e-SQUARE, September 2008

Eyes Reveal Heart Disease !
Eyes May Carry Early Clues to Heart Disease
The eyes may carry important early clues to heart disease, signaling damage to tiny blood vessels long before symptoms start to show elsewhere, researchers reported. People with a type of eye damage known as retinopathy were more likely to die of heart disease over the next 12 years than those without it, according to the team at the University of Sydney and the University of Melbourne in Australia and the National University of Singapore. They studied the retinal photographs of 3,000 people, most of whom had diabetes. Such snapshots are often taken to see if the diabetes has begun to damage the eyes. Then they checked records for deaths. “Over 12 years, 353 participants (11.9 percent) had incident coronary heart disease-related deaths," the researchers reported. People with retinopathy were nearly twice as likely to die of heart disease as people without it, said the team of the University of Sydney. Retinopathy raised the risk of heart disease as much as diabetes did, they found. Diabetes is a well known risk factor for heart disease, the leading cause of death in most industrialized nations and many developing ones. People with these changes may be getting a first warning that damage is occurring in their arteries, and work to lower cholesterol and blood pressure, the researchers added.
SOURCE: Reuters Limited, August 2008	Return to top

Anxiety Genes !
Gene Variant May Predispose Some to Anxiety
A gene variation may explain why some people are more prone to anxiety disorders, such as post-traumatic stress, a new study says. People carrying two copies of the Met158 variation of the catechol-O-methyltransferase (COMT) gene showed greater anxiety on a standard personality test and also were significantly more startled than others when shown a series of unpleasant pictures, according to the findings. Depending on ethnicity, about a quarter of the population carries two copies of Met158. The COMT gene produces an enzyme that breaks down the brain chemical dopamine, weakening its signal. The study's German and American authors said their finding offers a biochemical explanation for why some people find it harder to regulate emotional arousal. Their sensitivity, combined with other genetic and environmental factors, may make them more likely to have anxiety disorders. This finding also confirms suspicions that variations in the gene that regulates dopamine signaling may be linked to negative emotionality. The Met158 variation, the authors speculated, may increase dopamine levels in the brain's memory and emotional support systems, resulting in an "inflexible attentional focus" on unpleasant stimuli. Essentially, people with the Met158 carriers can't tear themselves away from something that's arousing -- even if it's bad. A single gene variation, though, can explain only some anxious behavior, said one of the researchers. "This single gene variation is potentially only one of many factors influencing such a complex trait as anxiety," said the study co-author. The researcher said that if further research continues to back this finding, one day "it might be possible to prescribe the right dose of the right drug, relative to genetic makeup, to treat anxiety disorders."
SOURCE: HealthDay News, August 2008	Return to top

Vitamin D And Death Risk !
Lack of Vitamin D Boosts The Risk of Death
Inadequate vitamin D could increase risk of death by 26 percent, a new study concludes. Yet many people are not getting enough vitamin D. A nationwide survey found that 41 percent of men and 53 percent of women in the United States were not getting enough of this vital nutrient. "The importance of vitamin D may be underappreciated," said lead author, a clinical fellow at Johns Hopkins University. "There are studies that link low vitamin D levels to the development of heart disease, peripheral arterial disease, diabetes, hypertension and different cancers," the researcher added. For the study, the team collected data on more than 13,000 men and women. Levels of vitamin D were collected in 1988 and 1994, and the participants were followed through 2000. During more than eight and a half years of follow-up, 1,806 people died. Among these, 777 died from cardiovascular disease. Four hundred of these people were found to be deficient in their vitamin D levels. "Those who had the lowest levels of vitamin D had a 26 percent higher risk of death from all causes compared to those with the highest vitamin D levels," the scientist noted. The findings in this study confirm a trend seen in other studies linking vitamin D deficiency to increased risk for breast cancer and depression in the elderly, the researchers noted. This research group had previously shown that vitamin D deficiency increases the risk of peripheral artery disease by 80 percent. Among other things, vitamin D is essential for maintaining levels of calcium and phosphorus in the body. According to the U.S. Institute of Medicine, people should get between 200 and 400 international units of vitamin D a day. In addition, not getting enough vitamin D also increases ther risk for type 2 diabetes, the scientist noted. By increasing the vitamin D intake to 800 international units a day reduces the risk of developing diabetes by as much as a third, he said. The director of the Vitamin D, Skin and Bone Research Laboratory at Boston University Medical Center, advocates high levels of vitamin D supplements to maintain good health. Vitamin D deficiency is probably the most common medical problem worldwide, the researcher added.
SOURCE: HealthDay News, August 2008	Return to top

