theScript - Issue 39 by CJMarketing

Pharmacy Magazine

Obesity in Children and Adolescents

FOCUS ON EYE CARE AWARENESS From 23 September until to 20 October

The fight against tooth decay

CORPORATEPUBLICATION FREE • NOT FOR SALE

WIN WITH TIBB’S PRO RANGE

SPLENDID SPRING RECIPES

Issue 39

BRAND NEW SWEETENER PRODUCT NOW AVAILABLE IN SA

Ideal for

Life is Sweet.

Stevia Sweetner

Suvia is 100% Natural & Calorie Free and is 25 times sweeter than sugar. Suvia is the healthy way to sweeten and that is why with Suvia... Life is Sweet!

SUVIA IS HIGH QUALITY & 30% CHEAPER THAN THE LEADING BRAND For more info Contact Ilza on

083 272 5264

Diabetics!

Visit www.nissan.co.za or phone 0800 NISSAN (647726)

AFTER 35,

OSTEOPOROSIS IS A HAZARD

•

After 35, your bone density decreases1

•

1 in 3 women over 50 will experience a bone fracture related to osteoporosis2

•

Sandoz Calcium Forte is registered and clinically proven in the management of osteoporosis3

•

Sandoz Calcium Optim+ is an effective combination of calcium and vitamin D for enhanced absorption4

Reference: 1. Sandoz Calcium Forte Package Insert 2. Osteoporosis. http://www.emedicine.com. 3. International osteoporosis foundation: http://www.iofbonehealth.org/facts-and-statistics.html 4. Institute for clinical systems improvement. Health Care Guideline: Diagnosis and treatment of osteoporosis. 7th edition; July 2011.

S0 Sandoz Calcium Forte Effervescent Tablet. Each tablet contains 0,3 g calcium carbonate and 2,94 g calcium lactate gluconate, equivalent to 500 mg elemental calcium. Reg. No. E/24/1097. PIease refer to package insert for full prescribing information. Sandoz Calcium Optim Plus. Each tablet contains 1.5 g calcium carbonate equivalent to 600 mg elemental calcium, 400 IU vitamin D, 40 mg magnesium, 7.5 mg zinc, 1 mg copper and 250 µg boron. Ref. No. 136880 (complementary medicine). Marketed by Novartis Consumer Health. A division of Novartis South Africa (Pty) Ltd. 72 Steel Road, Spartan, Kempton Park. Tel. (011) 929-9111. Fax: (011) 929 2063. Co. Reg. No. 1946/020671/07 Customer Care Line: 0861 929 929. January 2012

Available at leading pharmacies

THE BONE DOCTOR

Nr. 12, 4th Street, Delmas PO Box 186, Delmas 2210 Tel: 013 665 1011 Fax: 013 665 4713 Registered: CJ Pharmaceutical Enterprises (Ltd) VAT Reg. 409 0205 909 Reg: 2001/009972.06 Telesales [tel] 013 665 1011 [fax] 086 695 5230 [fax] 086 512 0965 Ruan email: ruan@cjpharm.co.za Anette email: anette@cjpharm.co.za Mercia email: mercia@cjpharm.co.za Rep Orders Priscilla or Beauty email: telesales@cjpharm.co.za

[tel] 013 665 1011 [fax] 086 697 9506 Product Returns Maria, Brenda [tel] 013 665 1011

email: customercare@cjpharm.co.za

Operations Egon Sellner (COO) email: esellner@cjpharm.co.za

Customer Relations Theuns [cell] 072 638 4085 email: theuns.w@cjpharm.co.za

Ridwaan [cell] 072 534 8135 email: ridwaan@cjpharm.co.za

Lynne[cell] 071 472 7522

email: lynne@cjpharm.co.za

Account Queries Debtors : Maritsa

email: maritsa@cjpharm.co.za

Creditors : Sonja

email: sonja@cjpharm.co.za

Buying Department Estelle email: estelle@cjpharm.co.za Christa email: christa@cjpharm.co.za Inventory Manager Erika Oehley email: erika@cjpharm.co.za

Tech & Data Reporting Werner email: it@cjpharm.co.za Senior Management Christopher Williams (CEO) email: willchem@global.co.za

Chris Williams (MD)

email: chris@cjpharm.co.za

Nr. 12, 4th Street, Delmas PO Box 186, Delmas 2210 Tel: 013 010 0091 Fax: 013 665 4299 Advertising & Promotions Jan Bester (Marketing Coordinator)

Index Facts about Albinism 6 We look at the facts surrounding this inherit generic disorder

Commom eye conditions 8 With October bing eyecare awareness month, we look at the most common conditions surrounding ocular health.

Say Cheese 14 Tooth decay is still the most common food – related disease affecting all families, having the economic impact of heart disease, obesity and diabetes

Muscular Distrophe 17 Find out more about the diseases that weaken the musculoskeletal system and hamper locomotion

Food 22 Spring into action with these seasonally inspired recipes.

WIN! with Tibb’s Pro Range 24 Enter our competition and stand a chance to win 1 of 6 kitchen appliances.

Mind movers 26 The brain is like a muscle—the more you use it, the stronger it gets. ... Measure your mental fitness with these mind-bending tests

Obesity in Children & Adolescents 31 We look at the impact of obesity in the lives of young South Africans

email: cjmarketing@cjpharm.co.za

[fax] 086 698 1468 Thea Botes

email: marketing@cjpharm.co.za

[fax] 086 698 1468 Customer Relations Theuns [cell] 072 638 4085 email: theuns.w@cjpharm.co.za

Lynne[cell] 071 472 7522 email: lynne@cjpharm.co.za

Ridwaan [cell] 072 534 8135

email: ridwaan@cjpharm.co.za

Account Queries Debtors : Caron

About the cover

Eye Care Awareness Month is commemorated from 23 September to 20 October to raise awareness about the importance of eye health, specifically around the prevention and treatment of avoidable blindness. Seventy-five percent of blindness is avoidable either through prevention or through treatment – which is why it is important reccomend that patients have their eyes tested at least once per year. See page 8 for more on Common Eye Conditions. Cover picture : 123rf.com

email: finance@cjpharm.co.za MAGAZINE DESIGN & LAYOUT Marizelle Geldenhuis (Creative Director) Carl Loggenberg (Graphic Designer) Mariëtte Louw (Graphic Designer)

The information contained in this publication, is to the best of our knowledge, accurate and correct by the time of going to print. Claims and comments published in this magazine are that of the author and not of CJ Pharmaceuticals. We do not hold ourselves responsible for any errors and omissions in supplied material. All prices are excl. VAT and subject to change without prior notice. Pictures are for illustration purposes only. E&OE

The Script Pharmacy Magazine │September 2013 • October 2013

COMMON EYE CONDITIONS

Are you one of millions of people around the world walking around with a sight-threatening disease? Unless you have your eyes checked regularly by a professional, you might not even be aware that your sight’s in danger. Some diseases, like glaucoma, have no early warning signs. Instead, vision deteriorates silently and painlessly until it results in total blindness. But if glaucoma’s detected early enough and is correctly treated, vision loss and blindness may be prevented. Eyesight’s one of the most precious gifts a person can have. That’s why we encourage you to have your eyes checked this October, during Eye Care Awareness Month (ECAM). Many people don’t pay

much attention to their eyesight or the health of their eyes. It’s unfortunate, as 80% of blindness is avoidable. Most eye conditions can be successfully treated if detected early. So please get your eyes tested this October, and take practical measures to protect your eyes like wearing sunglasses and protecting your eyes against injuries. Your vision is a great gift. CAM eye-care tips: • Visit an optometrist or doctor

regularly and don’t ignore problems with your eyes. This way you can detect and treat eye conditions early on. • Protect your eyes from damage or scratches from foreign objects that can lead to infection or damage. Wear protective eye-wear when working with equipment that may cause shards to fly into your eyes. • Wear sunglasses that give your eyes proper protection from the damaging

The Script Pharmacy Magazine │September 2013 • October 2013

EYE CARE AWARENESS MONTH 23 SEPTEMBER - 20 OCTOBER

rays of the sun. • Take regular breaks from your computer screen to minimise eye strain and the development of eyefocusing problems. For more interesting information on eye care, http://www.eyelaserclinic. co.za Don’t get blue about pink eye Conjunctivitis is often called pink eye and is inflammation or infection of the membrane lining the eye and eyelids (the conjunctiva). Treatment of conjunctivitis depends on the cause, but is usually effective if treated timeously. Good hygiene can help its prevention and re-infection: such as keeping your hands away from your eyes and diligent hand washing; changing pillowcases frequently; not sharing eye cosmetics, towels or handkerchiefs; and proper handling and cleaning of contact lenses. And be careful when you have fever blisters, as touching your eyes after contact with a fever blister can give you pink eye!

Optic Nerve Hypoplasia (ONH) A person with Optic Nerve Hypoplasia (ONH) has small eye nerves (optic nerves) from the eye to the brain. Some people with ONH also have an abnormal brain and a poorly functioning pituitary gland. The attached brochure explains the problems that can occur in children with ONH. Your child may have none, any, or all of these problems in a mild or more serious form. Depending on the person’s problem sometimes the disease is called Optic nerve Hypoplasia (ONH), septo-optic dysplasia, or De Morsier’s syndrome. If you need support, please email Karen Muller karenkzn@telkomsa. net or phone her on: 083 328-1938 or 031 762-2602.

Refractive Errors The image illustrates what an orange Daisy might look like to a person with

Refractive Errors 8

Glaucoma

uncorrected refractive error. Refractive errors are a set of eye conditions that occur because of an irregular eye shape which affects the way light is focused in the eye- these conditions result in blurry or distorted vision. There are three different types of refractive errors, namely myopia/ near sightedness (close up sight is normal, but distant objects are blurry), hyperopia / far sightedness (objects at close range are blurry, while distant objects are not) and astigmatism where your vision is blurred at all distances. Statistics According to the WHO website (Resnikoff et al: 2004), uncorrected refractive errors account for 18.2% of global blindness, making it the 2nd biggest cause of blindness worldwide. Risk factors • As refractive errors are hereditary, people with a family history of a refractive error are at risk of having the condition themselves. • Eye injury as well as certain ocular disorders, like keratoconus, can put a person at risk of developing a refractive error. Prevention and treatment • Diagnosis and correction of a refractive error is quite quick and simple. Blindness as a result of this condition is avoidable if the condition is corrected, which is why it is important that every person have an eye examination at least once every two years. • Refractive errors can be corrected through the use of glasses, contact lenses or refractive surgery. • Corrective measures are relatively cheap and readily available.

Glaucoma Glaucoma is a treatable eye-condition that arises from an increase of pressure in the eye. Increased pressure can damage the eye’s optic nerve and cause vision loss and eventually, blindness. The image illustrates what an orange Daisy would look like to a person with glaucoma.

Diabetic retinopathy

The Script Pharmacy Magazine │September 2013 • October 2013

Cataract

Statistics According to the WHO website (Resnikoff et al: 2004), glaucoma accounts for 10.1% of global blindness, making it the 3rd largest cause of blindness worldwide. Risk Factors People who are at greater risk of developing glaucoma include: • Those with high blood pressure, • Those with high eye pressure, • Those who have a family history of glaucoma, • African and Asian people, who are said to have a greater chance of developing glaucoma, and • Those people who are over the age of 60 - chances of developing glaucoma increase as we age. Prevention and treatment • Prevention is always better than the cure - a comprehensive eye exam at least once every two years is strongly advised. • Treatment of glaucoma can include medicines (eye drops or pills) and surgery (laser or conventional) or a combination of both medicine and surgery.

Diabetic retinopathy People with diabetes are at risk of developing diabetic retinopathy, which is a disease of the blood vessels in the retina of the eye. The image illustrates what an orange Daisy would look like to a person with diabetic retinopathy. Statistics According to the WHO website (Resnikoff et al: 2004), diabetic retinopathy accounts for 3.9% of global blindness, making it the 6th biggest cause of blindness worldwide. Risk factors People who are at risk of developing diabetic retinopathy are those with diabetes –type 1 and 2. Prevention and treatment • Everyone with diabetes should get a comprehensive dilated eye exam every year. • Diabetics should have their blood sugar levels, blood pressure

Age-related macular degeneration

The Script Pharmacy Magazine │September 2013 • October 2013

EYE CARE AWARENESS MONTH 23 SEPTEMBER - 20 OCTOBER

and cholesterol under control by maintaining a healthy diet and sticking to their treatment plan. • Eliminating risks that are known to damage blood vessels, such as smoking, will help prevent the onset of diabetic retinopathy. • Diabetic retinopathy is treated with laser surgery (scatter laser or focal laser treatment) or with a vitrectomy (surgical procedure).

resulting in a progressive loss of central vision. The image illustrates what an orange Daisy would look like to a person with age -related macular degeneration.

Cataract

Risk factors There are certain factors that can increase your risk of developing AMD, which include: • Unhealthy diet, • Smoking and alcohol abuse, • Prolonged exposure to sunlight, • Cardiovascular disease and Hypertension, • Genetics - a family history of AMD will increase your chances of developing it and, • Age - the older you get, the higher your chance of developing AMD.

Cataract is a gradual clouding of the eye lens, leading to blurred or dull vision. The eye condition can however be corrected through surgery. The image illustrates what an orange Daisy would look like to a person with cataracts. Statistics According to statistics from the World Health Organisation (WHO) website (Resnikoff et al: 2004), cataract accounts for 39.1% of global blindness, making it the largest cause of blindness worldwide. Risk factors Contributing factors which increase risk of developing cataract include: • Prolonged exposure to the sun’s UV-B light; • Exposure to radiation; • Smoking and alcohol abuse; • Diabetes, as well as obesity; • Age - the older you get, the higher your chance of developing cataract. Prevention and treatment • As with many other eye conditions, the effects of cataract can be slowed down and reversed with early detection –a comprehensive eye exam is necessary at least once every two years. • Good nutrition, in particular, eating foods rich in antioxidants, can help slow the progress of cataract. • Wearing protection (such as sunscreen, sunglasses and a wide-brimmed hat) whilst in the sun can prevent future development of cataract. • Stop smoking. • Surgery is the only way to treat cataract.

Age-related macular degeneration Age-related macular degeneration (AMD) is a degenerative retinal disease that affects the macula of the eye

Statistics According to the WHO website (Resnikoff et al: 2004), AMD accounts for 7.1% of global blindness, making it the 4th biggest cause of blindness worldwide.

