Healthcare online Keeping you up-to-date
VOL.  11     ISSUE:  9    September  2013 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management





Dear Doctor:

Welcome to this edition of 'e-SQUARE' .

Our current issue focused on some interesting features like

"Antiviral & Glioblastoma !", "Fewer Death !", "Lower Income Risk !", "New Method !", "'Painkiller Risk !", "Alzheimer's Alert !".

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

Please send us 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.

 Antiviral & Glioblastoma !

 Antiviral Drug May Extend Brain Cancer Survival, Researchers Say

A drug used against a common virus may lengthen the lives of people with a deadly form of brain cancer, a preliminary study suggests. Writing in the Sept. 5 issue of the New England Journal of Medicine, researchers reported on 50 patients who were given the antiviral drug valganciclovir to help treat glioblastoma. The cancer is the most common form of brain tumor in adults, and it carries a dismal prognosis -- with a typical survival of just over a year. These 50 patients, however, fared far better, researchers found. After two years, 62 percent were still alive. Of the 25 who took the antiviral continuously, 90 percent were still alive. That compared with just 18 percent of patients who received most of the same treatments -- including surgery and chemotherapy -- but did not take valganciclovir. "These data are by far the best ever seen for these patients," said lead researcher. valganciclovir is a pill used to treat cytomegalovirus (CMV) eye infections in people with AIDS. CMV is a very common virus -- up to 80 percent of adults contract it by age 40 -- and it usually causes no harm in someone with a healthy immune system. Researchers have found, however, that CMV dwells in the tumor cells of most people with glioblastoma, which suggests that the virus contributes to the cancer in some way. One recent lab study found that when certain cancer-promoting gene mutations are present, CMV might speed the growth of glioblastoma. "It appears that the virus alone is not sufficient to cause any human tumors," said one of the researchers on that study. Instead, it seems that CMV "cooperates with human cancer gene alterations to accelerate development and growth of the cancer," he said. The researchers then compared them with 137 patients who were treated for glioblastoma at the same hospital around the same time, but were not given valganciclovir. All patients in both groups received standard treatment, which typically meant surgery, chemotherapy and, in many cases, radiation. Whether the drug treatment actually reduced CMV levels in the patients' tumors, or if the virus was still lurking. Plus, there's a risk of side effects with valganciclovir, researcher said, including diarrhea, vomiting and upset stomach. It can also harm kidney or liver function. Despite all that, he added, given the poor prognosis with glioblastoma, "anti-CMV treatment should be seriously considered." Glioblastoma is diagnosed in two or three people per 100,000 in the United States and Europe, according to the National Brain Tumor Society. No one is sure what causes the cancer, but it is more common in men and in people older than 50.

SOURCE: HealthDay News, September 2013

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 Fewer Death !

    Better Diet Tied To Fewer Deaths After Heart Attack

People who changed their eating habits for the better following a heart attack tended to live longer than those who stuck to eating not-so-heart-healthy foods in a new U.S. study. Among some 4,000 men and women, those whose post-heart attack diets improved the most were 30 percent less likely to die from any cause and 40 percent less likely to die of heart disease, compared to those whose diets improved least. "This study really suggests that lifestyle changes - specifically those geared toward making changes in your diet - will have an impact," Dr. David J. Frid, a preventive cardiologist at the Cleveland Clinic in Ohio, told Reuters Health. "I think it's something we've assumed for a long time, but we had no compelling data to substantiate it," Frid, who wasn't involved in the new study, said. Research into how diet improvements may be linked to improvements in health after a heart attack is limited, Dr. Shanshan Li at the Harvard School of Public Health in Boston and her colleagues write in JAMA Internal Medicine. For the new analysis Li's group used data from two long-term studies of male and female healthcare workers who reported major lifestyle and medical events every two years and filled out diet questionnaires about every four years. The researchers included data on 2,258 women and 1,840 men who had no history of heart attack, stroke, cardiovascular disease or cancer when they began participating in the mid-1970s and mid-1980s. But they all later had heart attacks. Based on the questionnaires, researchers assigned each person a diet-quality score that factored in several diet components, including how much red and processed meat, nuts, sugar-sweetened beverages, vegetables, fats, alcohol, whole grains and salt the person ate. During the studies, there were 1,133 deaths from all causes. Of those, 558 were linked to cardiovascular disease. Among the 20 percent of men and women with the greatest post-heart attack improvements in their diet quality score, 140 died. That compares to 247 deaths among the 20 percent of people with the least-improved diet quality. An overall high-quality diet score after a heart attack was tied to about 24 percent fewer deaths from any cause during the study, compared to those people with the lowest diet-quality scores. Lead author and her colleagues point out that their results are consistent with past findings about Mediterranean-style diets, which are high in olive oil, nuts, fish and fresh fruits and vegetables. 

