Pharmacy Magazine
Golf, you’ve got skin in the game Common Childhood Cancers
DIABETES
WHAT CAN
YOU DO? CORPORATE PUBLICATION FREE • NOT FOR SALE
PARTICIPATE IN THE SURVEY ON PG. 43
TRY OUR CHRISTMAS CUISINE
Issue 40
SLEEP WHAT IS CALMETTES NITE? It is a HERBAL MEDICINAL PRODUCT indicated for the relief of temporary difficulty in falling asleep2 WHEN TO USE CALMETTES NITE? When you temporarily experience difficulty in falling asleep2 When you are not getting a good nights sleep2 Improves quality of sleep2 Improves problems associated with sleep disturbances in adults & children over 12 years
Calmettes nite tablets. Composition: Per tablet: Valerian dry root extract 125 mg. 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. Date of publication of this promotional material: April 2013. Promotional Material Reference Number: Calmettes-0313-0001-S-0185.
Nr. 12, 4th Street, Delmas PO Box 186, Delmas 2210 Tel: 013 665 1011 Fax: 013 665 4713 Registered: CJ Pharmaceutical Enterprises (PTY) Ltd. VAT Reg. 409 0205 909 Reg: 2001/009972.06 Telesales [tel] 013 665 1011 [fax] 086 695 5230 [fax] 086 512 0965 Anette email: anette@cjpharm.co.za Mercia email: mercia@cjpharm.co.za Rep Orders Beauty email: promotions@cjpharm.co.za Priscilla 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
Index Diabetes: the short & sweet of it 6 Am I at risk? 7 If you have wondered or possibly been told that you are at risk for developing diabetes
Take a step for diabetes 10 No matter what kind of shoes you’re wearing, it is time to take a step for diabetes
Skin cancer facts 14 HIV & AIDS in South Africa 18 An estimated 5.6 million people were living with HIV and AIDS in South Africa
Ridwaan [cell] 072 534 8135
Sun Facts: Golf: you have skin in the game 24
Lynne [cell] 071 472 7522
The PGA TOUR shares The Skin Cancer Foundation’s commitment
Pam [cell] 071 480 5322
to reaching men at risk with skin cancer prevention information
Account Queries Debtors : Maritsa
By the way 27 Food 28
email: ridwaan@cjpharm.co.za email: lynne@cjpharm.co.za
email: pam.vc@cjpharm.co.za
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) 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
Christmas Cuisine
By the way 27 Cancer in children 32 Mind Movers 47 Meet the team 53 CJ Pharmaceuticals Finance
Congratulations to the Issue 39 winners Leslies Booysen Pharmacy Hoppies Pharmacy Fishers Hill Pharmacy Hillcrest Pharmacy Melrow Pharmacy Rivermall Pharmacy
- Monica Kwaza - Belinda Marais - Alicia Greyvenstein - Makgotso Matagela - Jacinda Benecke - Zelda Minnie
Need product knowledge? Struggling to get information? Watch this space for a solution AND the opportunity to win great prizes!
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
Pam [cell] 071 480 5322 email: pam.vc@cjpharm.co.za
Account Queries Debtors : Caron
email: finance@cjpharm.co.za MAGAZINE DESIGN & LAYOUT Marizelle Geldenhuis (Creative Director) Carl Loggenberg (Graphic Designer) Mariëtte Louw (Graphic Designer)
About the cover
Diabetes Awareness Month is commemorated on 14 November to raise awareness for the treatment and testing of those living with diabetes. Over 1,2 million South Africans are living with Diabetes, 85% of S.A. diabetics are undiagnosed. See from page 6 for more on diabetes. Cover picture : 123rf.com 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 │November 2013 • December 2013
3
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Contact CJ Pharmaceuticals at 013 010 0091, or your local rep
FOR SENSITIVE
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VIPDAYS
Keep your eye on our calendar for important industry dates. To contribute events to our calendar, kindly email cjmaketing@cjpharm.co.za 2NOV2013
14NOV2013
National Children’s Day
1DEC2013
World Diabetes Day
The aim of the National Children’s Day celebration is to highlight progress being made towards the realisation and promotion of rights of children.
World AIDS Day
The UN Resolution makes World Diabetes Day stronger than ever and provides the opportunity for a significant increase in the visibility of the campaign and an increase in government and media participation on or around November 14.
The day creates an opportunity to show solidarity for the global fight against HIV and AIDS. The year 2013 marks the 25th Anniversary of World AIDS Day, thus making it the longest – running international health commemorative day.
17NOV2013
25NOV2013 - 10DEC2013
16DEC2013
World Remembrance Day for Victims of Road Accidents
16 Days of Activism for No Violence Against Women and Children
Day of Reconciliation
Annually, over 15 000 South Africans die in road traffic accidents costing the South African economy approximately R46 billion. This leaves a trail of untold suffering for victims and families.
16 December is a day of great significance in South Africa because of two historical events that took place on that date. With the advent of democracy in South Africa 16 December retained its status as a public holiday. South Africa’s first non-racial and democratic government was tasked with promoting reconciliation and national unity. One way in which it aimed to do this symbolically was to acknowledge the significance of the 16 December in both the Afrikaner and liberation struggle traditions and to rename this day as the Day of Reconciliation.
The South African Government runs a 16 Days of Activism Campaign to make people aware of the negative impact of violence on women and children and to act against abuse. We are firmly committed to lead a coordinated effort to sustain the campaign into its next decade.
25DEC2013
26DEC2013
Christmas Day
Day of Goodwill
Christmas is an annual commemoration of the birth of Jesus Christ and a widely observed holiday, celebrated generally on December 25 by millions of people around the world.
Boxing Day is traditionally the day following Christmas Day, a public holiday that occurs on the 26 December. In South Africa, Boxing Day was renamed to Day of Goodwill in 1994.
Important notice - Delivery schedule December 2013 and January 2014 Public holidays – 16th, 25th and 26th of December 2013 | Public holiday – 1st January 2014 Dear valued customer. The public holidays will unfortunately result in slight changes to our delivery schedule: • There will be no deliveries on Monday, 16th of December 2013. • Orders placed up until 19h00 on Monday, the 16th of December 2013 will be delivered on Tuesday, 17th of December 2013 to all customers. • There will also be no deliveries on the 25th and 26th of December 2013.
• Orders placed up until 19h00 on Thursday, the 26th of December 2013, will be delivered on Friday, the 27th of December 2013 to all customers. New Year • There will be no deliveries on Wednesday, 1st of January 2014. • Orders placed up until 19h00 on Wednesday, the 1st of January 2014 will be delivered on Thursday, 2nd of January 2014 to all customers.