Vitamin C Cuts Diabetes !
High Vitamin C Intake May Cut The Risk of Diabetes
An abundance of vitamin C in the diet may help lower a person's risk of developing type 2 diabetes, new research suggests. In a study of middle-aged and older men and women, those with the highest blood levels of vitamin C were significantly less likely to develop diabetes over 12 years than those with the lowest levels, researchers found. The research team followed 21,831 healthy men and women who were 40 to 75 years old for the development of type 2 diabetes. At study entry, all participants provided detailed health and lifestyle information, as well as blood samples, which investigators used to determine vitamin C levels. Over the course of the study, 423 men and 312 women developed type 2 diabetes, an overall rate of 3.2 percent. According to the investigators, the likelihood of developing diabetes was 62 percent lower in men and women with the highest circulating vitamin C levels, relative to men and women with the lowest vitamin C levels. Factoring out other characteristics associated with diabetes risk, such as older age, gender, family history, alcohol intake, physical activity, smoking status and body weight did not significantly alter these associations. These data offer "persuasive evidence of a beneficial effect of vitamin C and fruit and vegetable intake on diabetes risk," the research team concluded.
SOURCE: Reuters Health, August 2008	Return to top

Flu Vaccine Alert !
Flu Vaccine May not Protect Seniors From Pneumonia
Flu vaccine may not protect older people from pneumonia once they get the disease, researchers report. Older, frail adults are more susceptible to getting the flu, even if they have been vaccinated, and once getting the flu, they are more susceptible to such complications as pneumonia. It had been thought that flu vaccine would prevent flu -- and pneumonia -- across all groups of seniors, but this benefit appears to be largely confined to younger, healthier seniors. "In seniors, flu vaccine was not linked to a reduced risk of pneumonia," said lead researcher, a postdoctoral fellow at the Group Health Center for Health Studies in Seattle. The researcher still recommends that seniors get flu vaccine, however. "There have been good randomized trials that show, at least in healthy seniors, that the vaccine reduces the risk of influenza," he said. "However, earlier studies have overestimated how well the vaccine works in reducing complications of influenza. So, the vaccine may not reduce the risk of complications as much as previously thought," he said. Among young healthy seniors, the vaccine reduces the risk of flu, the scientist said. For the study, the research team collected data on 1,173 people between the ages of 65 and 94 who developed pneumonia. They compared these individuals with 2,346 people who did not get pneumonia. Both groups had similar rates of flu vaccination over the three seasons of studies, the researchers say. The researchers found that vaccinated seniors who got the flu were as likely to develop pneumonia as unvaccinated seniors who got the flu. The dean of the master of public health program at the State University of New York Downstate Medical Center in New York City, was not surprised by these results. "It is known that elderly people do not form sufficient antibodies to certain vaccines, the flu vaccine included," the scientist said. "In addition, people in their 70s and 80s and 90s are more prone to pneumonia with or without influenza. A number of these pneumonias may be secondary to other causes aside from influenza." Even though many of the elderly will not develop sufficient antibodies to the flu vaccine, getting the shot is still worthwhile, the researcher said.
SOURCE: HealthDay News, August 2008	Return to top

Birth Defect Risk !
Pre-Pregnancy Diabetes Boosts Risk for Birth Defects
Women who develop diabetes before they become pregnant are three to four times more likely than non-diabetic women to have a baby with at least one birth defect, says a U.S. Centers for Disease Control and Prevention study. This is the first study to identify the wide range of birth defects -- such as heart defects, brain and spine defects, oral clefts, limb deficiencies, and defects of the kidneys and gastrointestinal tract -- associated with pre-pregnancy diagnoses of type 1 or type 2 diabetes. "The continued association of diabetes with a number of birth defects highlights the importance of increasing the number of women who receive the best possible preconception care, especially for those diagnosed with diabetes," lead author, an epidemiologist at the CDC's National Center on Birth Defects and Developmental Disabilities, said. "Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children," the researcher added. In addition, preconception care should be considered and promoted for women with pre-pregnancy obesity, which is a known risk factor for diabetes and birth defects, the research team recommended. For this study, the researchers analyzed data on more than 30,000 people seen at nine birth defects centers across the country.
SOURCE: HealthDay News, July 2008	Return to top

New Products of SQUARE Pharmaceuticals Ltd.

	Product	Panodin^® SR
	Generic Name	Etodolac
	Strength	600 mg
	Dosage form	Tablet
	Therapeutic Category	Antirheumatic non-steroid
	Product	Esloric^® 300 Tablet
	Generic Name	Allopurinol
	Strength	300 mg
	Dosage form	Tablet
	Therapeutic Category	Antigout preparations
	Product	Frabex^® 500 mg Capsule
	Generic Name	Tranexamic acid
	Strength	500 mg
	Dosage form	Capsule
	Therapeutic Category	Antifibrinolytics
	Product	Cefotil^® Suspension
	Generic Name	Cefuroxime axetil
	Strength	70 ml
	Dosage form	Powder for suspension
	Therapeutic Category	Antibiotic cephalosporin

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Healthcare online	Keeping you up-to-date
VOL. 6 ISSUE: 9 September 18, 2008	Medical Services Department **SQUARE Pharmaceuticals Ltd.**