Prevention and treatment • A new treatment is available for “wet” AMD whereby an anti-angiogenic is injected into the eye to slow the formation of new rogue blood vessels which can cause sudden and dramatic vision loss. • A regular eye examination, at least once every two years, will allow for early detection of AMD. • A healthy diet with an increase in zinc and antioxidants will significantly reduce your risk of developing advanced AMD. Cataract, refractive errors, glaucoma, age-related macular degeneration and diabetic retinopathy could cause you to lose your sight. Regular eye tests, from a young age, will allow you to treat the early signs of these eye conditions, before you lose your sight later in life. Fight for your sight – test your eyes today. See more at: http://www.sancb.org. za/categories/your-eyes/commoneye-conditions#sthash.6cnXRu35. dpuf

Children and eyecare. The following signs it could be indicative of a vision problem: • Rubs eyes frequently • Attempts to brush away blur (children) • Has dizziness, headaches or nausea following close proximity work

The Script Pharmacy Magazine │September 2013 • October 2013

• Is inattentive during lessons done on chalkboard, wall chart or map (children) • When looking at distant objects:  Holds body tense  Contorts face in attempts to see distant things clearly  Thrusts head forward  Squints eyes excessively • When reading:  Blinks excessively  Holds book too far from face  Holds book too close to face  Makes frequent changes in distance when book is held  Stops after brief period  Shuts or covers one eye  Tilts head to one side  Tends to reverse words or syllables  Tends to look cross-eyed Tends to lose place on page Confuses words or letters Complains that eyes hurt or feel “dusty” (children) Prefers to view distant objects rather than those close-by • Frequent appearance of sties, a bloodshot condition, eye watering or redness of the tissues around the eye • Unusual tendency to hold or move a hand in front of the eyes • Abnormal sensitivity to light or unusual difficulty adapting to very low levels of light When any of the above symptoms or indicators is noted, a professional eye care specialist should be consulted for a thorough eye examination and test.

Important causes of blindness in one eye Injuries These can result from accidents caused by a variety of objects, such as sticks, stones, BB pellets and fireworks. Children should be discouraged from playing with items like these. “Lazy eye” This may occur where children have a squint (when eyes are not straight), or sometimes if the child needs glasses. If neglected, this condition cannot be treated. How to prevent childhood blindness? • No sticks, stones, BB gun pellets and fireworks • No harmful traditional eye medicines • Ensure good nutrition and face hygiene If you think your child has a vision problem, don’t delay; get their eyes tested by a professional. http://www.blind-institute.org.za

Fa s t e f f e c t i v e

Comparable

efficacy to coxibs

Analgesic

efficacy

brand of Ibuprofen

proven clinical

Wide ranging

well-known international

Fast , effective

nfid ty fe e s a i l d r e n in adu l h

Superior pain relief

to aspirin & paracetamol

& chronic inflammatory conditions

Reliable efficacy in acute

Comparable s o fAnti-infl efficacy tocoxibs ammatory

clinical efficacy

Wide ranging proven

Fast, effective rom mild to relief fmoderate pain

well-known international brand of Ibuprofen

aspirin han d t etamol te c ra p a ra n

e r fo f e v

t & en ion tm at ea m tr lam e , inf linpain

Bette r s a f e t ol e rt ha

n safety e i children c n s& t

antipyretic

f i d ence Co n in i n adults & c

r or ve t f fe en & m on at ati tre mm ne fla -li in st in, Fir pa

i n a dul

e i n safe nc & chi ldr ty

rs Fi

l Ns a f e s tI D SA

Conf ide

Fine Healthcare 315919

Straight to the source of pain

NUROFEN速 PERIOD PAIN. COMPOSITION: Each sugar-coated tablet contains ibuprofen 400 mg. REG. NO.: W/2.7/142. NUROFEN速 Tablets. COMPOSITION: Each sugar-coated tablet contains ibuprofen 200 mg. REG. NO.: S/2.7/123. NUROFEN速 PLUS. COMPOSITION: Each tablet contains ibuprofen 200 mg and Codeine phosphate 12,8 mg. REG. NO.: 37/2.7/0666. S2 NUROFEN速 Colds and Flu. COMPOSITION: Each film-coated tablet contains ibuprofen 200 mg and pseudoephedrine hydrochloride 30 mg. REG. NO.: Z/5.8/256. S2

NAME AND ADDRESS OF THE HOLDER OF THE REGISTRATION CERTIFICATE: Reckitt Benckiser Pharmaceuticals (Pty) Ltd, 8 Jet Park Road, Elandsfontein, 1601. IBU. 13/02-20. For further information, refer to package insert.

Ibuprofen: pharmacology, efficacy and safety Rainsford KD. Inflammopharmacology 2009; 17: 275-342.

Summary Introduction Ibuprofen has become one of the most commonly used analgesic-antipyreticanti-inflammatory drugs worldwide. For non-prescription, over-the-counter (OTC) treatment of acute pain, inflammation and fever, it probably ranks third after aspirin and paracetamol, but is less toxic than these alternative analgesics, being rarely associated with serious adverse reactions or with deaths from deliberate or accidental ingestion. Much of the success of ibuprofen may be attributed to an emphasis on cautious use after its introduction in 1969, with subsequent experience and reassurance of its safety leading to escalation of the recommended daily dose from 400-1200 mg to the current recommended dosage of 2400 mg a day. In comparison with the non-prescription OTC use of paracetamol in paediatric patients, ibuprofen is equally efficacious in controlling fever. However, because of their differing and complimentary mechanisms of action, the combination of ibuprofen and paracetamol may be even more effective, with the two treatments having additive or synergistic effects. When used for OTC indications, claims that paracetamol may be associated with fewer gastrointestinal (GI) and renal adverse effects than ibuprofen appear to be unfounded, as these differences have proven to be minimal or nonexistent. In contrast, liver toxicity is a particular concern with paracetamol, and at prescription doses ibuprofen may be associated with a lower risk of GI side effects compared to other alternative NSAIDs, such as naproxen and ketoprofen.

Pharmacokinetics Oral pharmacokinetics in adults Most ibuprofen formulations exist as a diastereoisomeric mixture of the S(+) enantiomer, which inhibits prostaglandin (PG) synthesis, and the R(-) enantiomer, which is less active as a PG synthesis inhibitor, but may have pharmacological properties relevant to the anti-inflammatory actions of ibuprofen. After absorption, R(-) is converted to S(+) ibuprofen.

In adults, ibuprofen has predictable and reliable pharmacokinetic properties. It is rapidly absorbed, with peak plasma concentrations occurring at approximately 1-2 hours. Plasma S/R ratio may vary depending on the time-release characteristics of the formulation. The half-life of approximately 2-3 hours is relatively unaffected by the dosage and phase I metabolism is principally by cytochromes P450 2C9 (CYP-2C9) and CYP-2C8. Phase II metabolism is by glucuronidation and, less importantly, by conjugation with taurine. Approximately 1% of unchanged drug and active phase II metabolites are excreted in the bile, in contrast with 50% of urinary excretion. Consequently, genetic polymorphisms involving these CYP enzymes, compromised liver metabolism (for example in patients with cirrhosis), renal disease and age may influence and prolong the clearance of ibuprofen. Ibuprofen is highly protein bound, with a low volume of distribution, but has the capacity to accumulate in inflamed compartments, such as synovial fluid and cerebrospinal fluid where there is a need for anti-inflammatory/analgesic activity. Although chronic disease states, such as arthritis, have little impact on the kinetics of ibuprofen, perioperative stress responses affecting GI function may reduce ibuprofen absorption and reduce serum concentrations, arguing in favour of higher doses of the drug when used for pain control perioperatively.

Pharmacokinetics in children In general the pharmacokinetic properties of ibuprofen in children aged younger than 12 years and the group aged 12-18 years are comparable to those in young-middle aged adults. Differences that have been described in younger children include a lower conversion of R(-) ibuprofen to its S(+) enantiomer in infants (6-18 months) and, in children less than 5 years of age, lower clearance and volume of distribution with prolonged plasma half-life of elimination.

General safety profile Large scale controlled clinical trials and extensive postmarketing epidemiologi-

cal data have attested to the favourable safety profile of ibuprofen. At prescription doses, in comparison with other traditional, non-selective NSAIDs, ibuprofen is among those with the lowest risks of serious (e.g. peptic ulcer bleeds) gastrointestinal adverse events and adverse events related to the liver and biliary system and ‘body as a whole’. With long term use (>6 months), in comparison with the coxibs, ibuprofen has a comparable and low risk of serious GI adverse events. Symptomatic GI events (e.g. dyspepsia, nausea, heartburn) are in general comparable with those from the coxibs. In clinical trials, ibuprofen was no more likely than the coxibs to be associated with withdrawal from studies due to adverse events. At OTC doses the occurrence of adverse events with ibuprofen is comparable to paracetamol and less frequent than with aspirin. After single doses, the occurrence of adverse events is comparable to, or less frequent than placebo. Ibuprofen has a low risk of symptomatic or serious GI events and is unlikely to be associated with the development of renal or cardiovascular (CV) events. It is not associated with a risk of liver injury, and especially not with the irreversible liver damage observed with paracetamol and occasional liver reactions associated with aspirin. The safety of ibuprofen has been extensively evaluated in studies of paediatric patients with fever and/ or pain (including patients ≤2 years and ≤6 months) and all have shown that, when administered at the recommended dose, ibuprofen is associated with a low incidence of serious and non-serious adverse events, comparable to paracetamol. Notably, ibuprofen was not associated with severe renal or asthmatic events, anaphylaxis or a risk of Reye’s syndrome.

Conclusions There is substantial evidence of safety and efficacy in support of the view that ibuprofen is a safe and very effective drug for use in a range of painful, acute and chronic inflammatory conditions.

SAY

CHEESE

Even with fluoridation and oral hygiene, tooth decay is still the most common food â&#x20AC;&#x201C; related disease affecting all families, having the economic impact of heart disease, obesity and diabetes. There seems to be a lot more that can be done to help individuals prevent tooth decay based on what is already known.

develop inside pits and fissures in grooves on chewing surfaces where the brush and fluoride toothpaste cannot reach.

However decay is easy to prevent by reducing acid demineralisation from food left on teeth, neutralising acid after eating, or at least twice a day chewing a special form of toothpaste before or after brushing.

Fissure sealants painted over chewing surfaces blocks food being trapped inside pits and fissures and changed to acid helping prevent acid demineralisation and tooth decay about as much as fluoridation where over 80% of cavities occur. Sealants forced inside pits and fissures under chewing pressure penetrate deeper inside chewing surfaces where food is forced under chewing pressure where brushing cannot reach as seen with a glass model of a fissure.

All cavities occur from acid demineralisation of teeth where chewing leaves food trapped on teeth. Though more than 95% of trapped food is left packed between teeth after every meal or snack, over 80% of cavities 14

The Script Pharmacy Magazine â&#x201D;&#x201A;September 2013 â&#x20AC;˘ October 2013

Chewing fibre like celery after eating helps force saliva inside pits and fissures and between teeth to dilute carbohydrate like sugar in trapped food, neutralise acid and remineralise tooth better than chewing gum that cannot absorb or expel saliva. Chewing toothpaste before or after brushing would help fluoride remineralise susceptible tooth surfaces between teeth and inside pits and fissures where brushing cannot reach.

Public health dentistry, dental speciality concerned primarily with prevention of dental decay and of periodontal disease (disease of the

NATIONAL ORAL HEALTH MONTH SEPTEMBER 2013

tissues surrounding the teeth). Public health dentistry is practiced generally through governmentally sponsored programs, which are for the most part directed toward public-school children in the belief that their education in oral hygiene is the best way to reach the general public. The pattern for such programs in the past was a dentist’s annual visit to a school to lecture and to demonstrate proper toothbrushing techniques. The 1970s saw the emergence of a more elaborate program that included a week of one-hour sessions of instruction, demonstration, and questions and answers, conducted by a dentist and a dental assistant and aided by a teacher who had previously been given several hours of instruction. Use was also made of televised dental health education programs, which parents were encouraged to observe. On a larger scale, public health dentistry has been concerned with the improvement of oral health in large populations. Thus, the fluoridation of municipal water supplies in the mid1940s resulted from research studies conducted by the U.S. Public Health Service. This service is also involved in the delivery of dental care to specialized populations, including Native Americans on reservations, as well as the Eskimo population of Alaska. *Journal of Public Health Dentistry

What is Fluoride? Fluoride is a natural element that can be found in many things, like the water we drink and the food we eat. Decades ago, scientists began to notice that children who lived in places where fluoride occurred naturally in the water, had fewer dental cavities. Fluoride that is absorbed by your body is used by the cells that build your teeth to make stronger enamel. Topical fluoride - fluoride that is applied to the outside of the enamel - makes the crystals that form enamel more durable. Tooth enamel crystals that have fluoride are much more resistant to acid. They are less likely to breakdown and cause the tooth surface to become porous. If your dentist recommends a fluoride treatment during your next dental visit, you’ll be receiving topical protection. The fluoride your dentist puts in your mouth will help make the crystals in your tooth enamel stronger. Always use toothpaste with fluoride.

What causes Cavities? Your mouth is a busy place. Bacteria - tiny colonies of living organisms are constantly on the move on your teeth, gums, lips and tongue. Having bacteria in your mouth is a normal thing. While some of the bacteria can be harmful, most are not and some are even helpful. Certain types of bacteria, however, can attach themselves to hard surfaces like the enamel that covers your teeth. If they’re not removed, they multiply and grow in number until a colony forms. More bacteria of different types attach to the colony already growing on the tooth enamel. Proteins that are present in your saliva (spit) also mix in and the bacteria colony becomes a whitish film on the tooth. This film is called plaque, and it’s what causes cavities.

Tooth growth and development. What’s the difference between “baby” teeth and permanent teeth? At between six and ten months of age, most infants begin to get their “baby” teeth. The Central Incisors (front middle teeth) usually come in first, and then teeth begin appearing on either side or work their way back to the second molars. By the time a child has reached three years old, most of the “baby” teeth should be present. The process begins to repeat itself when the child is about seven years old. The Central Incisors fall out first and are replaced by permanent teeth. By the age of 21, most people have all of their permanent teeth. “Baby” teeth are important because they hold the place for permanent teeth and help guide them into correct position. “Baby” teeth play an important role in the development of speech and chewing. Cut the sugar, grab the milk! Each time you eat a snack containing sugar or starch (carbohydrates), the resulting acid attack on your teeth can last up to 20 minutes, and a lot of snacks and drinks contain sugar. How much sugar? A single can of pop contains up to 10 teaspoons of sugar, and if you think that natural sugar (like the sugar in raisins or other fruit) is better for your teeth it’s not. Sugar is sugar, and the average person consumes over 40 kilograms of sugar each year!