Should there be any queries, please don’t hesitate to call Darren (083 229 5212), Lynne (071 472 7522), Ridwaan (072 534 8135), Theuns (072 638 4085), Pam (071 480 5322) or Egon (082 055 3503). Thank you that we could be part of your business over the past year – We sincerely appreciate your support! We wish you and your families a safe and peaceful Festive Season! Regards, Christopher Williams
The Script Pharmacy Magazine │November 2013 • December 2013
5
FEATURE HEADER
AM I AT RISK? If you have wondered or possibly been told that you are at risk for developing diabetes or that you have pre-diabetes, you should know that diabetes prevention is proven, possible, and powerful. Studies show that people at high risk for diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their weight, if they are overweight— that’s 10 to 14 pounds for a 200-pound person. The Script Pharmacy Magazine │November 2013 • December 2013
7
FEATURE ARTICLE
Two keys to success:
Diabetes Is Preventable
• Get at least 30 minutes of moderateintensity physical activity five days a week.
Nearly 26 million Americans have diabetes, a serious disease in which blood glucose (blood sugar) levels are above normal. Most people with diabetes have type 2, which used to be called adult-onset diabetes. At one time, type 2 diabetes was more common in people over age 45. But now more young people, even children, have the disease because many are overweight or obese.
• Eat a variety of foods that are low in fat and reduce the number of calories you eat per day. In other words, you don’t have to knock yourself out to prevent diabetes. The key is: small steps that lead to big rewards. Learn more about your risk for developing type 2 diabetes and the small steps you can take to delay or prevent the disease and live a long, healthy life.
Diabetes Risk Factors There are many factors that increase your risk for diabetes. To find out about your risk, note each item on this list that applies to you.
Gestational Diabetes If you had gestational diabetes when you were pregnant, you and your child have a lifelong risk for getting diabetes. Learn what you can do to lower your risk.
Take Small Steps to Prevent Diabetes When you take steps to prevent
diabetes, you will also lower your risk for possible complications of diabetes such as heart disease, stroke, kidney disease, blindness, nerve damage, and other health problems. That’s a big reward for you and your family and friends.
Diabetes Health Sense Find tools and programs that can help you with making lifestyle and behaviour changes. Diabetes Health Sense also includes research articles on lifestyle changes and behavioural strategies.
Family Health History Family health history is an important risk factor for developing a number of serious diseases, including type 2 diabetes. In fact, most people with type 2 diabetes have a family member – such as a mother, father, brother, or sister – with the disease.
must-reads ENGLISH
Learn how to prevent or delay type 2 diabetes by losing a small amount of weight. To get started, use these tips to help you move more, make healthy food choices, and track your progress.
Reduce Portion Sizes Portion size is the amount of food you eat, such as 1 cup of fruit or 6 ounces of meat. If you are trying to eat smaller portions, eat a half of a bagel instead of a whole bagel or have a 3-ounce hamburger instead of a 6-ounce hamburger. Three ounces is about the size of your fist or a deck of cards.
Put less on your plate, Nate.
Eat a small meal, Lucille.
1. Drink a large glass of water
4. Use teaspoons, salad forks, or
2.
Make less food look like more by serving your meal on a salad or breakfast plate.
NATIONAL DIABETES EDUCATION PROGRAM
child-size forks, spoons, and knives to help you take smaller bites and eat less.
10 minutes before your meal so you feel less hungry.
5.
Keep meat, chicken, turkey, and fish portions to about 3 ounces.
3. Share one dessert.
6. Eat slowly. It takes 20 minutes for
How much should I eat? Try filling your plate like this:
Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).
your stomach to send a signal to your brain that you are full.
7.
1/4 grains
1/2 vegetables and fruit
dairy (low-fat or skim milk) 1/4 protein
TAKE YOUR FIRST STEP TODAY
Choose More than 50 Ways to Prevent Type 2 Diabetes
www.YourDiabetesInfo.org
Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes: Information for Patients This three-booklet package helps people assess their risk for developing diabetes and implement a program to prevent or delay the onset of the disease and it includes an activity tracker and a fat and calorie counter.
8
Choose More than 50 Ways to Prevent Type 2 Diabetes
It’s Not Too Late to Prevent Diabetes
This tip sheet helps African Americans at risk for type 2 diabetes find ways to move more, make healthy food choices, and track their progress with making lifestyle changes to lower their risk.
This tip sheet helps older adults at risk for type 2 diabetes move more and eat less to lower their risk for diabetes.
The Script Pharmacy Magazine │November 2013 • December 2013
Diabetes STATISTICS
NORTH AMERICA AND CARIBBEAN
EUROPE
MIDDLE EAST AND NORTH AFRICA
More healthcare dollars were spent on diabetes in this region than any other
1 in 9 adults in this region has diabetes
•
More than half of people with diabetes in this region don’t know they have it
•
1 in 10 adults in this region has diabetes
•
•
WESTERN PACIFIC
1 out of every 3 dollars spent on diabetes healthcare was spent in this region 21.2 million people in this region have diabetes and don’t know it
•
1 in 3 adults with diabetes lives in this region
•
6 of the top 10 countries for diabetes prevalence are Pacific Islands
6.7%
10.5% 38.6% UNDIAGNOSED
55 M
PREVALENCE
PREVALENCE 29.2% UNDIAGNOSED
38 M
10.9%
52.9% UNDIAGNOSED
34 M
PREVALENCE
70 M
51.1% UNDIAGNOSED 8.7%
9.2% 4.3%
8.3%
26 M
PREVALENCE
PREVALENCE
PREVALENCE
45.5% UNDIAGNOSED
81.2% UNDIAGNOSED
15 M
8.0%
PREVALENCE
PREVALENCE
132 M
50% UNDIAGNOSED
WORLD 371 M people living with diabetes
SOUTH AND CENTRAL AMERICA
AFRICA
ASIA
Only 5% of all healthcare dollars for diabetes were spent in this region
Over the next 20 years, the number of people with diabetes in the region will almost double
1 in 5 of all undiagnosed cases of diabetes is in this region
1 in 11 adults in this region has diabetes
This region has the highest mortality rate due to diabetes
57.9% UNDIAGNOSED
1 in 4 deaths due to diabetes occurred in this region *all estimates are presented as comparative rates
More than 371 million people have diabetes.
The number of people with diabetes is increasing in every country.
Half of people with diabetes don’t know they have it.
TOP 10 COUNTRIES /TERRITORIES FOR PEOPLE WITH
TOP 10 COUNTRIES / TERRITORIES FOR PREVALENCE*
UNDIAGNOSED PERCENTAGE AND UNDIAGNOSED CASES OF
4 Kiribati
25.5
5 Tuvalu
24.8
6 Kuwait
23.9
Egypt
7.5
7 Saudi Arabia
23.4
Japan
7.1
8 Qatar
23.3
Pakistan
6.6
9 Bahrain
22.4
10 Vanuatu
22.0
10
20
30
40
50
60
70
80
90
100
4 out of 5 people with diabetes live in low- and middle-income countries.