SOURCE: Reuters Health, September 2013

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 Lower Income Risk !

                                                  Lower Incomes Linked To Migraines

In a large new U.S. study, migraine headaches were found to be more likely to happen to people with lower household incomes, but tended to go into remission at the same rate for people at all income levels. It was already well know that migraines were associated with lower income, said the new study's lead author. His first research suggesting the idea was published in 1992. Since most people who get migraines eventually go into remission, he said, researchers wondered if remission was more common for people with higher incomes, which would have explained the connection between headaches and lower earnings. Researchers used data from 162,700 people with occasional, not chronic, migraines who were interviewed about their symptoms, including how old they were when the headaches began and the date of their most recent attack. For both men and women, migraines became more common as income decreased. And when participants were grouped by age, more women and men with migraines had household incomes under $60,000. For instance, among women ages 25 to 34, 37 percent had household incomes under $22,500, while 29 percent fell between $22,500 and $59,999 and 20 percent had household income greater than $60,000. Research group did not account for several factors that could influence the onset or remission of migraines, ranging from alcohol and tobacco use to access to healthcare. According to 2009 survey data from the Centers for Disease Control and Prevention, 10 percent of men and 23 percent of women reported having had a migraine in the past three months. Women are three times as likely as men to get migraines, which often begin to occur in the late teens and early adulthood, lead researcher said. After sex and age, the most important predictor of migraines is income, he said. Though he believes his study nixed the theory that migraines cause changes in income, another study published in the same issue of the journal links the headaches, especially those accompanied by a so-called aura, to long-term changes in brain structure. The review by another study examined 19 previous studies and determined that migraine sufferers were at increased risk for brain lesions, structural abnormalities and brain volume changes over time. Once again, the researchers point out, more study is needed to determine what is cause and what is effect, and whether the lesions seen in the brains of migraine sufferers have any notable effects on brain function.

SOURCE: Reuters Health, September 2013

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 New Method !

New Method Cuts Radiation During Pacemaker Procedure: Study

A new way of implanting pacemakers cuts radiation exposure for doctors and patients, German researchers report. Using electromagnetic tracking -- which works something like GPS navigation -- rather than traditional radiation-based imaging may be a safer, faster way to implant cardiac resynchronization therapy (CRT) pacemakers, the scientists explained. "This is a novel technology that has been shown to enable navigation of devices on pre-recorded X-ray images, which allows the physician to reduce the duration of live X-ray during a procedure," said lead researcher. The ability to use pre-recorded X-ray images -- instead of live X-ray -- during a cardiac implant procedure reduces exposure to potentially harmful radiation, he explained. "This new technology has the potential to revolutionize the way we image inside the body while we perform a wide range of diagnostic and therapeutic interventions in the future," he added. CRT implantation, which paces both the left and right ventricles, is becoming more common for patients with severe congestive heart failure and other heart problems, the researchers noted. "Currently, to view and manipulate the different tools that enable implantation of the left-sided lead in the patient's heart veins, physicians are forced to continuously use live X-ray imaging, exposing patients and themselves to potentially harmful amounts of X-ray," lead researcher said. "CRTs are implanted near the chest, and help the heart chambers beat more synchronously together and to pump blood more efficiently." Electrical lead wires extend from the device to the patient's heart chambers, and these leads provide electrical stimulation to the right and left sides of the heart so that the two sides beat together, pumping blood to the rest of the body more easily, he explained. The MediGuide system uses 3-D imaging to precisely navigate the catheter. "MediGuide, with the use of pre-recorded X-ray images, creates a real-time clinical environment that adjusts automatically for heart rate, respiratory motion and patient motion, and accurately tracks catheter position," he noted. The average amount of time of X-ray exposure needed to implant a CRT is often more than 20 minutes. With the new tracking system, X-ray exposure averages just five minutes, the researchers found. "It is well known that increased radiation exposure can be very harmful to the patient, the physician and the staff, increasing the risk of developing various types of cancer," he said. For the study, Richter's team used the new tracking system in 15 heart failure patients. In the procedure, X-ray imaging was used for the two device leads on the right side of the heart and the new tracking system was used to place the third lead, on the heart's left ventricle. One expert said he saw great potential for other uses for the technology.

SOURCE: HealthDay News, September 2013

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 Painkiller Risk !