Beat the Clock - foods that are eaten during a meal usually pose less of a threat to teeth because of the additional saliva produced during mealtime eating. Saliva helps to wash food particles from your mouth and lessen the damage from acid. Brush & floss those teeth toothbrushing is important, and you should brush twice a day. Did you know that if you don’t floss, you miss cleaning up to 35% of each tooth? If you’re not sure how to floss, just ask your dentist.

Sugar Content • Chocolate Cake: 113.4g piece —10 tsp. of sugar • Chocolate Eclaire: 1 — 7 tsp. of sugar • Chocolate mints: 1 piece — 23 tsp. of sugar • Cream puff (iced): 1 — 25 tsp. of sugar • Donut: 1 — Up to 34 tsp. of sugar • Fruitopia fruit drink: 0.6 liter size — Up to 17 tsp. of sugar • Fudge: 28.35g square — 4.5 tsp. of sugar • Hard candy: 113.4g piece — 20 tsp. of sugar • Peanut brittle: 28.35g — 3.5 tsp. of sugar • Raisins: Half-cup — 4 tsp. of sugar • Sherbet: 1 scoop — 9 tsp. of sugar • Slice of berry Pie: 1 slice — 10 tsp. of sugar • “Slush” frozen drink: 1 litre size — 28 tsp. of sugar • Soda pop: 0.35 litre size — Up to 10 tsp. of sugar • Sunkist Orange Soda: 0.35 litre size — 13 tsp. of sugar

Stock up on Dairy Products - yogurt and cheese, milk and milk products contain things that are good for your teeth. Everything that’s made from milk is a good source of calcium - an essential nutrient for the development of bones and teeth. Some scientific studies have shown that eating cheese might actually help to protect your teeth from cavities by preventing something called demineralization (the loss of important calcium in your teeth). www.healthyteeth.org

The Script Pharmacy Magazine │September 2013 • October 2013

South Africa’s leading brand for sore mouth and throat 1

When a sore mouth or throat makes you say einAah!

Turn to the solution that doctors trust

Relieving discomfort and reducing painful swallowing nalgesic •

nti-inflammatory • ntiseptic#

#Andolex-C Oral Rinse and Andolex-C Spray References: 1. IMS Total Private Market MAT. August 2010 (R02A. Pharyngeal Preparations). Scheduling status: S1 Proprietary name (and dosage form): ANDOLEX-C Oral Rinse. Composition: Each 15 mL contains: Benzydamine HCI 22.5 mg, Chlorhexidine gluconate 18 mg, Alcohol 9% v/v. Pharmacological classification: A. 16.4 Nasopharyngeal and bucco-pharyngeal antiseptics. Indications: For the relief of minor infections and painful inflammatory conditions of the mouth and throat. Chlorhexidine in Andolex-C Oral Rinse helps to reduce the development of plaque. Registration number: 31/16.4/0143. [Act 101/1965]. Scheduling status: S1 Proprietary name (and dosage form): ANDOLEX Solution. Composition: Each 15 mL contains Benzydamine HCI 22.5 mg. Preservative: Methyl hydroxybenzoate 0.1% m/v. Contains alcohol 10%v/v. Pharmacological classification: A.16 Ear, nose and throat preparations. Indications: Symptomatic relief of painful inflammatory conditions of the mouth and throat including: Traumatic conditions: Pharyngitis following tonsillectomy or after the use of nasogastric tube. Inflammatory conditions: Pharyngitis, aphthous ulcers and oral ulceration due to radiation therapy. Dentistry: For use after dental operations. Registration number: Z/16/40. [Act 101/1965]. Scheduling status: S1 Proprietary name (and dosage form): ANDOLEX LOZENGES. Composition: Each lozenge contains: Benzydamine HCl 3.00 mg. Registration number: 31/16/0239. [Act 101/1965]. Scheduling status: S1 Proprietary name (and dosage form): ANDOLEX-C LOZENGES RASPBERRY. Composition: Each lozenge contains: Benzydamine HCI 3.00 mg, Cetylpyridinium chloride 1.33 mg. Registration number: 31/16.4/0042. [Act 101/1965]. Scheduling status: S1 Proprietary name (and dosage form): ANDOLEX-C ORAL GEL. Composition: Benzydamine HCI 10 mg/g, Cetylpyridinium Chloride 1 mg/g. Pharmacological classification: A 16.4 Naso-pharyngeal and bucco-pharyngeal antiseptics. Indications: Temporarily relieves painful inflamed conditions of the mouth, including mouth and denture ulcers and sore gums. Registration number: 33/16.4/0285. [Act 101/1965]. Name and business address of applicant: iNova Pharmaceuticals (Pty) Limited, Co. Reg. No. 1952/001640/07, 15E Riley Road, Bedfordview. Tel. No. (011) 021- 4155. www.inovapharma.com. For full prescribing information, refer to the individual package inserts. Further information is available on request from iNova Pharmaceuticals. IN495/10.

Pain relief for up to 3 hours

MUSCULAR DYSTROPHY Muscular Dystrophy (MD) is a group of muscle diseases that weaken the musculoskeletal system and hamper locomotion. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue. In the 1860s, descriptions of boys who grew progressively weaker, lost the ability to walk, and died at an early age became more prominent in medical journals. In the following decade, French neurologist Guillaume Duchenne gave a comprehensive account of thirteen boys with the most common and severe form of the disease, which now carries his name—Duchenne muscular dystrophy. It soon became evident that the disease had more than one form. The other major forms are Becker, limb-girdle, congenital, facioscapulohumeral, myotonic, oculopharyngeal, distal, and Emery-Dreifussmuscular dystrophy. These diseases predominantly affect males, although females may be carriers of the disease gene. Most types of MD are multi-system disorders with manifestations in body systems including the heart, gastrointestinal system, nervous system, endocrine glands, eyes and brain. Apart from the nine major types of muscular dystrophy listed above, several MD-like conditions have also been identified. Normal intellectual, behavioral, bowel and sexual function is noticed in individuals with other forms of MD and MD-like conditions. MDaffected individuals with susceptible intellectual impairment are diagnosed through molecular characteristics but not through problems associated with disability. However, a third of patients who are severely affected with DMD may have cognitive impairment, behavioural, vision and speech problems.

Signs and symptoms • Progressive muscular wasting • Poor balance • Drooping eyelids • Atrophy • Scoliosis (curvature of the spine and the back) • Inability to walk • Frequent falls • Waddling gait • Calf deformation • Limited range of movement • Respiratory difficulty • Joint contracture • Cardiomyopathy • Arrhythmias • Muscle spasms

Cause These conditions are generally inherited, and the different muscular dystrophies follow various inheritance patterns. However, mutations of the dystrophin gene and nutritional defects (with no genetics history) at the prenatal stage are also possible in about 33% of people affected by DMD. The main cause of the Duchenne and Becker types of muscular dystrophy is the muscle tissue’s cytoskeletal impairment to properly create the functional protein dystrophin and dystrophin-associated protein complex. Dystrophin protein is found in muscle fibre membrane; its helical nature allows it to act like a spring or shock absorber. Dystrophin links actin (cytoskeleton) and dystroglycans of the muscle cell plasma membrane, known as the sarcolemma

(extracellular). In addition to mechanical stabilization, dystrophin also regulates calcium levels.

Diagnosis Histopathology of gastrocnemius muscle from patient who died of pseudohypertrophic muscular dystrophy, Duchenne type. Cross section of muscle shows extensive replacement of muscle fibers by adipose cells. The diagnosis of muscular dystrophy is based on the results of muscle biopsy, increased creatine phosphokinase (CpK3), electromyography, electrocardiography and DNA analysis. A physical examination and the patient’s medical history will help the doctor determine the type of muscular dystrophy. Specific muscle groups are affected by different types of muscular dystrophy. Often, there is a loss of muscle mass (wasting), which may be hard to see because some types of muscular dystrophy cause a buildup of fat and connective tissue that makes the muscle appear larger. This is called pseudohypertrophy.

Management There is no known cure for muscular dystrophy, although significant headway is being made with antisense oligonucleotides. Physical therapy, occupational therapy, orthotic intervention (e.g., ankle-foot orthosis),

The Script Pharmacy Magazine │September 2013 • October 2013

MUSCULAR DYSTROPHY AWARENESS MONTH SEPTEMBER 2013

speech therapy and orthopedic instruments (e.g., wheelchairs and standing frames) may be helpful. Inactivity (such as bed rest, sitting for long periods) and bodybuilding efforts to increase myofibrillar hypertrophy can worsen the disease. There is no specific treatment for any of the forms of muscular dystrophy. Physiotherapy, aerobic exercise, low intensity anabolic steroids, prednisone supplements may help to prevent contractures and maintain muscle tone. Orthoses (orthopedic appliances used for support) and corrective orthopedic surgery may be needed to improve the quality of life in some cases. The cardiac problems that occur with Emery-Dreifuss muscular dystrophy and myotonic muscular dystrophy may require a pacemaker. The myotonia (delayed relaxation of a muscle after a strong contraction) occurring in myotonic muscular dystrophy may be treated with medications such as quinine, phenytoin, or mexiletine, but no actual long term treatment has been found. Occupational therapy assists the individual with MD in engaging in his/ her activities of daily living (self-feeding,

Duchenne and Becker Types

self-care activities, etc.) and leisure activities at the most independent level possible. This may be achieved with use of adaptive equipment or the use of energy conservation techniques. Occupational therapy may implement changes to a person’s environment, both at home or work, to increase the individual’s function and accessibility. Occupational therapists also address psychosocial changes and cognitive decline which may accompany MD, as well as provide support and education about the disease to the family and individual. High dietary intake of lean meat, sea food, pulses, olive oil, antioxidants; such as leafy vegetables and bell peppers, and fruits like blueberry, cherry etc. is advised. Decreased intake of refined food, trans-fats, and caffeinated and alcoholic beverages is also advised; as is a check for any food allergies. Diagnosis, neurology, GI-nutrition, respiratory care, cardiac care, orthopedics, psychosocial, rehabilitation, and oral care form the integral part of disease management, all through the patient’s life span.

EmeryDreifuss Type

Limb Girdle Type

Types Becker’s muscular dystrophy Becker muscular dystrophy (BMD) is a less severe variant of Duchenne muscular dystrophy and is caused by the production of a truncated, but partially functional form of dystrophin. Survival is usually into old age. Affects only boys (with extremely rare exceptions) Congenital muscular dystrophy Age at onset: birth; symptoms include general muscle weakness and possible joint deformities; disease progresses slowly; shortened life span. Congenital muscular dystrophy includes several disorders with a range of symptoms. Muscle degeneration may be mild or severe. Problems may be restricted to skeletal muscle, or muscle degeneration may be paired with effects on the brain and other organ systems. A number of the forms of the congenital muscular dystrophies are caused by defects in proteins that are thought to have some relationship to the dystrophin-glycoprotein complex and to the connections between muscle cells and their surrounding cellular structure. Some forms of congenital muscular dystrophy show severe brain

Facioscapulohumeral Type

Oculopharyngeal Type

Main areas of muscle weakness in different types of dystrophy 18

The Script Pharmacy Magazine │September 2013 • October 2013

MUSCULAR DYSTROPHY AWARENESS MONTH SEPTEMBER 2013

malformations, such as lissencephaly and hydrocephalus. Duchenne muscular dystrophy Duchenne muscular dystrophy (DMD) is the most common childhood form of muscular dystrophy, it generally affects only boys (with extremely rare exceptions), becoming clinically evident when a child begins walking. By age 10, the child may need braces for walking and by age 12, most patients are confined to a wheelchair. Patients usually die around age 25, but this depends from person to person. In the early 1990s, researchers identified the gene for the protein dystrophin which, when absent, causes DMD. The amount of dystrophin correlates with the severity of the disease (i.e. the less dystrophin present, the more severe the phenotype). Since the gene is on the X chromosome, this disorder affects primarily males, and females who are carriers have milder symptoms. Sporadic mutations in this gene occur frequently, accounting for a third of cases. The remaining two-thirds of cases are inherited in a recessive pattern. Dystrophin is part of a complex structure involving several other protein components. The “dystrophinglycoprotein complex” helps anchor the structural skeleton (cytoskeleton) within the muscle cells, through the outer membrane (sarcolemma) of each cell, to the tissue framework (extracellular matrix) that surrounds each cell. Due to defects in this assembly, contraction of the muscle leads to disruption of the outer membrane of the muscle cells and eventual weakening and wasting of the muscle. Distal muscular dystrophy Distal muscular dystrophies’ age at onset: 20 to 60 years; symptoms include weakness and wasting of muscles of the hands, forearms, and lower legs; progress is slow and not lifethreatening. Miyoshi myopathy, one of the distal muscular dystrophies, causes initial weakness in the calf muscles, and is caused by defects in the same gene responsible for one form of LGMD (Limb Girdle Muscular Dystrophy)

from cardiac conduction defects and arrhythmias which, if left untreated, increase the risk of stroke and sudden death. There are three subtypes of Emery-Dreifuss Muscular Dystrophy, distinguishable by their pattern of inheritance: X-Linked, autosomal dominant and autosomal recessive. The X-linked form is the most common. Each type varies in prevalence and symptoms. The disease is caused by mutations in the LMNA gene, or more commonly, the EMD gene. Both genes encode for protein components of the nuclear envelope. However, how the pathogenesis of these mutations is not well understood. Facioscapulohumeral muscular dystrophy Facioscapulohumeral muscular dystrophy (FSHD) initially affects the muscles of the face, shoulders, and upper arms with progressive weakness. Symptoms usually develop in the teenage years. Some affected individuals become severely disabled. The pattern of inheritance is autosomal dominant, but there are a significant number of spontaneous mutations. Seminal research published in August 2010 documents that two defects are needed for FSHD, which for the first time provides a unifying theory for the underlying genetics of FSHD. The first is the deletion of D4Z4 repeats and the second is a “toxic gain of function” of the DUX4 gene. Facioscapulohumeral muscular dystrophy (FSHD) occurs both in males and females. Limb-girdle muscular dystrophy Limb-girdle muscular dystrophy is also called LGMD affects both boys and girls. LGMDs all show a similar distribution of muscle weakness, affecting both upper arms and legs. Many forms of LGMD have been identified, showing different patterns of inheritance (autosomal recessive vs. autosomal dominant). In an autosomal recessive pattern of inheritance, an individual receives two copies of the defective gene, one from each

parent. The recessive LGMDs are more frequent than the dominant forms, and usually have childhood or teenage onset. The dominant LGMDs usually show adult onset. Some of the recessive forms have been associated with defects in proteins that make up the dystrophin-glycoprotein complex. Though a person normally leads a normal life with some assistance, in some extreme cases, death from LGMD occurs due to cardiopulmonary complications. Myotonic muscular dystrophy Myotonic muscular dystrophy is an autosomal dominant condition that presents with myotonia (delayed relaxation of muscles) as well as muscle wasting and weakness. Myotonic dystrophy varies in severity and manifestations and affects many body systems in addition to skeletal muscles, including the heart, endocrine organs, eyes, and gastrointestinal tract. Myotonic muscular dystrophy type 1 (DM1), also known as Steinert disease, is the most common adult form of muscular dystrophy. It results from the expansion of a short (CTG) repeat in the DNA sequence of the DMPK (myotonic dystrophy protein kinase) gene. Myotonic muscular dystrophy type 2 (DM2) is much rarer and is a result of the expansion of the CCTG repeat in the ZNF9 (zinc finger protein 9) gene. While the exact mechanisms of action are not known, these molecular changes may interfere with the production of important muscle proteins. Oculopharyngeal muscular dystrophy Oculopharyngeal MD’s age at onset: 40 to 70 years; symptoms affect muscles of eyelids, face, and throat followed by pelvic and shoulder muscle weakness, has been attributed to a short repeat expansion in the genome which regulates the translation of some genes into functional proteins. www.wikipedia.co.za

Structure of skeletal muscle

Emery-Dreifuss muscular dystrophy Emery-Dreifuss Muscular Dystrophy patients normally present in childhood and the early teenage years with contractures. Clinical signs include muscle weakness and wasting, starting in the distal limb muscles and progressing to involve the limb-girdle muscles. Most patients also suffer

The Script Pharmacy Magazine │September 2013 • October 2013

lekker local latex. Afrikaners is Versigtig Kondome! is die bekroonde, veilige en kleurvolle reeks voorbehoedmiddels, wat meer as net wenkbroue laat lig! Dit versprei die belangrike boodskap van verantwoordelike verhoudings, met ‘n lekker Afrikaanse tong-in-die-kies. Sonder om los te wees.