*
PREVALENCE* BY INCOME GROUP AND AGE
0. 6
40
45
50
55
60
*comparative prevalence
High-income Upper middle-income
60 36
21
12
18
11
40 20
12
Lower middle-income Low-income
65
70
75 80 Age (years)
9 -5 s 5 0 e ar y
2 1.
M
387
0
7 ye 0-79 ar s
1. 3
1.3
6 ye 0 - 6 ar 9 s
300
1.2
250
1.1
200
1.0
150 0.5
0.0
M
400 350
1.5
M
M
5% 35
0
80
29%
20
100
4.8 million people died and 471 billion USD were spent due to diabetes in 2012.
Deaths per 1,000
10 %
30
76
30
10
50%
38%
2.0
1. 2
0.1 M M 0.4
40 yea-49 rs
15 %
20-29 years
39 30- ars ye
20 %
25
45%
40
120
51%
HEALTHCARE EXPENDITURES AND DEATHS PER 1,000 DUE TO DIABETES BY INCOME GROUP
25 %
20
50
comparative prevalence
Half of people who die from diabetes are under the age of 60.
58%
53%
0.5 53
100 29
1.2
50 0
Billions (USD)
0
Millions
140
60
Cases in Millions
27.1
World
3 Marshall Islands
160
Western Pacific
7.6
70
Low-income
Indonesia
30.1
South-East Asia
Mexico
10.6
2 Nauru
200 180
South and Central America
12.7
80
Lower middleincome
Russian Federation
37.2
North America and the Caribbean
13.4
1 Federated States of Micronesia
187 81%
Upper middleincome
Brazil
90
Europe
24.1
100
PREVALENCE (%)
High-income
USA
COUNTRY /TERRITORY
Middle East and North Africa
63.0
Percentage
India
Africa
92.3
China
FEATURE HEADER
TAKE A STEP FOR DIABETES 345 million steps! A big thank you to the over 500 individuals and organisations that have registered on the Take a Step for Diabetes platform. We are inching closer and closer to the target with just 26 million steps left to go.
demos, support groups, community wellness days and corporate health days. 14th November is World Diabetes Day and therefore we would like to implement Denim For Diabetes nationally on that day.
The campaign will close at the World Diabetes Congress in Melbourne on 2 December 2013 so it’s not too late to register an account and show the world how you are taking a step for diabetes.
We have implemented a fun, fundraising initiative called, Denim for Diabetes – It’s in your genes’ this involves your company hosting a casual day for us where staff will wear an item of denim in exchange for a small donation of R10.
Keep on submitting your steps at http:// steps.worlddiabetesday.org.
No matter what kind of shoes you’re wearing, it is time to take a step for diabetes! Top 10 Groups 1. ADINA Peru 2. N.A.DIA (Argentina) 3. Liga Peruana de Diabetes 4. CUI.D.AR (Argentina) 5. SERDIABETICO (Argentina) 6. DIABETES SA (Australia) 7. ASFED (Ivory Coast) 8. ADU (Uruguay) 9. FAD (Argentina) 10. DIABEMEDICA (Mexico)
Top 10 Individuals 1. Gina (Peru) 2. Rafael Medardo (Peru) 3. Eumelio César (USA) 4. Cath (Peru) 5. Edgar (Mexico) 6. Edgard (Venezuela) 7. Rosa Maria (Mexico) 8. Fred (France) 9. Tanya (Suriname) 10. Marcelo (Chile) http://steps.worlddiabetesday.org
10
Johannesburg Global Diabetes Run/Walk 2013 2nd November 2013 This year the walk will be held at Walk Haven, Walk Haven is a dog park and is situated in the Muldersdrift area right next to the Cradle of Humankind on 22 hectares of rolling grassland. They also have two large dams surrounded by lush wetland that is home to a large variety of feathered friends. The reason for having the walk at Walk Haven is because of all the dog’s with diabetes and we would like to create awareness not only around the people with diabetes but also around animals with diabetes.
Denim For Diabetes Corporate Day We are offering you a unique opportunity to participate in our “Denim for Diabetes” Corporate Project. Diabetes South is a registered Non-profit (000-795) / public benefit organization (930014852). Diabetes South Africa organizes many projects and programs to promote awareness about prevention and management of diabetes, these include: workshops for newly diagnosed patients, cookery
The Script Pharmacy Magazine │November 2013 • December 2013
We have the printed stickers, which read, “I’ve escaped my uniform! Denim for Diabetes Day and Diabetes SA”. We have also designed a poster for the company to display, advertising the day. We are focusing on the benefits of a healthy diet and exercise in the management of diabetes and the prevention of Type 2 diabetes which is most prevalent in adults and can be curbed by a healthy lifestyle. We have only just initiated the project and our aim is for the program to be ongoing and sustainable throughout South Africa. We hope to encourage all corporates to participate in order for us to reach as many people as possible with this diabetes awareness project. Diabetes South Africa would like the opportunity of adding value to your companies staff who are diabetic as well as educating those who are not and do not understand what diabetes is. Therefore Diabetes South Africa would be an asset to your organization, in this way and others.
Contact: Wendy Francis - Fundraiser Diabetes Focus Magazine - Advertising Sales: funding@diabetessa.org.za Tel: 011886 3765/21, Cell: 079 509 6426 www.diabetessa.co.za
14 Nov colour your world blue
R46,95
R58,30
R34,05
R48,90 R72,90
SKIN CANCER
FACTS
AWARENESS
TANNNING
MELANOMA
GENERAL
• Ultraviolet radiation (UVR) is a proven human carcinogen.
• From 1970 to 2009, the incidence of melanoma increased by 800 percent among young women and 400 percent among young men.
• Skin cancer is the most common form of cancer in the United States. More than 3.5 million skin cancers in over two million people are diagnosed annually.
• One person dies of melanoma every hour (every 57 minutes).
• Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.
• The International Agency for Research on Cancer, an affiliate of the World Health Organization, includes ultraviolet (UV) tanning devices in its Group 1, a list of the most dangerous cancer-causing substances. Group 1 also includes agents such as plutonium, cigarettes, and solar UV radiation. • Currently tanning beds are regulated by the FDA as Class I medical devices18, the same designation given elastic bandages and tongue depressors. • Frequent tanners using new highpressure sunlamps may receive as much as 12 times the annual UVA dose compared to the dose they receive from sun exposure. • Just one indoor tanning session increases users’ chances of developing melanoma by 20 percent, and each additional session during the same year boosts the risk almost another two percent. • Among people ages 18 to 29 who have ever used a tanning bed and were diagnosed with melanoma, 76 percent of those melanoma cases were attributable to tanning bed use. • People who tan indoors just four times per year increase their risk of basal cell carcinoma and squamous cell carcinoma by 15 percent.
