e-SQUARE, January 2022

Features

Alzheimer's Diseases !

'Good Cholesterol' !

Bariatric Surgery !

Lung Cancer !

Efficacious ORS !

Chronic Pain !

Products of SQUARE Pharmaceuticals PLC.

EDITORIAL TEAM

OMAR AKRAMUR RAB

MBBS, FCGP, FIAGP,

P G Dip. Business Management

RUBYEAT ADNAN

MBBS, MPH

Mushfiqur Rahman

MBBS

EDITORIAL

Dear Doctor,

Welcome to our online healthcare bulletin e- SQUARE !

In this issue, we focused on some interesting features like -
"Alzheimer's Diseases !", "'Good Cholesterol' !", "Bariatric Surgery !", "Lung Cancer !", "Efficacious ORS !", "Chronic Pain !".

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

Please send your feedback ! We always value your comments !

Click on to reply mode.

On behalf of the management of SQUARE, we wish you all a very happy, healthy and prosperous life.

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 PLC.

Alzheimer's Diseases !
Immune genes are altered in Alzheimer's patients' blood
A new study has found the immune system in the blood of Alzheimer's patients is epigenetically altered. That means the patients' behavior or environment has caused changes that affect the way their genes work. Many of these altered immune genes are the same ones that increase an individual's risk for Alzheimer's. Scientists now theorize the cause could be a previous viral infection, environmental pollutants or other lifestyle factors and behaviors. Many of these altered immune genes are the same ones that increase an individual's risk for Alzheimer's. Northwestern scientists theorize the cause could be a previous viral infection, environmental pollutants or other lifestyle factors and behaviors. Previous research showed that many of the mutated genes putting a person at higher risk for Alzheimer's are in the immune system. But scientists primarily studied the central immune system in the brain because Alzheimer's is a brain disease. Scientists have largely ignored the immune system in the blood, also known as the peripheral immune system. Scientists decided to study the blood & discovered every immune cell type in Alzheimer's patients has epigenetic changes, indicated by open chromatin. Chromatin is the packaging of the DNA within cells. When chromatin is open or exposed the cells' genome is vulnerable to alterations. Then, Scientists examined which genes are more open in these immune cells & discovered that a receptor CXCR3 on the T cells was more exposed. Scientists believes CXCR3 functions like an antenna on T cells that allows the cells to enter the brain. T cells do not normally enter the brain because they can cause inflammation. The brain is emitting a signal that it is damaged, and the T cells are homing to that signal by their antenna, CXCR3. T cells can be very toxic in the brain, but researcher don't know if these cells might be attempting to repair the damage in the brain. Scientists also discovered epigenetic changes in inflammatory proteins in white blood cells called monocytes & altogether, these findings indicate that immune function in Alzheimer's patients is significantly altered. It could be that environmental factors, like pollutants, or infections that a person has in their lifetime cause these epigenetic changes. The findings revealed several genes that may be therapeutic targets for manipulating the peripheral immune system. Next steps in the research are preclinical studies using in vitro culture systems and animal models to test these targets. The research is supported by National Institute of Neurological Disorders and Stroke grant NS112458 and National Institute on Aging grant AG078713, both of the National Institutes of Health, Bright Focus Foundation, Alzheimer's Association and Cure Alzheimer's Fund.
SOURCE: January, 2024 , Daily Science	Return to top

'Good Cholesterol' !
Very high levels of 'good cholesterol' may be associated with dementia risk
Abnormally high levels of HDL-C, colloquially known as 'good cholesterol', are associated with an increased risk of dementia in older adults. Researchers said very high levels of HDL-C linked to dementia risk in this study were uncommon and not diet related, but more likely to reflect a metabolic disorder. The findings may help doctors to recognise a group of older patients potentially at risk of dementia, particularly in those aged 75 and older. Published in The Lancet Regional Health Western Pacific, this is one of the largest studies of elevated HDL-C levels and dementia in initially healthy older people aged mostly over 70, enrolled in the ASPREE* (The Aspirin in Reducing Events in the Elderly) study. Over an average 6.3 years, participants with very high HDL-C (>80 mg/dL or >2.07 mmol/L) at study entry were observed to have a 27 per cent higher risk of dementia compared to participants with optimal HDL-C levels, while those aged 75 years and older also showed a 42 per cent increased risk compared to those with optimal levels. Very high HDL-C levels were categorised as 80 mg/dL (>2.07 mmol/L) or above. The optimal level of HDL-C of 40 to 60 mg/dL (1.03-1.55 mmol/L) for men and 50 to 60 mg/dL (1.55-2.07 mmol/L) for women was generally beneficial for heart health. Among 18,668 participants included in this analysis, 2709 had very high HDL-C at study entry, with 38 incidents of dementia in those aged less than 75 years with very high levels, and 101 in those aged 75 and more with very high levels. Research was needed to explain why a very high HDL cholesterol level appeared to affect the risk of dementia & these study findings could help improve our understanding of the mechanisms behind dementia, but more research was required. While know HDL cholesterol is important for cardiovascular health, this study suggests that further research to understand the role of very high HDL cholesterol in the context of brain health. It may be beneficial to consider very high HDL cholesterol levels in prediction algorithms for dementia risk.
SOURCE: January, 2024 , Daily Science	Return to top