Nou met ‘n verbeterde 54mm Magasyn!

Het jy geweet? Afrikaners is Versigtig Kondome! • word trots in SA vervaardig • is SABS goedgekeur • spog met 4 geurige produklyne • guitige vertoonrakkie ingesluit • praat die mooiste Afrikaans • het al 2 Pendorings gewen • bevorder ‘n verantwoordelike lewensstyl • is ook unieke, kreatiewe geskenke • is @ R29,95 op die rak waarde vir geld

Smaak ons op facebook

AfrikanersIsVersigtigKondome

Stuur ‘n e-posduif na ontvangsdame@afrikanersisversigtig.com - www.afrikanersisversigtig.com

by way

LAUGH A LITTLE

Let’s face it - English is a crazy language. There is no egg in eggplant, nor ham in hamburger; neither apple or pine in pineapple. English muffins weren’t invented in England or French fries in France. Sweetmeats are candies while sweetbreads, which aren’t sweet, are meat. We take English for granted. But if we explore its paradoxes, we find that... quicksand can work slowly, boxing rings are square, and a guinea pig is neither from Guinea nor is it a pig. If teachers taught, why didn’t preachers praught? If a vegetarian eats vegetables, what does a humanitarian eat? Sometimes I think all the English speakers should be committed to an asylum for the verbally insane. In what language do people recite at a play and play at a recital? Ship by truck and send cargo by ship? Have noses that run and feet that smell?

Word Games

I wondered why the baseball kept getting bigger. Then it hit me. Two silk worms had a race. They ended up in a tie. A grenade thrown into a kitchen in France would result in Linoleum Blownapart. A dog gave birth to puppies near the road and was cited for littering. No matter how much you push the envelope, it’ll still be stationery. I thought I saw an eye doctor on an Alaskan island, but it turned out to be an optical Aleutian.

Senior Joke

Two elderly ladies had been friends for many decades. Over the years, they

had shared all kinds of activities and adventures. Lately, their activities had been limited to meeting a few times a week to play cards. One day, they were playing cards when one looked at the other and said, ‘Now don’t get mad at me. I know we’ve been friends for a long time, but I just can’t think of your name! I’ve thought and thought, but I can’t remember it. Please tell me what your name is.’ Her friend glared at her. For at least three minutes she just stared and glared at her. Finally she said, ‘How soon do you need to know?’

Nervous Dad “Just relax”, the hospital staff kept telling Jim, but it was to no avail. Jim’s wife was in labor and Jim was a nervous wreck. After what seemed like a week, to both Jim and the hospital staff, a nurse came out with the happy news, “it’s a girl”, she cried. “Thank Goodness, a girl”, said Jim, “at least she won’t have to go through what I just went through!”

Oops

“I’m OK but I didn’t like the four-letterword the doctor used in surgery,” he answered. “What did he say,” asked the nurse. ... “OOPS!

Just Being Practical A man wasn’t feeling well so he went to the doctor. After examining him the doctor took his wife aside, and said, “your husband has a very sensitive heart. I am afraid he’s not going to make it, unless you treat him like a king, which means you are at his every beck and call, 24 hours a day and that he doesn’t have to do anything himself. On the way home the husband asked with a note of concern “what did he say?” “Well”, the lady responded, “he said it looks like you probably won’t make it.”

Politeness I work as a pediatric nurse, and often have the painful job of giving shots to the children. One day upon entering the examining room to give a shot the little girl starting screaming “NO! NO! NO!” “Jessica” her mother scolded, “that is not polite behavior!” At that the girl continued to scream “NO THANK YOU! NO THANK YOU! NO THANK YOU!”

The Script Pharmacy Magazine │September 2013 • October 2013

FEATURE HEADER

SPRING

into action...

Spring is here! The time for picnics & braai’s. Here are a few recipes to try out when inviting your friends and family over, or even just to get back to a healthy lifestyle 22

The Script Pharmacy Magazine │September 2013 • October 2013

FOOD

Honeyed fruit brochettes with rosewater cream Ingredients: Serves: 6 For the rosewater cream • 280 ml double cream • 2 tablespoons rosewater (or kirsch if you prefer) • 1-2 tablespoons of sifted icing sugar (omit if using kirsch) For the brochettes • 1 medium pineapple • 5 medium bananas • 2 ripe nectarines or peaches (not too soft) • Juice of 1/2 lemon • 6 tablespoons honey (or maple-syrup as a variation) • Fresh lime (to serve) • You will also need a dozen 15cm wooden skewers soaked in water for at least 3 hours. For the rosewater cream, whisk all the ingredients together until the cream forms soft peaks. Put into a serving bowl.

cream – Sauternes would be the perfect match for this.

Gourmet Braaibroodjie Recipe Ingredients • Sourdough bread, sliced • 100g buffalo mozzarella, sliced • Slow-roasted tomatoes (see recipe underneath) • Red onion marmalade (see recipe underneath) • Butter, to spread • Watercress, to serve Directions Spread butter evenly on one side of the slices of sourdough bread. On the other side of the slices, generously spread the red onion marmalade. Then, in between two slices, sandwich together the slow roasted tomatoes and sliced mozzarella (with the butter side facing out), and place on the grill until the bread is nicely toasted and the mozzarella is melted. Serve with watercress leaves to add some freshness and bite to the braaibroodjie.

For the brochettes, slice off the top and bottom of the pineapple, cut away the peel and remove any ‘eyes’. Quarter the pineapple lengthways and cut away the core. Cut each quarter in half lengthways then slice into chunks, about 5mm thick. Quarter and stone the nectarines (removing the peel if using peaches) and cut into similar-sized chunks. If preparing the fruit ahead of time, toss the fruit in lemon juice.

Apricot-and-Basil Shortbread Tart

Thread the pieces of pineapple, banana and nectarine or peach onto the skewers alternating the fruit. Melt the honey in a small saucepan over a low heat and remove as soon as it turns runny (or heat in a bowl for about 20 seconds on high in the microwave) . Brush generously over the fruit. Cook the brochettes on the barbecue for about 5 minutes turning regularly. If you want to cook these indoors you can toss the fruit in the melted honey, cook the fruit on a hot griddle pan and thread onto skewers afterwards. Serve drizzled with any extra honey, a squeeze of fresh lime juice and the

• 2 1/2 tablespoon(s) cornstarch

Ingredients Pastry Cream • 1 cup(s) whole milk • 5 tablespoon(s) granulated sugar • 1/4 cup(s) packed basil leaves with stems • 2 large egg yolks • 2 tablespoon(s) unsalted butter Pastry • 1 large hard-boiled egg yolk • 1 3/4 stick(s) unsalted butter • 1/2 cup(s) confectioners’ sugar • 1 1/2 cup(s) all-purpose flour • 1/4 cup(s) potato starch • 1 1/4 teaspoon(s) kosher salt Topping • 6 apricots, halved • 3 tablespoon(s) granulated sugar • 1/3 cup(s) apricot jam, melted

Directions Make the pastry cream: In a saucepan, combine 3/4 cup of the milk with the sugar and basil; bring to a simmer. Remove the milk from the heat and let stand for 15 minutes. Remove the basil and squeeze any milk back into the pan; discard the basil. In a small bowl, whisk the remaining 1/4 cup of milk with the yolks and cornstarch until smooth. Slowly whisk the egg yolk mixture into the warm milk; bring to a simmer over moderate heat, whisking constantly until very thick, 2 minutes. Remove from the heat and whisk in the butter until melted. Scrape the cream into a bowl. Press a piece of plastic wrap directly on the surface and refrigerate until chilled, 2 hours. Make the pastry: Preheat the oven to 375°. Spray a 14-by-4 1/2-inch rectangular tart pan with a removable bottom with nonstick cooking spray. In the bowl of a standing mixer, beat the hard-boiled egg yolk with the butter and sugar at medium speed until smooth, about 2 minutes. Add the flour, potato starch, and salt and beat at low speed until just combined. Using lightly floured hands, press the dough evenly over the bottom and up the side of the tart pan. Refrigerate the crust for 30 minutes, or until chilled. Bake the crust for about 25 minutes, until golden. Transfer the crust to a rack and let stand until cooled, about 1 hour. Make the topping: Increase the oven temperature to 450°. Line a baking sheet with parchment paper. Arrange the apricot halves cut side up on the paper and sprinkle all over with the sugar. Roast for about 20 minutes, until the apricots are tender and lightly browned. Let the apricots stand until completely cooled, about 30 minutes. Unmold the crust and transfer it to a serving plate. Using a small offset spatula, spread the cream evenly in the crust. Arrange the apricots on the cream, cut sides down, and brush with the melted jam. Cut the tart crosswise into strips and serve at once.

The Script Pharmacy Magazine │September 2013 • October 2013

TIME T

Pro

Why do people need to supplement? Because the diet lacks the nutrients that the bodies need to respond to the demands the body makes on it, plus there are certain substances that the body cannot make and can only be obtained from supplementing. The human body functions off of macronutrients â&#x20AC;&#x201C; these are obtained from food such as carbohydrates, fats, proteins and water. Micronutrients include vitamins, micro minerals and these are generally obtained from the diet and from supplements.

What to expect from taking ProMan or ProWoman? People can expect to have more energy (due to the B vitamins), the anti-oxidant effects of Vitamin A, C, E, zinc and selenium help to prevent the negative effects of free radicals which helps the body cope with stress and enhances immune response. The body functions more effectively, copes better with day-to-day stresses, replenishes losses more quickly and generally works better.

TO CALL IN THE

ofessional! ProWoman’s specific ingredients help woman to cope with the effects of menstruation, PMS and helps to maintain healthy bone structure Vitamin K3 – plays a role in blood clotting and the metabolism of bone. Starflower oil & Evening primrose oil (EPO) – contain the omega 6 fatty acid as well as GLA (gamma linoleic acid) which helps maintain the balance of prostaglandins which plays a role in temporarily relieving the symptoms of PMS and is suitable for use as a supplement during menstruation and menopause. Mixed natural carotenoids – have strong anti-oxidant properties

ProMan’s specific ingredients help men to burn fat, generate energy, cope better, remain healthier and be more structurally sound. L-carnitine – an amino acid that helps turn fat into energy,. Ubidecarenone (Coenzyme Q10 / CoQ10) – plays a role in generating energy. Siberian ginseng – helps the body cope with stress and enhances mental and athletic abilities. Increases energy, stamina, increases the bodies resistance to disease as well as helping to restore memory, concentration and cognitive abilities. Betacarotene – the body converts it into Vitamin A (an antioxidant) and therefore functions as an anti-oxidant. DL-methionine – an amino acid that helps the body’s detoxification process, supports liver function and helps remove excess fat from the body. L-arginine – assists in detoxing the liver, helps maintain a healthy immune system and may increase sperm count in males. Silicon – forms a part of connective tissue and skin Vitamin A – is an anti-oxidant, functions to maintain healthy eyesight, plays a role in the structure of the epithelium, enhances immune function and plays a role in maintaining healthy skin, teeth and mucous membranes of the urinary and respiratory tract

FILL IN THE FORM BELOW, AND FAX TO 0866981468 TO ENTER

WIN One of three

RUSSELL HOBBS BICUIT MAKERS

(worth R350 each) or one of threee

SALTON POPCORN MAKERS

(worth R200 each)

ENTRY FORM

1. Name the specific ingredient that plays a role in maintaining healthy mucus membranes of the urinary and respitratory tract.

2. What are the dosage directions found on the ProMan packaging?

Name & Surname

Daytime contact number

Pharmacy Name IMPORTANT: Winners to be announced in next edition of theScript. Your CJ Representative will delivery your prize once the winners have been drawn. Competition ends: 25 October 2013. FOR MORE INFORMATION CONTACT CJ MARKETING ON 0130100091

FOR FUN

mindmovers Sudoku

Summer Find all the listed words in the wordsearch below!