• An estimated 76,690 new cases of invasive melanoma will be diagnosed in the US in 2013. • An estimated 9,480 people will die of melanoma in 2013. • Melanoma accounts for less than five percent of skin cancer cases, but the vast majority of skin cancer deaths. • Of the seven most common cancers in the US, melanoma is the only one whose incidence is increasing. Between 2000 and 2009, incidence climbed 1.9 percent annually. • 1 in 50 men and women will be diagnosed with melanoma of the skin during their lifetime. • In 2009, there were approximately 876,344 men and women alive in the U.S. with a history of melanoma. • Survival with melanoma increased from 49 percent (1950 – 1954) to 92 percent (1996 – 2003). • About 86 percent of melanomas can be attributed to exposure to ultraviolet (UV) radiation from the sun.
• Just one indoor tanning session per year in high school or college boosts the risk of basal cell carcinoma by 10 percent. That risk is increased to 73 percent if one tans six times per year.
• Melanoma is one of only three cancers with an increasing mortality rate for men, along with liver cancer and esophageal cancer.
• Indoor tanners have a 69 percent increased risk of early-onset basal cell carcinoma.
• Survivors of melanoma are about nine times as likely as the general population to develop a new melanoma.
• Approximately 25 percent of early-onset basal cell carcinomas could be avoided if an individual never tanned indoors.
• The vast majority of mutations found in melanoma are caused by ultraviolet radiation.
• People who first use a tanning bed before age 35 increase their risk for melanoma by 75 percent.
• Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.
• Ten minutes in a sunbed matches the cancer-causing effects of 10 minutes in the Mediterranean summer sun. • Nearly 30 million people tan indoors in the U.S. every year.31 Two to three million of them are teens. • The indoor tanning industry has annual estimated revenue of $5 billion. • People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma. • Seventy-one percent of tanning salon patrons are females. • On an average day, more than one million Americans use tanning salons.
• The overall 5-year survival rate for patients whose melanoma is detected early, before the tumor has spread to regional lymph nodes or other organs, is about 98 percent in the US. The survival rate falls to 62 percent when the disease reaches the lymph nodes, and 15 percent when the disease metastasizes to distant organs.
• Treatment of nonmelanoma skin cancers increased by nearly 77 percent between 1992 and 2006. • Over the past three decades, more people have had skin cancer than all other cancers combined. • One in five Americans will develop skin cancer in the course of a lifetime. • 13 million white non-Hispanics living in the US at the beginning of 2007 had at least one nonmelanoma skin cancer, typically diagnosed as basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). • Basal cell carcinoma is the most common form of skin cancer; an estimated 2.8 million are diagnosed annually in the US. BCCs are rarely fatal, but can be highly disfiguring if allowed to grow. • Squamous cell carcinoma is the second most common form of skin cancer. An estimated 700,000 cases of SCC are diagnosed each year in the US. • An estimated 3,170 deaths from nonmelanoma skin cancers will occur in the US in 2013. • Between 40 and 50 percent of Americans who live to age 65 will have either BCC or SCC at least once. • Actinic keratosis is the most common precancer; it affects more than 58 million Americans. • Approximately 65 percent of all squamous cell carcinomas and 36 percent of all basal cell carcinomas arise in lesions that previously were diagnosed as actinic keratoses. • About 90 percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun. • Half of all adults report at least one sunburn in the past 12 months.
Black Ribbon
Melanoma Awareness
• A person’s risk for melanoma doubles if he or she has had more than five sunburns at any age. • One or more blistering sunburns in childhood or adolescence more than double a person’s chances of developing melanoma later in life.
The Script Pharmacy Magazine │November 2013 • December 2013
15
tools THE RIGHT
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AWARENESS
ETHNICITY
MEN/WOMEN
PEDIATRICS
• The overall 5-year melanoma survival rate for African Americans is only 77 percent, versus 91 percent for Caucasians.
• An estimated 45,060 new cases of invasive melanoma in men and 31,630 in women will be diagnosed in the US in 2013.
• Melanoma is nine times more common between the ages of 10 and 20 than it is between birth and 10 years.
• Skin cancer represents approximately two to four percent of all cancers in Asians. • Skin cancer comprises one to two percent of all cancers in African Americans and Asian Indians. • Melanomas in African Americans, Asians, Filipinos, Indonesians, and native Hawaiians most often occur on nonexposed skin with less pigment, with up to 60-75 percent of tumors arising on the palms, soles, mucous membranes and nail regions. • Basal cell carcinoma (BCC) is the most common cancer in Caucasians, Hispanics, Chinese Asian and the Japanese. • Squamous cell carcinoma (SCC) is the most common skin cancer among African Americans and Asian Indians. • Squamous cell carcinomas in African Americans tend to be more aggressive and are associated with a 20-40 percent risk of metastasis (spreading). • Late-stage melanoma diagnoses are more prevalent among minority patients than Caucasian patients; 52 percent of non-Hispanic black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced stage melanoma, versus 16 percent of nonHispanic white patients. • Asian American and African American melanoma patients have a greater tendency than Caucasians to present with advanced disease at time of diagnosis. • While melanoma is uncommon in African Americans, Latinos, and Asians, it is frequently fatal for these populations.
• An estimated 6,280 men and 3,200 women in the US will die from melanoma in 2013. • Melanoma is the fifth most common cancer for males and seventh most common for females.
• Ninety percent of pediatric melanoma cases occur in patients aged 10-19. • 6.5 percent of pediatric melanomas occur in non-Caucasians, which is a higher percentage than that seen in adults. • Melanoma accounts for up to three percent of all pediatric cancers.
• Five percent of all cancers in men are melanomas; four percent of all cancers in women are melanomas.
• Between 1973 and 2001, melanoma incidence in those under age 20 rose 2.9 percent.
• Up until age 40, significantly more women develop melanoma than men (1 in 391 women vs. 1 in 691 men). After age 40, significantly more men develop melanoma than women. Overall, one in 35 men and one in 54 women will develop melanoma in their lifetimes.
• Diagnosis and treatment is delayed in up to 40 percent of childhood melanoma cases.
• Women aged 39 and under have a higher probability of developing melanoma than any other cancer except breast cancer. • The majority of people diagnosed with melanoma are white men over age 50. • Caucasian men over age 65 have had an 5.1 percent annual increase in melanoma incidence since 1975, the highest annual increase of any gender or age group. • The number of women under age 40 diagnosed with basal cell carcinoma has more than doubled in the last 30 years; the incidence of squamous cell carcinoma among women under age 40 has increased almost 700 percent. • Adults over age 40, especially men, have the highest annual exposure to UV.