Some Painkillers Tied To Certain Birth Defects In Study

Women taking prescription painkillers such as Oxycontin, Vicodin and Percocet early in pregnancy are twice as likely to give birth to babies with devastating neural tube defects such as spina bifida, a new study suggests. Despite the doubled risk, researchers described the escalation as "modest" since neural tube defects -- which include those of the brain and spine -- seldom occur. With study participants' use of prescription opioids, the risk of these birth defects translated to a prevalence of nearly six per 10,000 live births. "We want to keep in mind that major birth defects of any kind affect only 2 percent to 3 percent of live births, so the risks we've identified should be kept in perspective," said study author . "Even though we found a doubling in the risk of neural tube defects, these are still rare occurrences." Defects of the neural tube, which typically occur in the first month of pregnancy, include problems such as spina bifida, where the spinal column doesn't close completely, and anencephaly, where most of the brain and skull don't develop. The new study echoes findings from previous research linking birth defects with early pregnancy opioid use. Prescription painkillers are second only to marijuana when it comes to drug abuse, according to a January 2013 government report, and about 22 million Americans have misused these painkillers since 2002. The prevalence of opioid use among pregnant women ranges between 2 percent and 20 percent, according to background information included in the new study, which looked at drugs such as codeine, oxycodone (Oxycontin) and hydrocodone (Vicodin), among others. The author and her team used data collected during a 12-year span from telephone interviews with mothers within six months of childbirth. The interviews included detailed questions about medication use. Mothers of 305 children born with neural tube defects were compared to those of more than 20,000 babies in two other groups -- one of healthy babies, and babies with other types of birth defects that weren't related to opioid use. "Periconceptual" opioid use was defined as any reported use in the two months after the last menstrual period. Although the study found an association between the use of opioid painkillers during pregnancy and a higher risk of neural tube birth defects, it did not establish a cause-and-effect relationship. She said women of reproductive age who feel they need treatment with opioid painkillers should communicate with their physicians to discern the pros and cons. "It's really important that women talk with their health care provider about whether the benefits of treatment outweigh the possible risks," she said. "The more important question is: If something is preventable, why not prevent it?" she said. "The focus is what we can do to prevent any birth defect. That window of time around conception is one of the most critical times to be in the best condition possible."

SOURCE: HealthDay News, September 2013

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 Alzheimer’s Alert !

Alzheimer’s Cases To Triple By 2050

The number of men and women with Alzheimer’s disease is expected to triple in the next 40 years, according to a new analysis of U.S. Census data. The findings are consistent with earlier estimates of the devastating and growing burden of Alzheimer’s disease. "This increase is due to an aging baby boom generation,” said co-author of the report. “It will place a huge burden on society, disabling more people who develop the disease, challenging their caregivers, and straining medical and social safety nets." The findings were published in Neurology, from the American Academy of Neurology. The researchers estimated that 4.7 million Americans aged 65 and older had Alzheimer’s in 2010, or about one new case every 68 seconds. The number will triple to around 13.8 million by 2050, according to their estimates. "Our detailed projections use the most up-to-date data, but they are similar to projections made years and decades ago,” said co-author. “All of these projections anticipate a future with a dramatic increase in the number of people with Alzheimer's and should compel us to prepare for it." For the study, the researchers analyzed information from 10,802 African-American and White seniors living in Chicago between 1993 and 2011. Study participants were interviewed and assessed for dementia every three years. The data were combined with U.S. death rates, education and current and future population estimates from the Census Bureau. Alzheimer’s remains the most common form of dementia in the elderly. The disease most often develops in those older than 70, and prevalence increases with age. Indeed, advancing age remains the principal risk factor for the disease. More than one in four of those over 90 have Alzheimer’s. Worldwide, an estimated 35 million people have Alzheimer’s, which typically leads to death three to nine years after a diagnosis. The findings are an urgent reminder about the need for better research and treatments for the disease.

SOURCE: HealthDay News, September 2013

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Products of SQUARE Pharmaceuticals Ltd.

  Product Pentadol®  100
  Generic Name Tapentadol HCl
  Strength 100 mg
  Dosage form Tablet
  Therapeutic Category Non Narcotic Analgesic
  Product Amistar®
Generic Name Amikacin Sulphate
Strength 100 mg/2ml, 500 mg/2ml
Dosage form IM/IV Injection
Therapeutic Category Aminoglycoside
  Product Iracet® Oral Solution
  Generic Name Levetiracetam
  Strength 500 mg/5ml
  Dosage form Oral Solution
  Therapeutic Category Antiepileptic

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