Bariatric Surgery !
Weight loss surgery most effective for long-term blood pressure control
Bariatric surgery is more effective in controlling hypertension rates, or high blood pressure, in people with obesity and uncontrolled high blood pressure compared to blood pressure medication alone, according to a new study. People who underwent bariatric surgery had lower BMI and were on fewer medications after five years while maintaining normal blood pressure levels than those who only used antihypertensive medications. According to the CDC, the U.S. obesity and hypertension rates in adults are 41.9% and 45.4%, respectively. Obesity is a known risk factor for cardiovascular disease and a major contributor to high blood pressure, which can make a person more susceptible to heart attack, stroke and heart failure, among other risks. In clinical practice, obesity is an overlooked condition. As a consequence, there is a frequent failure in approaching obesity as a crucial step for mitigating the risk of important cardiovascular risk factors including hypertension. Researchers in this study looked at the impact of treating obesity to lower high blood pressure. While there are new medications to treat obesity, long-term adherence to medication can be challenging. This study looks at bariatric surgery where all participants had hypertension and were using at least two medications. People with previous cardiovascular events and poorly controlled Type 2 diabetes were excluded. Subjects were assigned to either Roux-en-Y gastric bypass with medical therapy or medial therapy alone and the primary outcome was reduction of at least 30% antihypertensive medications while maintaining blood pressure levels less than 140/90 mmHg at five years. People who had bariatric surgery had an 80.7% reduction in the number of medications they were taking compared to a 13.7% reduction in those only using medical therapy. Hypertension remission, defined as controlled blood pressure without medications, was 46.9% in those who underwent bariatric surgery compared to 2.4% in those on medical therapy alone.The study provides important long-term data on the benefits of gastric bypass on weight loss and blood pressure control.
SOURCE: January, 2024 , Daily Science	Return to top

Lung Cancer !
How one type of lung cancer can transform into another
Lung tumors called adenocarcinomas sometimes respond to initially effective treatments by transforming into a much more aggressive small cell lung cancer (SCLC) that spreads rapidly and has few options for treatment. Researchers have developed a mouse model that illuminates this problematic process, known as histological transformation. The findings advance the understanding of how mutated genes can trigger cancer evolution and suggest targets for more effective treatments. It is very difficult to study this process in human patients. So my aim was to uncover the mechanism underlying the transformation of lung adenocarcinoma to small cell lung cancer in a mouse model. The complex mouse model took several years to develop and characterize but has allowed the researchers to crack this difficult problem. It is well known that cancer cells continue to evolve, especially to escape the pressure of effective treatments. This study shows how new technologies including the detection of molecular features of single cancer cells, combined with computer-based analysis of the data can portray dramatic, complex events in the evolution of lethal cancers, exposing new targets for therapeutic attack. SCLC most commonly occurs in heavy smokers, but this type of tumor also develops in a significant number of patients with lung adenocarcinomas, particularly after treatment with therapies that target a protein called Epidermal Growth Factor Receptor (EGFR), which promotes tumor growth. The new SCLC-type tumors are resistant to anti-EGFR therapy because their growth is fueled by a new cancer driver, high levels of Myc protein. Oncogenes, such as EGFR and Myc, are mutated forms of genes that normally control cell growth. They are known for their roles in driving the growth and spread of cancer. Tumor suppressor genes, on the other hand, normally inhibit cell proliferation and tumor development. Surprisingly, this study showed that oncogenes act in a context-dependent manner. While most lung cells are resistant to becoming cancerous by Myc, neuroendocrine cells, are very sensitive to the oncogenic effects of Myc. Conversely, epithelial cells, which line the air sacs of the lungs and are the precursors to lung adenocarcinomas, grow excessively in response to mutated EGFR. The researchers also discovered a stem cell-like intermediate that was neither adenocarcinoma nor SCLC. Cells in this transitional state became neuroendocrine in nature only when mutations in the tumor suppressor genes RB1 and TP53 were present. This study further supports efforts seeking therapeutics that target Myc proteins, which are implicated in many types of cancers.
SOURCE: January, 2024 , Daily Science	Return to top