“Classic” Atypical Mole Syndrome Some people are so affected by both normal and atypical moles that they are classified as having atypical mole syndrome. They are at exceptionally high risk of developing melanoma. People with “classic” atypical mole syndrome have the following three characteristics: • 100 or more moles • One or more moles 8 mm or larger in diameter • One or more moles which are atypical. At exceptionally high risk of developing melanoma are those with familial atypical multiple mole melanoma syndrome (FAMMM). These individuals not only have atypical mole syndrome, but also have one or more first or second-degree relatives with melanoma. While atypical moles often arise in childhood, they can appear at any time of life in people with FAMMM.
AGING/SUN DAMAGE • More than 90 percent of the visible changes commonly attributed to skin aging are caused by the sun. • Contrary to popular belief, 80 percent of a person’s lifetime sun exposure is not acquired before age 18; only about 23 percent of lifetime exposure occurs by age 18. Ages Average Accumulated Exposure* These facts and statistics have been reviewed by David 1-18
22.73 percent
19-40
46.53 percent
41-59
73.7 percent
60-78
100 percent
*Based on a 78 year lifespan
Polsky, MD, Assistant Professor of Dermatology and Pathology, New York University Medical Center and Steven Q. Wang, MD, Director of Dermatologic Surgery and Dermatology, Memorial Sloan-Kettering Cancer Center, Basking Ridge, NJ. The Skin Cancer Foundation, SkinCancer.org, 212 725-5176 Last Updated: February 12, 2013
http://www.skincancer.org/skin-cancer-information/skin-cancer-facts The Script Pharmacy Magazine │November 2013 • December 2013
17
HIV & AIDS IN SOUTH AFRICA
An estimated 5.6 million people were living with HIV and AIDS in South Africa in 2011, the highest number of people in any country. In the same year, 270,190 South Africans died of AIDS-related causes. Although this number reflects the huge amount of lives that the country has lost to AIDS over the past three decades, it is 100,000 fewer deaths than in 2001, demonstrating the many lives that have been saved through a massive scale-up of treatment in the last few years.
AWARENESS
Impact of HIV upon South Africa The impact of the HIV and AIDS epidemic has been seen in the dramatic change in South Africa’s general mortality rates. The overall annual number of deaths increased sharply between 1997, when 316,559 people died, and 2006 when 607,184 people died. Those who are particularly shouldering the burden of the increasing mortality rate are young adults, the age group most affected by the epidemic; almost one-in-three women aged 25-29, and over a quarter of men aged 30-34, are living with HIV. The link suggests that AIDS was the principle factor in the overall rising number of deaths. However, lifeexpectancy has risen vastly since 2005.
Impact upon children and families The age bracket that AIDS most heavily targets – younger adults – means it is not uncommon for one or more parents to die from AIDS while their offspring are young. The number of premature deaths due to HIV/AIDS has risen significantly over the last decade from 39 percent to 75 percent in 2010. The loss of a parent not only has an immense emotional impact on children but for most families can spell financial hardship. One survey on HIV’s impact on households found that, “80 percent of the sample would lose more than half their per capita income with the death of the highest income earner, suggesting a lingering and debilitating shock of death.” It is estimated there are 1.9 million children orphaned by AIDS where one or both parents are deceased in South Africa, and that the HIV and AIDS epidemic is responsible for half of the country’s orphans. Another estimate puts the proportion of maternal orphans – those who have lost their mother – orphaned by AIDS as over 70 percent. Orphans may put pressure on older relatives who become their primary carers; they may have to relocate from their familiar neighbourhood; and siblings may be split apart, all of which can harm their development. In some cases orphaned, often HIV infected, children are cared for by institutions, such as the Mohau Centre in Pretoria.
Institutions such as this deliver essential care and support for children throughout their childhood years, many of whom have special needs. As treatment has improved and become more available, children are surviving beyond childhood. Whilst this is a great achievement, governments now need to consider how to deliver care and support for HIV-positive orphans that have survived into adulthood.
Prevention of mother-to-child transmission The impact of HIV and AIDS on children has been vast, but since 2009 South Africa has had one of the sharpest declines in new infections among children. In 2011, more than 95 percent of pregnant women with HIV received treatment to prevent the infection of their child. Yearly infections in children have dropped from 56,500 in 2009 to 29,100 in 2011. Between 1990 and 2001 the infant mortality rate increased significantly from 44 deaths per 1000 infants to 56.9 per 1000 infants. The trend continued into the early 2000s, when South Africa was one of the few countries of the world where child and maternal mortality increased. Although infant mortality remains high in South Africa, it has declined steadily since 2003 to a mid-year estimated rate of 37.9 per 1000 infants in 2011. Around 30 percent of pregnant women in South Africa’s 2009 National Antenatal Survey were HIV positive, demonstrating the need for South Africa to deliver effective PMTCT programmes. South African guidelines for PMTCT issued in 2008 were heavily criticised for not meeting World Health Organization recommendations. The WHO recommended a ‘cover-the-tail’ strategy, which used antiretroviral drugs AZT and 3TC for the mother during labour and postpartum to reduce the risk of HIV transmission and drug resistance. The Treatment Action Campaign responded to South Africa’s omission of using this strategy in the guidelines, stating, “The ‘cover-the-tail’ strategy was strongly recommended by expert HIV paediatricians who advised the Department of Health on the new protocol; we are disappointed that this
well-founded recommendation has been ignored.” In 2010 South Africa released new PMTCT guidelines, which are more in line with WHO recommendations. In South Africa’s guidelines HIV-positive pregnant women are advised to start treatment when their CD4 count drops below 350 cells/mm3; all pregnant women who test HIV-positive will begin receiving treatment at 14 weeks rather than in the last term of pregnancy; and HIV-positive women are advised to receive antiretroviral drugs postpartum.
HIV testing in South Africa HIV testing is vitally important in order to access treatment, and knowledge of one’s positive status can lead to behaviours to protect other people from infection. The 2007-2011 National Strategic Plan aimed for one quarter of all people to take a test every year by 2011, with the proportion of those ever taking a test rising to 70 percent. The latest National Strategic Plan has set out more ambitious targets, aiming to ensure that everyone in South Africa is voluntarily tested every year. In 2010, a quarter of the population aged between 15 and 49 had been tested for HIV in the last 12 months. The launch of the national HIV counselling and testing (HTC) campaign in April 2010 had resulted in a remarkable increase in the number of people accessing testing. In his 2011 health budget policy speech, health minister Motsoaledi announced that 11.9 million people now test for HIV each year. It is evident that there is a link between an individual’s socio-economic background and the likelihood that they will test for HIV. For example, those who have taken an HIV test and know their result are more likely to have a higher level of education, be in employment, have accurate HIV knowledge, and a higher perception of risk, among other factors. These links suggest that an improvement in the general standard of living would be beneficial to the uptake of testing. Another significant factor determining HIV testing is whether an individual lives in a rural or urban setting, with those residing in the latter almost twice as likely to have been tested than those in the former. Testing facilities should therefore be
The Script Pharmacy Magazine │November 2013 • December 2013
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made more accessible for hard to reach rural populations, possibly with mobile testing units. One creative way of providing testing for the general population has been demonstrated by a colourful campervan, the Tutu Tester, that tours Cape Town neighbourhoods, testing around 50 people per day. Its success is largely due to the fact that it offers testing for a number of chronic illnesses. “Many of our patients have told us that they prefer not to go to public clinics for an HIV test because they are afraid of being seen by people they know. Because we test for other diseases too, like diabetes and high blood pressure, the outside world does not know for what reason patients are waiting at our doors.” Liz Thebus, Tutu Tester health worker Home testing is also advocated for, as a way to bring HIV testing into the privacy of peoples homes: “ (Knowing your HIV status) simply ought to be a part of life ” - Edwin Cameron, Justice of the Constitutional Court in South Africa, talking about home testing Improving testing, however, can only be part of broader efforts to tackle the epidemic. Unless people who do test positive are able to receive appropriate care following their diagnosis, people may see little value in being tested.