8 7

6/26/13

The Daily SuDoku

7 4

Home Today's SuDoku

Daily SuDoku 9

Kids

Squiggly

Daily Sudoku: Wed 26-Jun-2013 [instructions] Classic

SuDoku Archive

There is only one rule: Every row, Kids column and SuDoku box offor3x3 cells must Draw/Play contain the numbers 1 through 9 exactly onceDiscussion (Solution Next FAQEdition)

Monster

B T V Y

Word Plexers Word Plexers

A A Links

V ANTS

JULY

AUGUST

FLIES

JUNE

SUNGLASSES

FLOWERS

MOSQUITOES

SUNSCREEN

BASEBALL

GARDENING

NO SCHOOL

SUNSHINE

BEACH

GOLF

PICNIC

SUNTAN

BEES

GREEN GRASS

ROLLER BLADES

SWEAT

BICYCLE

HAT

SANDALS

SWIMMING

BLUE SKY

HIKING

SKATEBOARD

U V RAYS

BOATING

HOLIDAYS

SOCCER

WASPS

BREEZE

HOT

SOLSTICE

WATER FIGHTS

CAMPING

ICE CREAM

SPRINKLERS

WATERMELON

Boggler M = 13

U = 21

J = 10

Show page

Help:

Hide solution Play online

medium

PLEXERS ARE PICTURE PUZZLES OF WORDS AND PHRASES. IT’S IMPORTANT TO CONSIDER HOW WORDS ARE WRITTEN, THE NUMBER OF ITEMS, AND THE DIRECTION Name: Date: APPEARS. LOCATION IS ALSO IMPORTANT WHEN FIGURING Name: IN WHICH SOMETHING Name:Date: Date: The Sudoku Book OUT PLEXERS. SOMETIMES An introduction w ithIT’S 101 EASIER TO SOLVE THESE PUZZLES IF YOU SAY YOUR Some are common words and phrases are encoded in these plexers. Can you tell what puzzles Some common words and phrases encoded in these plexers.are Can you tell in what Some common words and phrases encoded these plexers. CanSOLUTION. you tell what ANSWERS OUT LOUD. SUBTLE WORD PLAY IS OFTEN PART OF A PLEXER they are? HH | Am azon UK | USA

Word Plexers Plexers Word Plexers Word

A A V

they are?

TOUCH DOWN

www.dailysudoku.com/sudoku/today.shtml

Date:

Copies: 1

Determine W:

Printable page: Size:

SUNBURN

BARBECUE

Name: Date:

Some common words and phrases encoded in these plexers.are Can you tell in what Some are common words and phrases encoded these plexers. Can you te Nurikabe they are? they are? Now available in all good bookshops

FISHING

G=7

Email and News Name: Contact

V rs e x le P

Words to find:

Solution IS.38

Books Syndication

Comments, questions

80 60 40 20

64 19

Lymphocytes T-cells CD8+ p=0.035

cell counts x 10 6 per L blood

100

100 80 60

Bion速

Control

(vitamins and minerals without probiotics)

82 21

Lymphocytes T-cells CD4+ p=0.081

ALS

Reduce the spasm.1 Relieve the pain.2 Muscle relaxants interrupt the pain-spasm-pain cycle:3 • help relieve pain 3 • help restore movement 3 • improvement from impaired function 4

Recommend Norflex Co combined action of Orphenadrine + Paracetamol Orphenadrine, used in combination with simple analgesics is more effective than an analgesic alone1 Works quickly ≥ 30 minutes 1

South Africa’s No. 1 prescribed muscle relaxant brand5 References: 1. Waldman HJ. Centrally acting skeletal muscle relaxants and associated drugs. J Pain Symptom Manage 1994;9(7):434-441. 2. Roland MO. A critical review of the evidence for a pain-spasm-pain cycle in spinal disorders. Clin Biomech 1986;1:102-109. 3. Beebe FA, et al. A clinical and pharmacologic review of skeletal muscle relaxants for musculoskeletal conditions. Am J Therap 2005;12:151-171. 4. McGuinness BW. A double-blind comparison in general practice of a combination tablet containing orphenadrine citrate and paracetamol (‘Norgesic’) with paracetamol alone. J Int Med Res 1983;11(1):42-45. 5. IMS: NDTI Proj. Rx December 2011 (M03B Muscle Relaxants, Central). Scheduling status: S2 Propriety name (and dosage form): NORFLEX CO Tablets. Composition: Each tablet contains 35 mg Orphenadrine citrate and 450 mg Paracetamol. Pharmacological classiﬁcation: A.2.9 (Other analgesics). Reference number: B 1098 [Act 101/1965]. Name and business address of applicant: iNova Pharmaceuticals (Pty) Limited Co. Reg. 1952/001640/07, 15e Riley Road, Bedfordview. Tel: + 27 11 021 4155. www.inovapharma.com For full prescribing information, refer to the package insert. Further information is available on request from iNova Pharmaceuticals. IN638/12.

RECOMMEND ANUSOL FOR EFFECTIVE RELIEF FROM PILES

Anusol® ointment and suppositories

Anusol® Pain Relief ointment

• Lubricates affected areas

• Significantly relieves itch 1

• Soothes and calms irritated areas

• Onset of action within 5 minutes 2

• Relieves pain and discomfort

• Relieves pain

• Helps reduce swelling

• Surface anaesthetic thereby numbing the affected area

• Can be used in pregnancy

anusol References: 1. Facts and Comparisons® E Answers Pramoxine Hydrochloride – Topical. Wolters Kluwer Health, Inc. 2010. 2. Yosipovitch G, Maibach HI. Effect of topical pramoxine on experimentally induced pruritis in humans. J Am Acad Dermatol 1997;37:278-280. S0 ANUSOL® OINTMENT: Reg. No. E/11.8/0513. Each 1 g of ointment contains: Bismuth Subgallate 22.5 mg. Bismuth Oxide 8,75 mg, Zinc Oxide 107,5 mg. S0 ANUSOL® SUPPOSITORIES: Reg. No. E/11.8/0515. Each suppository contains: Bismuth Subgallate 59,0 mg, Bismuth Oxide 24,0 mg, Zinc Oxide 296,0 mg.

S1 ANUSOL® PAIN RELIEF: Reg. No. T/11.8/65. Each 1 g of ointment contains:

Pramoxine Hydrochloride 10,0 mg.

For full prescribing information, refer to the package insert approved by the Medicines Control Council. ®Trademark © Johnson & Johnson (Pty) Ltd 2013.

01/ANU/01/13/P/PRT

OBESITY

IN CHILDREN & ADOLESCENTS The terms overweight and obesity refer to abnormal or excessive fat accumulation to the extent that it may have adverse effects on the health and well-being of the individual.

Evaluating overweight and obesity in individuals or groups is based on an anthropometric indicator, a reference population and cut-off points for normal, overweight and obesity. Various measures are used, ranging from clinical assessment, to skin fold thicknesses, weight-for-age, body mass index (BMI; kg/m2), waist-to-hip ratio and others. Although not a perfect anthropometric indicator, BMI is the most generally used index, or indicator, of weight status. Whereas adult BMI assessment is fairly straightforward, the BMIs of children differ at different ages. Overweight and obesity in children and adolescents are therefore usually expressed as BMI-for-age. A number of internationally comparable reference sets for children and adolescents exist, such as those of the International Obesity Taskforce (IOTF),

the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). However, these charts have thus far been compiled without adequate normative values for the African and Asian continents. Once considered predicaments mainly of the affluent, overweight and obesity are now markedly on the increase in low-income and middle-income populations, particularly in urban areas. In 2010, it was estimated that, globally, about 43 million children under the age of 5 years were overweight, and 35 million of these were living in developing countries. The fastest overweight and obesity growth rates are found in Africa â&#x20AC;&#x201C; the number of overweight or obese children in 2010 was more than double that in 1990. The two overriding causes of the increased prevalence of overweight and obesity in developing

countries are said to be a decline in physical activity and diets rich in refined fats, oils and carbohydrates. Whereas under nutrition and communicable diseases were once the overriding health threat in developing countries, it is now estimated that non-communicable diseases, such as obesity-associated disorders, could be the cause of 7 out of every 10 deaths by 2020. The impact of overweight and obesity in childhood and adolescence Overweight and obesity during childhood and adolescence have negative impacts, on both physical and psychological well-being. From a physical point of view, obesity is associated with a higher risk for the development of insulin resistance, type 2 diabetes mellitus, and a number of

The Script Pharmacy Magazine â&#x201D;&#x201A;September 2013 â&#x20AC;˘ October 2013

NATIONAL OBESITY WEEK 15 - 19 OCTOBER 2013

cardiovascular abnormalities during childhood and adolescence. Although the end points for cardiovascular risks are not necessarily seen in childhood or adolescence, most of the major risk factors are, including high systolic and diastolic blood pressure, dyslipidaemia (increased low-density lipoprotein cholesterol, raised triglycerides and low levels of high-density lipoprotein cholesterol), and abnormal vascular endothelial function, and abnormal left ventricular function, abnormalities in left ventricular mass and atherosclerotic lesions. While most cases of childhood diabetes mellitus were once type 1, there has, over the last couple of decades, been a rapid increase in the development of obesity-associated type 2 diabetes mellitus.12 Symptoms of the insulin resistance syndrome, including hyperinsulinaemia, dyslipidaemia and hypertension, are not uncommon in obese children. Other conditions found in association with overweight and obesity in childhood and adolescence include the risk of developing asthma, or an increase in the severity of existing asthma, low-grade systemic inflammation, obstructive sleep apnoea, early onset of puberty, foot and other skeletal abnormalities, and fatty liver disease. Overweight and obesity during childhood and adolescence not only influence well-being during this period, but can persist into adulthood. Excess body fat in children and adolescents increases the risk for the development of several medical conditions during adulthood, including insulin resistance, adult-onset type 2 diabetes mellitus and cardiovascular problems such as hypertension, ischaemic heart disease and stroke. Overweight and obesity are also said to increase the risk for different cancers, skeletal problems, non-alcoholic fatty liver disease, polycystic ovarian syndrome, and a variety of inflammatory conditions. A recent systematic review of the literature showed that overweight and obesity in childhood and adolescence increase adulthood risk for disability pension, premature mortality and morbidity. From a psychological point of view, low self-esteem seems to be the overriding concern of overweight and obesity during childhood and adolescence. Overweight and obesity during childhood and adolescence can give rise to a lack of confidence, negative self-perception and depression. From a psychosocial perspective, stereotyping, 32

discrimination and social rejection may occur. These, in turn, may lead to withdrawal from physical activities with further aggravation of the weight problem. In a local study on urban school children living in Potchefstroom (South Africa), it was shown that overweight and obesity can significantly influence scholastic and athletic competency, physical self-concept and social acceptance. As with the physical effects of overweight and obesity, the psychological impact may extend into adulthood.

The South African problem Overweight and obesity in children and adolescents are on the increase worldwide. Overweight and obesity increase the risk for the development of non-communicable diseases during childhood and adolescence, and predispose the individual to the development of overweight, obesity, cardiovascular disease, and metabolic and other disorders in adulthood. In Africa the number of overweight or obese children has doubled since 1990. In South Africa, overweight and obesity in children and adolescents are on the increase, but the prevalence varies with age, gender and population group. These differences are important when intervention programs and policies are considered. South Africa faces a double burden of disease where under nutrition and overweight or obesity are found in the same populations, in the same households and even in the same children. Malnutrition is a major contributor to the double burden of disease in South African children and adolescents. The occurrence of overweight and obesity in South African children at present is said to be at least comparable to that found in developed countries more than a decade ago. It has even been said to be on par with that of many industrialised nations and amongst the highest in Africa. These statistics are rather alarming as the WHO reported that the fastest growing rates in overweight and obesity are in Africa, with the number of overweight or obese children in 2010 more than double that in 1990. In general, there appears to be an increase in the prevalence of overweight or obesity in childhood and adolescence in South Africa. Armstrong, in a comparison between rates from The South African Primary Schools’ Anthropometric Survey and The Health of the Nation

The Script Pharmacy Magazine │September 2013 • October 2013

Study, estimated an increase in overweight from 1.2% to 13% and in obesity from 0.2% to 3.3% over the period from 1994 to 2004. Results from studies before 1999 showed low overweight and obesity rates, whilst more recent studies showed a mean prevalence of just over 15% for overweight and obesity combined. However, this prevalence does not give a true reflection of the problem as overweight and obesity differ markedly between age groups, between boys and girls, between ethnic groups and between geographical areas. There appear to be strong agedependent trends from early childhood to late adolescence in the prevalence of obesity and overweight, especially in previously disadvantaged populations. Some of the highest rates for overweight and obesity have been reported for early childhood. In rural communities from the Limpopo, Eastern Cape and KwaZulu-Natal Provinces, high overweight and obesity rates were observed with up to 50% of the underone-year olds being either overweight or obese. Mamabolo. suggest this high prevalence of overweight and obesity is related to cultural beliefs and practices where fat infants are seen as healthy and mothers therefore indulge in overfeeding – often with energyrich foods. This high prevalence of infant overweight and obesity may not be representative of the whole of the previously disadvantaged South African population as a recent large study on a population in a Mpumalanga district found moderate levels of overweight and obesity in early childhood. It is, however, important to note that the latter study did not include individuals under one year of age – an age for which a very high prevalence was reported elsewhere. From crosssurvey comparisons, the prevalence of overweight and obesity seems to decrease from early to late childhood, after which it once again increases to reach values of over 20% in girls in late adolescence. This increase from late childhood to adolescence appears to be gender, and perhaps ethnicity, dependent. In the majority of studies on children and adolescents in South Africa, a higher prevalence of overweight or obesity was found in girls than in boys. In most of these studies, there was an increase in the prevalence of overweight or obesity with age, where development

of overweight or obesity in girls was linked to the time of menarche. These findings are supported by the results of a recent study (2010) on 3511 children and adolescents from rural villages in a former Gazankulu homeland in Mpumalanga. This study showed a relatively low overweight or obesity prevalence in boys and a higher prevalence, reaching 20% – 25% in late adolescence, in girls. Factors suggested to play a role in this gender disparity include possible differences in the energy needs between boys and girls, in the levels of physical activity, in behavioural or cultural phenomena and in the timing of sexual maturation. The association between puberty and overweight in girls may be a doubleedged sword: On one hand, overweight or obesity is said to contribute to the early onset of puberty, 13 while on the other hand, early onset of puberty is reported to predispose to an increase in BMI and to the development of overweight or obesity in later life. Armstrong observed a phenomenon that may be culture related – overweight increased with age in African girls but decreased with age in White girls. This finding is speculated to be linked to the fact that overweight, in certain African cultures, is seen as an indication of wealth and happiness and, in more recent times, as an indication that the individual does not have HIV or AIDS. South Africa is in a rural-to-urban transition phase and it is known that populations in a transition towards urbanisation may experience an increase in overweight and obesity. Although there are indications of higher rates of overweight and obesity in South African children in urban areas, more studies are needed to confirm these indications. To say that urbanisation leads to the development of overweight and obesity is a simplification, as it is known that poor families facing urban industrialisation may be at a risk for the development of nutritional disorders. Higher rates of overweight and obesity in relatively well-fed urban children are probably related to lower activity levels, smaller families, the availability of energy-rich fast-foods and, often, higher parental income. South Africa, like many other middle-income and low income countries, faces the so-called double burden of disease, where overweight contributes to the burden of disease caused by under nutrition and communicable diseases.