Efficacious ORS !
ORS could save half a million children's lives each year
Health care providers in developing countries know that oral rehydration salts (ORS) are a lifesaving and inexpensive treatment for diarrheal disease, a leading cause of death for children worldwide. A new study suggests that closing the knowledge gap between what treatments health care providers think patients want and what treatments patients really want could help save half a million lives a year and reduce unnecessary use of antibiotics. There are several popular explanations for the under prescription of ORS in South Asia. Physicians assume their patients do not want oral rehydration salts, which come in a small packet and dissolve in water, because they taste bad or they aren't "real" medicine like antibiotics. Physicians make more prescribing antibiotics, even though they are ineffective against viral diarrhea. In study, providers were randomly assigned to patient visits where patients expressed a preference for ORS, a preference for antibiotics or no treatment preference. During the visits, patients indicated their preference by showing the health care provider a photo of an ORS packet or antibiotics. The set of patients with no treatment preference simply asked the physician for a recommendation. To control for profit-motivated prescribing, some of the standardized patients assigned as having no treatment preference informed the provider that they would purchase medicine elsewhere. Health care providers' perception that patients do not want ORS accounted for roughly 42% of under prescribing, while stock outs and financial incentives explained only 6% and 5%, respectively. Patients expressing a preference for ORS increased prescribing of the treatment by 27 percentage points a more effective intervention than eliminating stock outs (which increased ORS prescribing by 7 percentage points) or removing financial incentives (which only increased ORS prescribing at pharmacies). Study authors said these results can be used to design interventions that encourage patients and caretakers to express an ORS preference when seeking care, as well as efforts to raise awareness among providers about patients' preferences.
SOURCE: January, 2024 , Daily Science	Return to top

Chronic Pain !
Researchers uncover potential non-opioid treatment for chronic pain
A new approach to treating neuropathic pain is making a key step forward. Neuropathic pain is among the most difficult types of pain to alleviate and current treatments are often ineffective. Researchers have identified a potential non-opioid treatment. Among the most difficult types of pain to alleviate is neuropathic pain, pain that is usually caused by damage to nerves in various body tissues, including skin, muscle and joints. It can cause patients to suffer feelings like electric shocks, tingling, burning or stabbing. Diabetes, multiple sclerosis, chemotherapy drugs, injuries and amputations have all been associated with neuropathic pain, which is often chronic, sometimes unrelenting and affects millions of people worldwide. Many of the available pain medications are only moderately effective at treating this type of pain and often come with serious side effects, as well as risk of addiction. Scientist found it to be an effective painkiller, and the effects were rather long-lived. When tested it on different models, diabetic neuropathy and chemotherapy-induced neuropathy, for example, researcher found this compound has an incredible beneficial effect. The new compound, dubbed FEM-1689, does not engage opioid receptors in the body, making it a possible alternative to existing pain medications linked to addiction. In addition to reducing sensitivity, the compound can help regulate the integrated stress response (ISR), a network of cellular signaling that helps the body respond to injuries and diseases. When well regulated, the ISR restores balance and promotes healing. When it goes awry, the ISR can contribute to diseases such as cancer, diabetes and metabolic disorders. It's goal to make this compound into a drug that can be used to treat chronic pain without the dangers of opioids. Neuropathic pain is often a debilitating condition that can affect people their entire lives, and need a treatment that is well tolerated and effective. This work is the culmination of a wonderful five-year collaboration with our colleagues at UT Austin and is a great example of academic drug discovery pushing the field of non-opioid pain therapeutics forward. Scientist has the potential to take us toward clinical development in the next few years, which is extraordinarily exciting.
SOURCE: January, 2024 , Daily Science	Return to top

Products of SQUARE Pharmaceuticals PLC.

	Product	Antiscar^TM
	Generic Name	Extractum Cepae +Heparin +Allantoin
	Strength	100 mg+ 0.278 mg+10 mg
	Dosage form	Gel
	Therapeutic Category	Antiscar
	Product	Nomi^TM
	Generic Name	Zolmitriptan
	Strength	2.5 mg/spray
	Dosage form	Nasal Spray
	Therapeutic Category	Antimigraine
	Product	Magnide^TM
	Generic Name	Magnesium Oxide
	Strength	365 mg
	Dosage form	Tablet
	Therapeutic Category	Mineral

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Healthcare online	Keeping you up-to-date
*VOL. 22 ISSUE: 1 January 2024*	Medical Services Department **SQUARE Pharmaceuticals PLC.**