Antiretroviral treatment in South Africa South Africa has recently had one of the largest increases in treatment access in the world, with a scale-up of treatment services of 75 percent between 2009 and 2011. In October 2012, South Africa reached the target of universal access to treatment as the total number of people receiving treatment reached 2 million, 80 percent of all in need of treatment.
antiretroviral therapy has a great impact on their chances of responding well to treatment. The WHO now recommends that all countries, including those that are poorly resourced, begin treatment at a CD4 count of <350 cells/mm3. In 2010, the South African government released guidelines that did not adhere to WHO recommendations. Advocates of raising the treatment threshold to <350 cells/mm3 acknowledged that this would require greater expenditure but argued it would be cost effective in the long run. A representative from the Treatment Action Campaign said, “This is going to be expensive to implement, but these recommendations will eventually lead to cost savings. It’s a cost that has simply been deferred.” In 2011 the government amended treatment guidelines so that treatment is initiated at a cell count of <350 cells/ mm3. This was a hugely positive step towards universal access to treatment in South Africa.
Child treatment According to the South African government, provision of HIV treatment for children has greatly increased in recent years. In 2007, more than 32,000 children were receiving antiretroviral therapy, a 250 percent increase on 2005’s figure, though still only meeting half of the estimated need. A major trial in South Africa, the CHER study, found the risk of death decreased by about three-quarters when infected infants under 12 months began treatment immediately after being diagnosed with HIV, compared with a control group which received treatment at a late stage of infection.
Treatment guidelines
During late 2009 and early 2010 the government committed to testing all children exposed to HIV and providing all HIV-positive children with antiretroviral drugs. However, in November 2010 it was reported that almost a third of KwaZulu-Natal hospitals in a survey had no recent records of ARV treatment initiation for HIV-positive infants. Authors of the research blamed mothers’ reluctance to get their children tested for HIV and health workers’ confusion over the national treatment guidelines.
The level at which someone begins
A government guide to treating HIV-
The huge scale-up of treatment in South Africa is especially impressive in the context of years of doubting the effectiveness of treatment at the highest levels of government, and the initial delay and slow pace of delivering a public ARV programme.
infected children in South Africa is available here.
The way forward As President Zuma outlined in a landmark 2009 World Aids Day speech, South Africa has had to overcome massive challenges in its past: “At another moment in our history, in another context, the liberation movement observed that the time comes in the life of any nation when there remain only two choices: submit or fight. That time has now come in our struggle to overcome AIDS. Let us declare now, as we declared then, that we shall not submit.” South Africa has come a long way in responding to its HIV epidemic. Life expectancy has increased by 10 percent since 2005 - this level of improvement in a country’s mortality is usually associated with ‘a huge change in society’. Drug stockouts, continued use of ARVs with severe side effects, and a lack of entry points to care, are factors that must still be overcome in order to continue to scale-up effective treatment provision. Recent trends indicate a possible turning point in the epidemic, with infections decreasing among youth. Condom use has increased throughout the decade across all age groups and is highest among younger people, a notable achievement in South Africa’s fight against HIV. However, far more will need to be done if South Africa is to meet its latest goal of halving the current infection rate by 2016. “If we stop anything, we will just reverse all our gains” Health Minister, Dr. Aaron Motsoaledi Continued pressure from activists and civil society, and sustained commitment by the government, including increased funding, are needed to see South Africa effectively bring its HIV/AIDS epidemic under control. As Health Minister Dr. Aaron Motsoaledi said in 2010, “If we stop anything, we will just reverse all our gains”Health Minister, Dr. Aaron Motsoaledi www.avert.org/hiv-aids-southafrica.htm
The Script Pharmacy Magazine │November 2013 • December 2013
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1
65% of melanoma cases are associated with exposure to ultraviolet (UV) radiation from the sun
sun-facts
2 3 4 Men over age 40 have the highest annual exposure to UV radiation
The majority of people diagnosed with melanoma are white men over age 50
Melanoma is one of only three cancers with an increasing mortality rate for men
GOLF:
AWARENESS
YOU HAVE SKIN IN THE GAME The PGA TOUR shares The Skin Cancer Foundation’s commitment to reaching men at risk with skin cancer prevention information. They debuted the awareness video below while being honored at the 2012 Skin Cancer Foundation Gala.
Early/Late tee time
Long sleeve shirts and hats
Tee off at sunrise or in late afternoon — avoid the sun at its most intense (between 10 AM and 4 PM)
Wear long-sleeved shirts and long pants, covering as much skin as possible.
UV Protective sunglasses
Seek the shade Whenever you can, seek shade on the course — stand under a tree or sit in your car
Wear wraparound sunglasses that block 99-100 percent of UV radiation, protecting the eye, eyelid, and surrounding areas.
The Golden Rule
BURN
Protection on overcast days
Do Not Burn.
Remember to protect yourself on overcast days: Up to 80 percent of the sun’s UV radiation can penetrate clouds and harm your skin.
Wide brim hats Wear a hat with a brim extending three inches or more all the way around, shading your face, neck, ears, and shoulder tops.
SPF SPF30+ Sunscreen
30+
Apply a generous amount of waterresistant, broad-spectrum (UVA/
UVB) sunscreen with an SPF of 30 or higher to all exposed areas 30 minutes before heading outside to play golf. Look for a sports sunscreen formula that is designed to stay put if you sweat and won’t run into the eyes and sting. An SPF 30+ lip balm will help protect your lips.