Whereas childhood under nutrition leads to stunted growth and underdevelopment, overweight increases the risk for metabolic, cardiovascular and other noncommunicable diseases. This coexistence of under nutrition and overweight in child populations from nations in nutritional transition has been known for decades. In addition to communicable diseases, major causes of the double burden of disease, according to the WHO, are inadequate prenatal, infant and young child nutrition, followed by micronutrientdeficient, energy-dense, high-fat foods coupled to a lack of physical activity. Several local studies investigated the coexistence of stunting, as a measure of under nutrition, and overweight. In a comparison between the incidence of overweight or obesity and stunting found in 1994 with that found in a survey from 2001 to 2004, stunting decreased, but overweight and obesity increased significantly from 1994 to 2004. In addition, lower levels of mild stunting and similar levels of moderate stunting were seen in overweight and obese children than in non-overweight and non-obese children. Despite an apparent decrease in certain areas, alarmingly high levels of stunting, varying with age, were recently still found in rural villages in Mpumalanga with a prevalence of up to 32% at 1 year of age, leveling off to about 3% – 6% at 5 years and, in boys, again rising to 14% – 15% during adolescence. Evidence exists that childhood overweight and obesity are, in fact, contributing to the non-communicable burden of disease in South Africa. In a recent study, the risk of developing metabolic disease, as estimated from the prevalence of central obesity (waist circumference), was seen to be 16% for girls and only 1% for boys. There have been several reports on a high prevalence of hypertension in children and adolescents, but only a few studies investigated the link between overweight or obesity and hypertension. Although hypertension rates as high as 22% were found in overweight children, and as high as 35% in obese children, hypertension was found in up to 25% of normal weight children – an indication that factors other than overweight or

obesity contribute to the prevalence of hypertension in South African children and adolescents. In summary, high levels of overweight and obesity are present in South African children and adolescents. The prevalence appears to be strongly dependent on age, gender and population. These differences are important when intervention programs and policies are considered. The coexistence of overweight or obesity and under nutrition in the same population, the same household or the same individual, confirms malnutrition as a major contributor to the double burden of disease in South African children and adolescents. Whilst a switch to energy-dense diets is considered the major cause of overweight and obesity, several other factors contribute; these factors include physical inactivity, intra-uterine and early life experience, level of education, cultural factors, stress levels and genetics. It is obvious that there is a need for an increase in research on overweight and obesity in South African children and adolescents. Although large-scale, preferably longitudinal, epidemiological studies on anthropometric aspects, such as height, weight, fat distribution and blood pressure, are essential, further studies into the causes and effects of overweight and obesity are also necessary. Whereas immunological, neural, hormonal, metabolic and other mechanisms are known to influence the weight regulating systems, it is said that genetic factors and genetic– environmental interactions may be amongst the more important. One can only hope that the current surge in the interest in epigenetic research will also ensue in the field of overweight and obesity. • Obesity is defined as excessive body fat and may also be regarded as a chronic and fatal disease since it contributes to causes of heart attack, cancer, arthritis and psychological problems. • National Obesity Week is commemorated to increase awareness about the impact of obesity in the lives of South Africans. www.sajs.co.za

The Script Pharmacy Magazine │September 2013 • October 2013

Dont forget National Obesity Week > 15 - 19 October 2013

clinically proven natural medicines

ADVERTORIAL

TA R G E T E D W E I G H T C O N T R O L

Slimcut has joined the Slimz family of weight management products.

AdiBurn+

AdiBurn 75

The highly concentrated SLIMZ AdiBurn 1000 oral serum allows for the RAPID ABSORPTION of the active ingredients, which helps raise the body’s temperature (thermogenesis), in order to support a healthy metabolism and maximize weight control and energy levels.

Slimz AdiBurn 75 is a well-tolerated formulation that works from day 1 to support a healthy metabolism, with ingredients that raise your body temperature (thermogenesis), aiding optimal weight management when combined with our 5-point programme.

1000 ORAL SERUM

Slimz has built up a reputation as one of the leading weight management brands in South Africa, and in their perpetual quest to deliver the best quality products to their clients; the Slimcut product was a perfect fit. Slimcut will now be known as Slimz Adiburn 200, and even though the name might have changed, the fast acting ingredients as well as the scientifically proven results when using it, will remain the same.

AdiDetox 180

FORTE

Detox and cleanse your body to maximise and accelerate fat breakdown potential with stimulant free AdiDetox 180 Accelerator

AdiBlock+ Forte contains Stimulant Free ID-alGTM which helps to manage your weight by limiting energy intake, which induces a better balance between intake and expenditure. It acts by reducing the effectiveness of carbohydrate and fat digestive enzymes, potentially reducing the uptake of these macronutrients, when required.

Log on to www.slimz.co.za

Slimz AdiBurn 200 is a high impact thermogenic liquid that works from day 1 to support a healthy metabolism by raising your body temperature (thermogenesis).

Target your problem areas the Slimz way.

GREAT TASTING PROTEIN SHAKE

TEA

AdiSlim

AdiTone 1000

WEIGHT MANAGEMENT is the simple equation of making sure that your calorie intake does not exceed your body’s actual calorie usage. Slimz AdiSlim Protein shake is a low-GI, high protein snack replacement containing essential nutrients to help control appetite between meals, for less calorie uptake into the system, potentially reducing weight gain. kJ USED > kJ INGESTED = WEIGHT REDUCTION

AdiSlim Tea harnesses the essence of the Hoodia cactus, a natural appetite suppressant from the Kalahari Desert that signals the brain that the stomach is full, therefore reducing appetite and ‘between meal’ cravings. It increases physical stamina and metabolism, stimulates higher energy levels and an improved sense of well-being.

Studies have shown that the most significant effect of CLA on weight management is on body composition: a reduction in total fat storage and an increase in lean body mass.

AdiSlim

Register to the Slimz way and get: Inspiration, Goal setting templates, eating plans, exercise plans, interesting information and motivation!

AdiBlock+

ACCELERATOR

AdiBurn 200

THERMOLEAN

ULCERS OF THE LOWER LIMBS It is estimated that 20.8 million people in the USA alone have diabetes. More than 60% of nontraumatic lower-limb amputations occur in people with diabetes. In 2002, about 82,000 nontraumatic lowerlimb amputations were performed in people with diabetes. The rate of amputation for people with diabetes is 10 times higher than for people without diabetes.

Ulcer Stats

Africa compared to Japan & Australia

10%

19%

48%

Australia

Japan Africa

children under 15

10% Other

55%

Lower limbs

35%

Upper limbs

in general, lesions occur on the

STEP 1

STEP 2

STEP 3

STEP 4

Male Female

52% 48% IF THE DIABETIC FOOT ULCER IS AT STAGE 1, IT HAS RED SKIN THAT DOES NOT TURN WHITE WHEN YOU PRESS IT. THE SKIN MAY FEEL WARM TO THE TOUCH.

IN STAGE 2 DIABETIC FOOT ULCERS, PATIENTS MAY HAVE LOST THICKER LAYERS OF SKIN

AT STAGE 3, THE DIABETIC FOOT ULCER PROBABLY LOOKS LIKE A POTHOLE OR CRATER. DEAD TISSUE MAY GO ALL THE WAY TO THE BOTTOM LAYER OF SKIN, AND YOU MAY HAVE SUFFERED NERVE DAMAGE.

IF THE DIABETIC FOOT ULCER IS AT STAGE 4 IT HAS DESTROYED A GREAT DEAL OF TISSUE AND DAMAGED MUSCLE, BONE, JOINTS, AND TENDONS. THIS IS THE MOST SEVERE STAGE

The Script Pharmacy Magazine │September 2013 • October 2013

66% 34% Japan

Africa

gender distribution

32%

35%

33%

Category I

Category II

Category III

in Afica, most cases are still diagnosed late

ULCERS OF THE LOWER LIMBS

Arterial Ulcers

Diabetic Ulcers

Approximately 10% of all leg ulcers are arterial ulcers. Feet and legs often feel cold and may have a whitish or bluish, shiny appearance. Arterial leg ulcers can be painful. Pain often increases when your legs are at rest and elevated. You can reduce pain by sitting on the edge of the bed with your feet on the floor. Gravity will then cause more blood to flow into your legs. Ulcers are breaks in the layers of the skin that fail to heal. They may be accompanied by inflammation. Sometimes they don’t heal and become chronic. Chronic foot and leg ulcers mainly affect the elderly. People with diabetes are at special risk of developing foot ulcers, and foot care is an important part of diabetes management. People with arterial leg ulcers often suffer from intermittent claudication. The condition causes cramp-like pains in the legs when walking. This is because the leg muscles don’t receive enough oxygenated blood to function properly. Claudication pain usually goes away if you stand still for a few minutes. Not all people with intermittent claudication have leg ulcers.

Diabetes also increases the likelihood of atherosclerosis (narrowing of the arteries). This means people with diabetes have a much increased risk of developing arterial ulcers. The long-term effect of diabetes on the nerves increases the likelihood of trauma to the feet. It causes a lack of sensation in the feet, which makes ulcers more likely to appear. But these ulcers are often neglected because they don’t cause pain. If ulcers aren’t treated, they can lead to more serious problems. Diabetic ulcers have similar characteristics to arterial ulcers but are more notably located over pressure points such as heels, tips of toes, between toes or anywhere the bones may protrude and rub against bedsheets, socks or shoes. In response to pressure, the skin increases in thickness (callus) but with a minor injury breaks down and ulcerates. Infected ulcers characteristically have yellow surface crust or green/yellow pus and they may smell unpleasant. There may be surrounding tender redness, warmth and swelling (cellulitis). Mexican Americans are 1.8 times as likely, non-Hispanic Blacks are 2.7 times as likely, and American Indians are 3 to 4 times as likely to suffer from lower-limb amputations. Amputation rates are 1.4 to 2.7 times higher in men than women with diabetes.

Causes of arterial leg ulcers? Arteries are the tubes that carry blood from the heart to the body’s tissues. The tissues receive oxygen and nutrients from the blood. The used blood, which now contains carbon dioxide and other by-products, is carried via the veins from the tissues back to the heart. Arterial leg ulcers are caused by poor blood circulation as a result of narrowed arteries. They are also caused by damage to the small blood vessels from long-standing diabetes.

Characteristics of arterial ulcers: • Usually found on the feet, heels or toes. • Frequently painful, particularly at night in bed or when the legs are at rest and elevated. This pain is relieved when the legs are lowered with feet on the floor as gravity causes more blood to flow into the legs. • The borders of the ulcer appear as though they have been ‘punched out’ • Associated with cold white or bluish, shiny feet • There may be cramp-like pains in the legs when walking, known as intermittent claudication, as the leg muscles do not receive enough oxygenated blood to function properly. Rest will relieve this pain.

Why are people with diabetes prone to foot ulcers? Reduced sensation of the skin on the feet Diabetic’s nerves may not work as well as normal because even a slightly high blood sugar level can, over time, damage nerves. This is a complication of diabetes called ‘peripheral neuropathy of diabetes’. The nerves that take messages of sensation and pain from the feet are commonly affected. If you lose sensation in parts of your feet, you may not know if you damage your feet. For example, if you tread on something sharp, or develop a blister due to a tight shoe. Therefore, you are more prone to problems such as minor cuts, bruises, blisters. Also, if you are not sensitive to pain from the foot, you will not protect these small wounds by not walking on them. Therefore, they can quickly worsen and develop into ulcers. Narrowing of arteries (blood vessels) going to the feet. If you have diabetes you have an increased risk of developing ‘furring’ of the arteries. This is caused by fatty deposits called atheroma that build up on the inside lining of arteries. This

can reduce the blood flow to various parts of the body. The arteries in the legs are quite commonly affected. This can cause a reduced blood supply (‘poor circulation’) to the feet. Skin with a poor blood supply does not heal as well as normal and is more likely to be damaged. Therefore, if you get a minor cut or injury, it may take longer to heal and is prone to worsen and develop into an ulcer. Particular, if you also have reduced sensation and cannot feel the wound.

What increases the risk of diabetics developing foot ulcers ? • Reduced sensation to your feet. • the longer you have diabetes, and the older you are. • if your diabetes is poorly controlled. This is one of the reasons why one aim of treating diabetes is to keep the blood sugar level as near normal as possible. • If you have narrowed arteries

The risk of this occurring increases: • the longer you have diabetes, the older you become, and if you are male. • if you have any other ‘risk factors’ for developing ‘furring of the arteries’. For example, if you smoke, do little physical activity, have a high cholesterol level, high blood pressure, or you are overweight. • If you have had foot ulcers in the past. • If you have other complications of diabetes such as kidney or eye problems. • If your feet are more prone to minor cuts, grazes, corns or calluses which can occur: • if you have foot problems such as bunions which put pressure on points on the feet. • if your shoes do not fit properly which can put pressure on your feet. • if you have leg problems which affect the way that you walk, or prevent you from bending to care for your feet.

Diabetic ulcer assessment There are 4 severity stages of diabetic foot ulcers. Most diabetic foot ulcers are like “icebergs.” Unlike a normal wound a diabetic foot ulcer can be largely hidden. It may appear small on the surface but extend very deep, even to the bone. More often, diabetic foot ulcers begin with pressure on the bottom of the foot. www.aotinc.net/ aoti_diabetic_ulcer.html

The Script Pharmacy Magazine │September 2013 • October 2013

FEATURE HEADER

Reg. No. L8869 ACT 36/1947

HHL Technology info@hhltechnology.co.za www.vitalprotection.co.za 38 The Script Pharmacy Magazine │September 2013 • October 2013 Tel: +27 (0) 21 100 - 0036 (JHB)

GET SYRINGE SAVVY! ENROL NOW

Introducing our new online course on Injections and Immunisation Send an email with your details to training@pdacademy.co.za

WHERE CREATIVE THINKING MEETS QUALITY TRAINING

FEATURE HEADER

TAKE YOUR PHARMACY TO A NEW LEVEL Let the Leading Pharmacy Franchise provide you with the competitive edge that you need to excel as an independent retail pharmacy.

What we offer: 1

Independence with the backup of a reputable brand.

Access to an extended range of products at competitive prices.

Corporate services to make your business run smoother and easier.

Expertise and input in terms of best practices in financial management, merchandising and stock control.

Front shop expansion to the benefit of your customer.

