individuals from UV skin damage, like burning or cancer, by promoting the tanning process, but it permits testicular stem cells to grow in the presence of DNA damage, when they are supposed to stop growing.” He explained that p53 stimulates skin tanning when ultraviolet light activates it in the skin. It then must bind a specific sequence of DNA located in a gene called the KIT ligand oncogene (KITLG), which stimulates melanocyte production, causing the skin to tan. To conduct the analysis co-author and lead bioinformatics scientist led a data mining expedition to sieve through many different data sets. The team selected possible leads from the intersection of more than 20,000 p53 binding sites in the human genome, 10 million inherited genetic variations genotyped in the 1000 Genomes Project, and 62,000 genetic variations associated with human cancers identified in genome-wide association studies (GWAS). These data sets were gathered through joint efforts of thousands of researchers from around the world. “In the end, one variant in the p53 pathway was strongly associated with testicular cancer, but also, surprisingly, displayed a positive benefit that is probably related to tanning that has occurred as humans evolved. Co-author noted. The group performed complex experiments to confirm the molecular mechanism that linked the variant with cancer and tanning. “White males with a single nucleotide variation in KITLG, called the G allele, have the highest odds of having testicular cancer. In fact, the twofold to threefold increased risk is one of the highest and most significant among all cancer GWAS conducted within the past few years,” researcher said. “The high frequency of this allele in light skin individuals may explain why testicular cancer is so much more frequent in people of European descent than those of African descent.” Researcher said although the G allele increases testicular cancer risk, it may explain why testicular tumors are often easily cured with chemotherapy. “Most other tumors have a mutant p53, but in these testicular cell tumors, the p53 is functioning properly, and the drugs used for testicular cancer appear to work in concert with p53’s tumor suppression function to kill the cancer cells.” 

SOURCE: National Institutes of Health, October 2013

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Vit- D Safety !

Vitamin D Supplements May Not Raise Risk For Kidney Stones

Taking vitamin D does not increase the risk for kidney stones, the study found. People's age, gender and weight, however, may play a role in developing the condition. Previous research suggested that adequate levels of vitamin D might help protect against a number of diseases, including certain forms of cancer. "Our results may lessen concerns by individuals about taking vitamin D supplements, as no link was shown between such supplementation and an increased risk for kidney stones," study leader said. The new study used data on more than 2,000 adults of all ages. After following the participants for 19 months, researchers found that only 13 people reported being diagnosed with a kidney stone during that time. The study, which appears Oct. 17 in the American Journal of Public Health, did show that being older or having a higher body-mass index (BMI) were both risk factors for this condition. BMI is a measurement of body fat based on height and weight. Men also are at greater risk for kidney stones than women, the study found. But vitamin D users are not, it suggested+. "Mounting evidence indicates that a vitamin D serum level in the therapeutic range of 40 to 50 [nanograms per milliliter] is needed for substantial reduction in risk of many diseases, including breast and colorectal cancer," said study leader. He added that supplements typically are needed to achieve this blood level of vitamin D. People with a higher BMI need more vitamin D to gain its health benefits, he said. 

SOURCE: HealthDay News, October 2013

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New Products of SQUARE Pharmaceuticals Ltd.

  Product Tebast®
  Generic Name Ebastine
  Strength 5 mg/5ml
  Dosage form Syrup
  Therapeutic Category Antihistamine
  Product Asynta®
Generic Name

Sodium Alginate+ Potassium Bicarbonate


(500 mg+ 100 mg)/5ml

Dosage form Suspension
Therapeutic Category Non Systemic Antacid
  Product Neurolin®
  Generic Name Pregabalin
  Strength 25 mg
  Dosage form Capsule
  Therapeutic Category Antiepileptic

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