9
Reapply sunscreen
Carry sunscreen with you, and reapply every two hours, immediately after sweating heavily, or at the ninth hole. Look for a sunscreen with The Skin Cancer Foundation’s Seal of Recommendation. Don’t forget to apply sunscreen to frequently over- looked spots, such as the scalp (there are sunscreens designed specifically for this area), the backs of the hands and neck, and the ears.
http://www.skincancer.org/ healthy-lifestyle/outdoor-activities/ golf#panel1-9
The Script Pharmacy Magazine │November 2013 • December 2013
25
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LAUGH A LITTLE
by way The day after a man lost his wife in a scuba diving accident . . . . . . he was greeted by two grim-faced policemen at his door. “We’re sorry to call on you at this hour, Mr. Strickland, but we have some information about your wife.” “Well, tell me!” The policeman said, “We have some bad news, some good news and some really great news. Which do you want to hear first?” Fearing the worse, Mr. Strickland said, “Give me the bad news first.” So the policeman said, “I’m sorry to tell you sir, but this morning we found your wife’s body in San Francisco Bay.” “Oh my goodness!,” said Mr. Strickland, overcome by emotion. Then, remembering what the policeman had said, he asked, “What’s the good news?” “Well,” said the policeman, “When we pulled her up she had two fivepound lobsters and a dozen good size Dungeoness crabs on her.” “If that’s the good news than what’s the great news?!”, Mr. Strickland demanded. The policeman said, “We’re going to pull her up again tomorrow morning.”
A veterinarian was feeling ill and went to see her doctor. The doctor asked her all the usual questions, about symptoms, how long had they been occurring, etc, when she interrupted him, “Hey look, I’m a vet and I don’t need to ask my patients these kind of questions. I can tell what’s wrong just by looking.” She smugly added, “Why can’t you?”
The doctor nodded, stood back, looked her up and down, quickly wrote out a prescription, handed it to her and said, “There you are. Of course, if that doesn’t work, we’ll have to put you to sleep.”
The old cowhand came riding into town on a hot, dry, dusty day. The local sheriff watched from his chair in front of the saloon as the cowboy wearily dismounted and tied his horse to the rail a few feet in front of the sheriff. “Howdy, stranger...” “Howdy, Sheriff...” The cowboy then moved slowly to the back of his horse, lifted its tail, and placed a big kiss where the sun doesn’t shine. He dropped the horse’s tail, stepped up on the walk, and aimed towards the swinging doors of the saloon. “Hold on, Mister...””Sheriff?” “Did I just see what I think I just saw?” “Reckon you did, Sheriff...I got me some powerful chapped lips...” “And that cures them?” “Nope, but it keeps me from lickin’ em.”
Three buddies die in a car crash . . . . . . and they find themselves at an orientation to enter heaven. They are all asked, “When you are in your casket and friends and family are mourning upon you, what would you like to hear them say about you? The first guy says, “I would like to hear them say that I was a great doctor of my time, and a great family man.” The second guy says, “I would like to hear that I was a wonderful husband and school teacher who made a huge difference in our children of tomorrow.” The last guy replies, “I would like to hear them say...... LOOK!!! HE’S MOVING!!!!!”
The Script Pharmacy Magazine │November 2013 • December 2013
27
Christmas Cuisine FOOD
ut Truffles Chocolate Hazeln
‘Tis the season to be jolly... Here are some recipes with a new take on traditional favourites. B a co n w ra pped
m u s h ro o m s
Asian style pork belly
Chocolate Hazelnut Truffles Ingredients • 3/4 cup confectioners’ sugar • 2 tablespoons baking cocoa • 4 milk chocolate candy bars (1.55 ounces each) • 6 tablespoons butter • 1/4 cup heavy whipping cream • 24 whole hazelnuts • 1 cup ground hazelnuts, toasted
28
Directions In a large bowl, sift together confectioners’ sugar and cocoa; set aside. In a small saucepan, melt candy bars and butter. Add cream and reserved cocoa mixture. Cook and stir over medium-low heat until mixture is thickened and smooth. Pour into an 8-in. square dish. Cover and refrigerate overnight. Using a melon baller or spoon, shape
The Script Pharmacy Magazine │November 2013 • December 2013
candy into 1-in. balls; press a hazelnut into each. Reshape balls and roll in ground hazelnuts. Store in an airtight container in the refrigerator. Yield: 2 dozen.
Bacon wrapped mushrooms Ingredients • 24 white button mushrooms • 24 slices of bacon (cut just long
FOOD
enough to wrap around the mushroom) • 24 soaked toothpicks • Good quality ready-made Barbeque sauce Method Wrap each mushroom in a slice of bacon and secure with a toothpick. Dip in barbeque sauce and place on braai. Keep turning until bacon is crisp. Serve.
Asian Style pork belly Ingredients • 1 cup soy sauce • 1 cup orange juice • peeled rind of 1 orange • 1-2 cup chicken stock • 1 whole star anise • 1 cinnamon stick • 1 tsp chopped fresh ginger • 1/2 cup brown sugar • 1 kg pork belly Method Load your man-oven with enough charcoal so that you can braai for 2 hours using the indirect method, and light the fire. Score the fat. This means you must use a sharp knife to cut a criss-cross pattern into the outer layer of fat. In a flameproof roasting tray (about 5 cm deep), large enough to fit your pork belly snugly, throw in all the ingredients except the meat. Stir well to dissolve the sugar slightly. Now add the pork belly fat side up, and spoon some of the marinade over the top. The liquid should come up the sides but not completely cover the top of the meat.
the top is brown and crispy and the meat is very tender. Half-way during the cooking process you can open the man-oven once to spoon more of the sauce in the roasting tray onto the meat. Remember that opening the man-oven lets lots of the heat escape, so only do it once and do it quickly. If you’re worried there might not be enough heat, rather don’t open it at all. Take the tray out of the man-oven and remove the meat from the tray. Put the meat on a wooden cutting board and let it rest for a few minutes. If you like, you can use the sauce left in the roasting tray to make a serving sauce (see below). Slice the meat into 2 cm-thick slices and serve with mashed potatoes and any other vegetables you have on hand. If you prefer the top of your belly even crunchier, braai the belly with the fat side down over direct coals at the end of the cooking time. Make a serving sauce with leftover roasting liquids Put the liquid into a pot, and give it a taste – if it has reduced too much and the flavour is too strong, just add a few tots of chicken stock, then bring to the boil. Mix half a tot of cornflour and half a tot of cold water in a cup, then add a little of the roasting liquid to create a paste.
(ask your butcher) • 200 ml buttermilk • 2 portions of Worldly rub • Oil Ingredients for the Worldly rub • 1 tbs ground cumin • 1 tbs paprika • 1 tsp onion flakes (you can use fresh onions too) • 2 tbs dry rose petals (not essential) • 1 tbs salt • 1 tbs turmeric • 2 tbs chilli flakes (leave out if you don’t like hot spicy food) • 1 tbs tamarind paste (often difficult to find and not essential) • 3 tbs fresh parsley, fi nely chopped (essential) • 2 tbs pine-nuts, toasted and ground (could be substituted with cashews or macadamias) • ½ teaspoon pepper Worldly rub Combine all the ingredients in a mixing bowl. You can refrigerate the rub in an airtight container for up to two weeks (it’s ideal to make at home before you leave). Lamb Mix the buttermilk and Worldly rub to form a marinade for the lamb (for best results, rub directly into the meat before marinating). Ideally leave overnight, otherwise leave for at least three to four hours. Brush kettle grill with oil. Cook lamb over medium coals for 30 to 40 minutes depending on your preference. Remove and set aside for five to 10 minutes. Slice and serve.