Join the growing number of independent pharmacies who are already benefitting from a unique business model. Download our application form from www.leadingpharmacy.co.za. 40

The Script Pharmacy Magazine â&#x201D;&#x201A;September 2013 â&#x20AC;˘ October 2013

FEATURE HEADER

Trusted advice: Training of all personnel in customer service, front shop management and product knowledge. Marketing campaigns to educate the consumer on medicine and the role of the pharmacist. Website and social media management.

Trusted price: Back-up of a reputable wholesaler. Negotiations with suppliers for pricing and product ranges.

CONTACT OUR TEAM NOW to gain knowledge about Leading Pharmacy’s offering and business model:

Send a mail to admin@leadingpharmacy.co.za or phone (013) 010 0091

Join our facebook page at www.facebook.com/Leading Pharmacy

trust

www.leadingpharmacy.co.za

The Script Pharmacy Magazine │September 2013 • October 2013

Supplier List Contact our Buying Agent, Estelle van Tonder: estelle@cjpharm.co.za • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

3M SOUTH AFRICA (PTY) Ltd. ABBOT ACTIVO HEALTH ACTOR PHARMA ADCOCK CRITICAL CARE ADCOCK INGRAM AKACIA HEALTHCARE ALCON ALLERGAN ANMARATE PHARMACEUTICAL ARCTIC ASPEN PHARMACARE ASTELLAS ASTRA ZENECA ATKA PHARMA AUROBINDO AUSTELL LABORATORIES AVID BRANDS S.A.(PTY)LTD BAOBAB HEALTHCARE BAUSCH & LOMB BAYER DIABETICS BAYER SCHERING BEIERSDORF CONSUMER PRODUCTS BENNETT BROTHERS BENNETTS THE CHEMISTS BETA PHARMACEUTICAL BE-TABS PHARMACEUTICALS BIOGARAN BIOSCIENCE BIOSWISS BIOTECH LABS BOEHRINGER BROTHERLY LOVE BRUNEL LABORATORIA BSN-MEDICAL CEDARPHARM COMED HEALTH CREME CLASSIQUE DENTAL WAREHOUSE DEVINO DR REDDY’S ELI LILY ENERGIZER EQUITY PHARMACEUTICALS EVOLABS FLORDIS FOUNTAIN MEDICAL FRESENIUS KABI SA FUTUREHEALTH GABINA HEALTH & BEAUTY GALDERMA GENOP

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

GEOREN PHARMACEUTICALS GLAXOSMITHKLINE SOUTH AFRICA GUIDELINE TRADING GULF DRUG COMPANY HARTMANN GROUP HERBEX HOMEMED HOUSE OF ZINPLEX HUMOR DIAGNOSTIC IMSYSER HEALTH PRODUCTS INCOLABS INOVA JANSEN CILAG JOHNSON & JOHNSONS KENZA HEALTH KYRON LABORATORIES LEE-CHEM LABORATORIES LEVTRADE INTERNATIONAL LISAN INTERNATIONAL LITHA PHARMACEUTICAL LOOCK PHARMACEUTICALS MC’NABS MEDA PHARMACEUTICAL MED-e-HEALTH MEDINOX MEDPRO PHARMACEUTICA MERCK MERCK OTC MICROLIFE MIRREN MNI LIFESTYLE MSD MSD CONSUMER MUNDI PHARMA NAMPAK NATIVA NATURAL PRODUCTS NATURAL WELLNESS NOVAGEN PHARMA NOVARTIS CONSUMER NOVARTIS PHARMA NOVO-NORDISK TAKEDA OMEGA LABS ONE FOR ALL SUPPLEMENTS OXYGEN FOR LIFE SA PAKMED SELF MEDICATION PENPHARM SA PEPPINA SALES PERMARK PFIZER LABORATORIES PHARMA DYNAMICS

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

PHARMA NATURA PHARMACEUTICAL ENTERPRISES PHARMACHEM PHARMACEUTICAL PHARMACO DISTRIBUTORS PHARMAMARK PINNACLE PHARMACEUTICALS PORTFOLIO PHARMACEUTICALS PRO DISTRIBUTORS PROCTER & GAMBLE QUALITY SUGARS RANBAXY RECKITT BENCKISER PHARMA REITZER PHARMACEUTICALS REVLON ROCHE DIAGNOSTIC ROCHE PRODUCTS (PTY)LTD ROLFE LAB SA NATURAL PRODUCTS SAM NUTRITIONALS SANDOZ SA SANOFI AVENTIS SANOFI PASTEUR SCHICK SERVIER LABORATORIES SG CONVENIENCE GAUTENG SLIMBETTI SMITH & NEPHEW SOLAL TECHNOLOGIES SPECPHARM SPORT AND HEALTH TECH STAR CHOICE (IMMUNADUE) TARA PHARMACEUTICAL TARGUARD SA TECHNICON LABS TELEGENIX TEVA PHARMACEUTICAL TFD (REDBUL) TIBB HEALTH SCIENCES TIGER BRANDS TOPAZ (SKIN PHD) ULTIMATE SPORTS NUTRITION VALIDUS MEDICAL VAN DYK PHARMACEUTICAL VIKELEKA HERBAL VITAL HEALTHCARE WATSON PHARMACEUTICAL WINTHROP WINTROP PHARMACHOICE XS HEALTH YIWIEDA TRADING

Supplier Return Policies ...

For more information contact : 013 665 1011 or email : customercare@cjpharm.co.za 3M South Africa (Pty) Ltd. A.I.Healthcare (Consumer) Acorn Products Activo Health Actor Pharma Adcock - MSD Adcock (UPD) Adcock Ingram Alman's Dried Fruit And Nuts Arctic Ascorbate Health Products Aspen Pharmacare Atka Pharma Austell Laboratories Avid Brands S.A.(Pty)Ltd Baobab Healthcare Bausch&Lomb Beacon Beiersdorff Bennett Brothers CC Bennetts The Chemists Be-Tabs Pharmaceuticals Bethpharm Biogaran SA (Pty) Ltd Biosphere Cosmetics South Biotech Laboratories Brunel Laboratoria (Edms) Bpk BSN-Medical (Pty) Ltd Cadbury Cedarpharm Colgate Palmolive Crovan Health Easi-Slim Equity Pharmaceuticals Pty Ferame Pharmaceuticals Georen Pharmaceuticals Glaxosmithkline South Africa Goldings Orthopaedic Gulf Drug Company Hartmann Group Healthwise Distrubutors Homemed House Of Zinplex Immunadue Herbals Isipani Pharmaceuticals CC Johnson & Johnsons Kenza Health Levtrade International Lisan International Litha Pharma Loock Pharmaceuticals Lundbeck Mc'nabs Wellth Med-E-Health Medinox CC Medpro Pharmaceutica

No Return 3 Months Before Exp - Aurth No Return 3 Months Before Exp. 2 Months Before - Aurth No Return No Return No Return (3 Months Before) 1 Month Before Exp. 3 Months Before Exp - Aurth No Return 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. No Return No Return Month Of Exp. No Return No Return No Return No Return No Return 3 Months Before Exp. No Return 3 Months Before Exp. No Return No Return 3 Months Before Exp. No Return No Return No Return No Return 3 Months Before Exp. No Return No Return No Exp Dates No Return No Return 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. No Return 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. No Return 3 Months Before Exp. 3 Months Before Exp. 4 Months Before Exp. 4 Months Before Exp.

Mirren Mish-Mish More To Life (Pty)Ltd Nampak Natel Healthcare (Pty)Ltd Nativa Pty Ltd Natural Products Nestle New Century Dist CC. New Life Healthcare Novagen Nu-Leaf Nutrilida (Pty) Ltd OTC-Pharma South Africa Oxygen For Life SA Penpharm SA (Pty) Ltd Permark Pharma Dynamics Pharmaceutical Enterprises Pharmachem Pharmaceutical Pharmafrica (Pty) Ltd Pharmamark (Pty)Ltd Pharmanatura Pharmaplan Pinnacle Pharmaceuticals Planet Hoodia Pro Distributors Reckitt Benckiser Pharma Reitzer Pharmaceuticals Revlon Roche (International Health) Rolfe Lab RTT - 3M RTT - Alcon RTT - Alliance RTT - Aspen RTT - Astellas Pharma RTT - Astrazeneca Pharmaceuticals RTT - Bioharmony RTT - Bioscience RTT - Canyon Organics RTT - Crovan RTT - Dr Reddy's RTT - Glenmark RTT - GSK RTT - GSK Consumer RTT - Inova RTT - Janssen Pharmaceutical RTT - Merck RTT - Mylan RTT -Natrodale â&#x20AC;&#x201C; Vital RTT - Nycomed Pty Ltd RTT - SCP RTT - Secpharma RTT - Specpharm RTT - Vital

No Return No Return No Return No Return No Exp Dates 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. No Return No Return No Return 4 Months Before Exp. 6 Months Before Exp. 6 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. Month Of Exp 6 Months Before Exp. 2 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp. 4 Months Before Exp. 4 Months Before Exp. No Return 3 Months Before Exp. No Return No Return No Return No Return No Return 3 Months Before Exp - Aurth Month Of Expiry - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp. 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp. 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp. 3 Months Before Exp. 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth 3 Months Before Exp - Aurth

SA Natural Products Sandoz - Hexal Sara Lee Servier Laboratories SG Convenience Smart Pharmaceuticals Pty Ltd Smith & Nephew (Pty)Ltd Solal Targuard SA CC Technicon Labs The Authentic Branded Thebe Medicare Consumer Tibb Health Sciences Tigerbrands Snacks/Treats Union Swiss Unique Formulations CC USN UTI - Abbott UTI - Allergan UTI - Bayer Consumer UTI - Bayer Dianetes Care UTI - Bayer Shering Pharm UTI - Boehringer Ingelheim Ethical UTI - Boehringer Ingelheim Selfmed UTI - Genop Pharmaceuticals UTI - Genop Skincare UTI - Imithi Ciba Vision UTI - Menholatum SA UTI - MSD UTI - Novartis Consumer UTI - Novartis Pharma UTI - Novartis Sandoz UTI - Novartis Sandoz Specialities UTI - Pfizer UTI - Pharmacia UTI - Pharmaco Amdipharm UTI - Pharmaco Distribution UTI - Pharmaplan UTI - Pharmaschript UTI - Ranbaxy UTI - Roche UTI - Sandoz - Hexal UTI - Sanofi/Aventis UTI - Shering Plough UTI - Simayla Pharma UTI - Solvay Pharma UTI - Sonke ARV UTI - USN (Ultimate Sport) UTI - Winthrop UTI - Wyeth UTI - Wyeth Consumer UTI - Pharmaplan Validus Medical Vital Wellness Direct Suppliers XS Health

6 Months Before Exp. 2 Months Before Exp. 3 Months Before Exp. Month Of Exp - Aurth No Return 3 Months Before Exp. 3 Months Before Exp. No Return No Exp Dates No Return No Return No Return 6 Months Before Exp. 3 Months Before Exp. No Return No Return No Return No Return Month Of Exp. Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth No Return No Return Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After Month Of Expiry - Aurth Month Of Exp 3 Months After Month Of Exp 3 Months After 2 Months Before Exp. 2 Months Before Exp. Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth No Return Month Of Exp 3 Months After - Aurth No Return Month Of Exp 3 Months After - Aurth 2 Month Before Exp. No Return Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth Months Before Exp. Month Of Exp. Month Of Exp 3 Months After - Aurth Month Of Exp 3 Months After - Aurth No Return 3 Months Before Exp. No Return 6 Months Before Exp. 3 Months Before Exp.

Credit and Returned Goods Policy Dear Valued Customer At CJ Pharmaceuticals we endeavor to provide you with the best service at all times. Accepting returned stock and passing a credit is part of that service. We would like to provide you with fair and practical guidelines. No credit exists until a credit note is issued by CJ Pharmaceuticals and no deduction, or adjustment to any invoice may be made by the customer except on the basis of a credit note. Before any product is returned to CJ Pharmaceutical Enterprises a CJW reference number must be obtained from our Customer Care Department. When returning liquids, place all the liquids in a plastic bag, before placing the products in a box. CJ Pharmaceuticals will only accept returns if the batch of the products are directly from CJ Pharmaceutical Enterprises. Products must be returned in full, unopened, undamaged, original packaging. Pharmacies must provide adequate documentation (invoice number, batch and expiry) to ensure that it is CJ Pharmaceutical Enterprises products.

ing errors. You will be issued with a CJW reference number and the product is to be returned. A credit will be issued upon receipt of the product

Acceptable Returns

Criteria applicable:

Product may be returned for credit under the following conditions: 1. Picking Errors 2. Visible Damage 3. Concealed Damage 4. Expired Goods 5. Customer Ordering Error 6. Shortages

Picking Errors: Immediately contact the Customer Care Department and report any Picking Errors. You will be issued with a CJW reference number for the product to be returned

Visible Damage: Any visible damage should be noted on the POD upon receipt of the order. Immediately contact our Customer Care Department for a CJW reference number

Concealed Damage: Immediately contact our Customer Care Department and report any concealed damage noted upon receipt of your order or within 48 hours. Our Customer Care Department will issue you with a CJW reference number as soon as we receive the stock a credit will be processed

Expired Goods: Stock received from us, nearing expiring date will be taken back according to the specific Supplier policy (Copy of Supplier Returns Policy will be attached) and provided it is from the same batch number received from us. If Better Dated stock was bought we cannot except expired stock back. Product must be in original, sealed, full unopened container. Product must have a batch number and expiration date

Customer Ordering: Immediately contact our Customer Care Department and report any customer order-

Shortages: Our policy in this case is purely based on our mutual trust relationship. We have recently introduced additional procedures and controls in order to improve our precision in this regard. Shortages must be reported within 48 hours upon receipt of stock to our Customer Care Department. Customer Care Department will give the information through to our Security Department for the CCTV footage to be viewed for the shortage. Feedback with regards to the query will be given before 48 hours after the call has been logged • Once the content of a box or parcel is checked against the invoice and any discrepancy is found ( items short or damaged), we request that it is reported to our Customer Care Department within 48 hours • A reference number (CJW number) must be obtained from our Customer Care Department within 24 hours of your delivery – 013 665 1011 • Once you have received a reference number (CJW number), our delivery team will present a collection manifest (CJW) (white and pink copy) and collect the stock within 24 hours • No stock will be collected without the pink copy (CJW) of the Collection Manifest attached to the goods – please also attach a copy of the applicable invoice • When the stock arrives at the warehouse it will be checked - the invoice with the pink copy of the collection manifest will be taken to our Customer Care Department for a credit to be passed • An authorised return must be returned within 48 hours from the receipt of a CJW reference number • A valid CJW reference number and invoice must accompany all returns for proper credit • Credit is based on the original purchase price • Credit will be issued in the form of a Credit Note • We require proof of purchase (invoice) of all products returned for credit

Non-Returnable Items:

• Products without a CJW reference number (non-approved returns) • Products with more than six (6) moths remaining shelf life • Products retained more than twelve (12) months beyond expiration date

• Private Label products or repacked goods • Products with missing label or with missing batch number and expiration date • Products broken, marked or with price stickers • Products sold on a non-returnable basis • Products damaged/deteriorated due to improper handling or storage • Products not purchased directly from CJ Pharmaceutical • Fridge items • Overstock, unless agreed by the CEO in writing We would like to suggest the following procedures when receiving stock: 1. Check every invoice number (and the number of boxes and parcels per invoice) individually.(Please don’t just reconcile the total number of boxes / parcels delivered, to the quantities indicated on the POD?) 2. If our driver is calling the invoice numbers, please ensure that you witness the process and put the verified boxes / parcels behind you. 3. In the event that a box has not been received or that the box is damaged the Receiving Person must immediately declare it - next to the Invoice number on the POD. (Ex. “Box not received”, “Box damaged”) 4. We cannot be held liable for any shortages or damages, unless the POD is specifically endorsed. 5. Please get the driver to counter sign the endorsement! 6. Once the POD has been signed, NO CREDIT can be passed for any delayed claims for damaged or short boxes / parcels. 7. Please take note that the absence of a tick, or a cross, next to the undelivered invoice number cannot suffice as a proper endorsement 8. As a final check we suggest that you do a count of all the boxes and parcels that were delivered and balance that back to the quantities indicated on the POD. 9. It is regretted that we cannot entertain credits for boxes not delivered, unless the POD is endorsed accordingly We trust that the suggestions will enable both parties to solely rely on the POD in case of any future discrepancies or claims. CJ Pharmaceuticals may at its discretion, make exceptions to the Return Goods Policy based on extenuating circumstances.All returns must be made according to this Return Goods Policy. Thank you Erika Oehley Inventory Risk Manager

CALENDAR ORDER Size (297mm x 425mm) A

your details go here

Landscapes (BL)

Minimum quantity of 250 per order Prices for Option BL and Option BW Black & White Header R2.40 each Excluding VAT.

Colour Header R2.86 each Excluding VAT.

Fax to 086 698 1468

your details go here

Wildlife (BW)

Quantity Option BL (Landscapes) x Option BW (Wildlife) x

Black and White Header

Pharmacy Name: Person Responsible for payment: Tel: Total amount Calendars:

What do you want on your calendar? Header Details:

Info: contact Marketing on 013 010 0091, or email: marketing@cjpharm.co.za

Colour Header

Introducing the animated bunch from

CUSTOMER CARE Hlengiwe

B eaut y

An e t te Priscilla

Lila M e rc i a

MEET THE TEAM

At first glance they seem like a bunch of chatty crazies -- but with their customers’ best interest at heart, they execute their busy department’s roles efficiently and with a great deal of passion. Always willing to assist - they work well as a team and never fail to support a worthy cause with creative enthusiasm (pictured here on Go Big Casual Day 2014 - In support of people living with disabilities) - Here’s a quick look at the person at the CJ Customer care team. Priscilla Mothibe

Hlengiwe Maphonga

( C.O.D sale orders) I consider myself to be…a bookkeeper or a CA I am inspired by…my pastor I am currently reading...Daddy’s girls by Pastor T.D. Jakes I recently watched...I do, I did Top of my current play list is ...Joyous Celebration Every day I ...pray before I do everything On Saturdays I ...rest or work Sometimes when noone’s looking I...just smile I am terrified by…arrogant and heartless people The craziest thing that has ever happened to me was ...falling on the stairs at work The best part of my work day is when …I finish all that I was expected to do. I am proud that I...am a woman, mother, wife, colleague and someone who is responsible I love people who... are always willing to communicate and honest I am happiest when...I achieve my goals The wisest thing I’ve ever… learnt is to respect everybody

Processing (Rep Orders)

Mercia Delport (Telesales) I consider myself to be… happy I am inspired by…strong, happy people I am currently reading...Fifty Shades I recently watched...7de Laan Top of my current play list is...Other Side-Jason Derulo Every day I ...want to be positive On Saturdays I ...work or sleep late Sometimes when no-one’s looking I...close my eyes I am terrified by…any creepy , crawling or flying bugs The craziest thing that has ever happened to me was...I jumped of a cliff The best part of my work day is when …it starts. I am proud that I...am a woman I love people who...loves me I am happiest when...I get my salary The wisest thing I’ve ever… seen – My dog.

I consider myself to be…a go getter I am inspired by…nature I am currently reading...Redeeming Love I recently watched...Temptation Top of my current play list is ...Micasa Every day I ...laugh On Saturdays I ...window shop I am terrified by…snakes and spiders The best part of my work day is when …I ask Reps and Pharmacists about their products I am proud that I...get what I want I love people who...inspire other by the good deeds they do I am happiest when...I make someone laugh or spoil somebody The wisest thing I’ve ever…did was choose a friend

Anette Jacobs (Telesales) I consider myself to be…a very quiet

Beauty Mazibuko

(Telesales) I consider myself to be… a PR consultant one day I am inspired by…positive people and a great outlook on live I am currently reading...kids magazines I recently watched...X Factor Top of my current play list is ...Gabriëlle Rise Again Every day I ...wake up and take a new day on to see if it has new challenges On Saturdays I ...relax Sometimes when no-one’s looking I... make funny faces I am terrified by… heavy thunderstorms The craziest thing that has ever happened to me was ...walked into a glass door The best part of my work day is when …a customer compliment me for my service I am proud that I...am a CJ Pharmaceutical employee I love people who...always smile and is friendly at all time I am happiest when...people around me are happy The wisest thing I’ve ever…done is thinking twice at some stages

Lila van der Merwe

done, is to live every day to be thankful

(Customer Care Supervisor) I consider myself to be… Weird I am inspired by… Unicorns I am currently reading... this sentence I recently watched... Bananas in pajamas Top of my current play list is ... Avril Lavigne “Here’s to never growing up” Every day I ... breathe On Saturdays I ... do as much as possible Sometimes when no-one’s looking I... Google I am terrified by… people who don’t drink coffee The craziest thing that has ever happened to me was ... experiencing a day were nothing crazy happened The best part of my work day is when … I drink my first cup of coffee I am proud that I... have a sense of humour I love people who... have fun I’m happiest when... I am on holiday The wisest thing I’ve ever… heard is: “In order to be

for what I have.

irreplaceable, one must be different”

person I am inspired by…nature Top of my current play list is ...Superman Every day I ...wake up and go to work On Saturdays I ...try to relax Sometimes when no-one’s looking I... day dream I am terrified by…horror movies The craziest thing that has ever happened to me was ...go-carting The best part of my work day is when … customers make me laugh. I am proud that I...can make a difference in people’s lives I love people who...like to have fun and enjoy life I am happiest when...I’m just relaxing and enjoy some time with family The wisest thing I’ve ever…

The Script Pharmacy Magazine │September 2013 • October 2013

The ANTISPASMODIC effect of Colofac effectively1... • Relieves abdominal pain & spasms1 • Relieves intestinal discomfort1

• It is suggested to restore bowel motility2

For various types of IBS and relief of smooth muscle spasm of the GIT1 Common symptoms of IBS 1,3

BLOATING

ABDOMINAL PAIN

DIARRHOEA

CONSTIPATION

â&#x20AC;˘ Colofac is well tolerated with no cholinergic side effects

References: 1. Package Insert. 2. Evans PR, Bak Y-T, Kellow JE. Mebeverine alters small bowel motility in irritable bowel syndrome. Ailment pharmacol Ther 1996; 10:787 - 793. 3. Kennedy T. et al.Cognitive behavior therapy in addition to antispasmodic treatment for IBS in Primary care: Randomised controlled trial. BMJ 2005;331;43

S2 ColofacÂŽ 135mg. Composition: 1 tablet contains mebeverine HCl,135 mg. Pharmacological Classification: A.11.2 Gastrointestinal anti-spasmodics and cholinolytics. Indications: Primary irritable colon characterised by persistent diarrhoea, alternating constipation and diarrhoea, abdominal pain and postprandial distension. Secondary irritable colon due to organic lesions such as regional enteritis, diverticulitis, specific and non-specific inflammatory conditions of the gastro-intestinal tract. Reg. No. Q/11.2/165. Name and business address of license holder: Abbott Laboratories S.A. (Pty) Ltd. Abbott Place, 219 Golf Club Terrace, Constantia Kloof, 1709. Tel: (011) 858 2000. For full prescribing information refer to package insert approved by the medicines regulatory authority. Date of publication of this promotional material: April 2013. Promotional Material Reference Number: Colofac-0313-0001-S-0184.

8117

tools THE RIGHT

We might live and work in a digital age, but the humble business card remains one of the cheapest and most effective marketing tools around the Name badge is an important visual ally, allowing your clients to know who you are by connecting their experience with your brand.

Name badges

R45

from*

00 each

*Discount for Bulk orders!

Business cards

Set of 500, Single Sided

R220

from

ORDER BEFORE NAME BADGES & BUSINESS CARDS OCT & SAVE! Quote promocode CJM022013* to qualify for a 5% Discount! We also do: Corporate Gifts, Graphic Design, Printing of flyers, posters, magazines (small & large quantities), Self-inking stamps, Banners, Snap-frames, Pull-up Banners, flags & much, much more! *ONE DISCOUNT PER CUSTOMER - VALID UNTIL 31 OCTOBER 2013

DIRECTORY

EXCLUSIVE PROMOTION!!

VALID FROM 1 SEP 2013 - 24 OCT 2013

Account No:

ORDER FORM

Pharmacy Name:

Product

Size

Price

Tropitone Splash Lotion Spf 20

125ml

41.84

Tropitone Splash Lotion Spf 30

125ml

49.46

Tropitone Splash Lotion Spf 40

125ml

60.87

Tropitone Acti-Sport Sunscreen Spray Spf 30

125ml

53.26

Tropitone Acti-Sport Sunscreen Aerosol Spray Spf 30

125ml

62.35

Tropitone Deep Tan Dry Oil Spf 6 - with Tan Enhancer

150ml

53.27

Tropitone UV Face Protection Spf 40

50ml

62.26

Tropitone Water Babies Sunscreen Lotion Spf 40

200ml

81.42

Tropitone Water Babies Sunscreen Spray Milk Spf 40

125ml

66.21

Tropitone Water Babies Sunscreen Spray Milk Spf 50

125ml

70.76

Tropitone Sunless Bronze Selftan Spray - Medium Tan Aerosol

125ml

60.88

Tropitone Sunless Bronze Selftan Lotion - Medium Tan

125ml

60.88

Tropitone Sunless Bronze Selftan Lotion - Dark Tan

125ml

60.88

Tropitone Aftersun Soothing Spray Gel

150ml

32.71

Tropitone Move it Shimmer Milk Pump Spray Spf30

125ml

52.77

Your order

All prices are exclusive of VAT FAX ORDERS TO: 086 697 9506

For any further enquiries regarding the above please contact Estelle 013 665 1011 The Script Pharmacy Magazine │June 2012 • July 2012

DIRECTORY

Account No:

ORDER FORM

Pharmacy Name:

EXCLUSIVE PROMOTION!!

VALID FROM 1 SEP 2013 - 24 OCT 2013 Product

Price

Dermalex Contact Eczema Crm 60g @ R99.20 @ 3 + 1

74.40

Dermalex Eczema Crm Adult 100g = R126.30 @ 3 + 1

94.72

Dermalex Eczema Crm Kids 100g = R126.30 @ 3 + 1

94.72

Dermalex Psoriasis Crm 150g = R126.30 @ 3 + 1

94.72

Dermalex Rosacea/Couperose Crm 30g = R132.90 @ 3 + 1

99.68

Your order

FAX ORDERS TO: 086 697 9506

All prices are exclusive of VAT

For any further enquiries regarding the above please contact Estelle 013 665 1011

The Script Pharmacy Magazine │June 2012 • July 2012

Account No:

ORDER FORM

Pharmacy Name:

DIRECTORY

EXCLUSIVE PROMOTION!!

VALID FROM 1 SEP 2013 - 24 OCT 2013 Product

Price

StaminoGro 8 Pack

1011.00

PregOmega 8 Pack

878.00

Your order

FAX ORDERS TO: 086 697 9506

All prices are exclusive of VAT

For any further enquiries regarding the above please contact Estelle 013 665 1011

The Script Pharmacy Magazine │June 2012 • July 2012

Account No:

ORDER FORM

Pharmacy Name:

DIRECTORY

EXCLUSIVE PROMOTION!!

VALID FROM 1 SEP 2013 - 24 OCT 2013 Product

Price

High Power Condoms 3`s

6.75

High Power Fast Up Tabs 1 Brown

20.95

High Power Gold Bullets 12’s

6.50

High Power Love Drops Red 5ml

5.50

High Power Man Tabs 1 Brown

16.95

High Power Pink Bullets 12’s

6.50

High Power Silver Bullets 12’s

6.50

High Power Vuka Vuka Caps 8’s

9.50

Your order

High Power Display Stand Available

All prices are exclusive of VAT FAX ORDERS TO: 086 697 9506

For any further enquiries regarding the above please contact Estelle 013 665 1011

The Script Pharmacy Magazine │June 2012 • July 2012

Snap Frames SUIT ANY SITUATION

Snap-open frames are so convenient when you need to swap one message for an updated version. Itâ&#x20AC;&#x2122;s so easy to exchange the information by inserting a new print or poster.

from

R120

*Prices subject to change without notice

We also do: Corporate Gifts, Graphic Design, Printing of flyers, posters, magazines (small & large quantities), Self-inking stamps, Banners, Pull-up Banners, flags & much, much more!

d n a r nb

w o r u ...Yo

As an independent pharmacy, we understand your unyielding commitment and passion to drive your business forward. Slimcut has launched proven fat burner capsules and slimming mixture products, that you can put into your own packaging and own as your very own, personalised slimming mixture and capsules.

Now also available iN bulk capsules!

What this means is that your business will be the heroes in the eyes of your consumers, and your profit will increase as you create your very own niche market and following with your very own slimming brand.

LKDA 17584

The Slimcut slimming mixture is packed in a 5 litre container, and the rapid fat loss capsules are packed in tubs of 1000, and allows for easy decanting.

Ask us about your own probiotic range! XS Health 012 342 6292

Posters and pamphlets available with every order.