Stir this paste slowly into the boiling sauce. It should thicken up instantly. Remove from the heat and serve with the meat.
Put the roasting tray inside the manoven (on the top grid), then close it and regulate the temperature with the top and bottom valves.
Butterflied leg of lamb
Cook at 150 °C for about 2 hours, until
• 1.5 to 2 kg leg of lamb, butterflied
Ingredients for the lamb
Butter flied leg of lamb
The Script Pharmacy Magazine │November 2013 • December 2013
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STRESS CALMETTES helps with nervous tension and anxiety associated with: Stress (work, exams, coping with everyday stresses of life)1 Inability to relax1 Feelings of nervousness and worry3 Over-excitement at bedtime3
References: 1. Calmettes Package Insert. 2. Calmettes Nite Package Insert. 3. Upton R, American Herbal Pharmacopoeia and Therapeutic Compendium, April 1999 S0 Calmettes tablets. Composition: Per tablet: Valerian dispert powder of natural origin 45 mg (extract of plant root Valeriana officinalis). Pharmacological Classification: A.2.6 Tranquillisers. Indications: Nervous tension and anxiety. Reg.No. F/2.6/60. 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: Calmettes-0313-0001-S-0185.
8117
vaginal gel
metronidazole 0.75% 2
CANCER IN CHILDREN
Childhood cancers are quite different from cancers affecting adults. They tend to occur in different parts of the body, look different under the microscope and respond differently to treatment.
AWARENESS
What is Cancer? Cancer begins when a particular cell or group of cells in the body begin to multiply and grow without control. Oncology is the study of these cells. The cancerous cells stop working properly and as their numbers increase they form a lump or tumor. Eventually, the normal cells will be crowded out and the cancerous cells, if not treated, will take over. When cancer cells break away and spread to other parts of the body they may produce secondary tumors known as metastases. Sometimes the cancer will affect the blood, causing leukemia; other cancerous cells form tumors. When these tumors form in bone or muscles they are known as sarcomas. Cancers which affect the lymphoid organs such as the lymph nodes, spleen and thymus are known as lymphomas. Cure rates for most childhood cancers are much higher than those for most adult cancers. Today, the majority of childhood cancers can be treated very effectively, and 65-70% can now be completely cured.
Treating childhood cancer A Paediatric Oncologist specialises in the diagnosis and treatment of childhood cancers, which is a highly specialised service. Your child should be looked after by a multidisciplinary team headed by a Paediatric Oncologist. No one knows what causes childhood cancer, although there are many different theories. A huge amount of research is being carried out worldwide, with studies into a number of possible causes. Cancer is not contagious, nor, for most cancers, is there any evidence that they are inherited. It is exceptionally rare for a second child in a family to develop cancer.It is reassuring to know that nothing you did or did not do as parents caused your child’s cancer.
Saint Siluan* - Warning Signs Many children in our country are never diagnosed because their symptoms are not recognized or they are diagnosed too late for effective treatment. To help solve this problem, the South African Children’s Cancer Study Group has prepared this list of Warning signs for destitution to primary health care centres.
*Saint Suluan was a Russian monk who died on Mount Athos in 1938. He prayed ceaselessly for all humanity.
information about childhood cancer in South Africa.
• Lump: Abdomen and pelvis, head and neck, limbs, testes and glands.
The most common childhood cancer is leukemia, which accounts for about one third of all cases of childhood cancer. The next most common childhood cancers are brain tumors and lymphomas, followed by embryonal tumors and sarcomas.
• Aching: Bones, joints, back and easy fractures.
Leukemia
• Seek: Medical help early for persistant symptoms • Eye: White spots in the eye, new squint, blindness and bulging eyeball.
• Neurological Signs: Change or deterioration in walking, balance, speech or behavior, regression of milestones, early morning vomiting and or headache for more than a week, enlarging head. This list has been compiled by the South African Children’s Cancer Study Group and is now used throughout the world.
Childhood Cancer Cancer in children is rare. Worldwide, 150 children per million are diagnosed with cancer each year. In South Africa, accurate figures have not yet been published, but some data suggests that only 70-80 children per million are diagnosed with cancer each year — a total of between 500 and 600 children each year. It is therefore estimated that a further 500 children die of childhood cancer in South Africa each year before it is diagnosed or treated. Why is this? Childhood cancer sometimes goes undiagnosed and untreated because people don’t have access to the specialised medical services they need. This is especially true in rural areas or in very poor communities, where people do not have the means (finances or transport, etc.) to seek medical help. Lack of awareness of childhood cancer is another reason. Many parents don’t recognize the early warning signs and symptoms. Doctors sometimes lack knowledge because childhood cancer is a rare disease and few family physicians (GPs) see any cases in their practice. Making the public, doctors and medical personnel more aware of childhood cancer and its early warning signs and symptoms is one of the aims of CHOC. CHOC is helping to raise the funds needed to support the Childhood Cancer Registry, which is operated by the SA Children’s Cancer Study Group. This will enable them to keep accurate records and make this registry a very effective and reliable source of
When cancer affects the blood it is called leukemia. It is the most common cancer in children and accounts for 34% of all cancers. Blood is mainly formed (made) in the bone marrow, a spongy material inside the long bones of the body, but the lymph glands, spleen and thymus glands (behind the breast bone) also play a role. There are three different types of blood cells: White blood cells (T-cells and B-cells) and neutrophils, which are important in fighting infections; Red blood cells, which carry oxygen around the body; Platelets, which help blood to clot and control bleeding. In leukemia, one of the types of blood cells is changed into a cancerous cell that is no longer under the body’s control. These abnormal cells divide and multiply in number, taking over the bone marrow and spreading out into the blood, lymph glands and rest of the body.
Brain tumors There are many different forms of brain tumor, some benign (non-cancerous) and others malignant (cancerous). They account for 22% of all childhood cancers. Brain tumors do not usually spread throughout the body.
Lymphomas Tumors that start in the lymph glands are called lymphomas and this account for 11% of all childhood cancers. The body’s lymphatic system is made up of a collection of lymph nodes, each the size of a pea. These nodes are connected by lymphatic vessels (similar to veins) which circulate fluid and cells. The main function of the lymphatic system is to control infection and provide a collecting and transporting system for white blood cells and help fight infections in the body.
Wilm’s tumor (Nephroblastoma)
The Script Pharmacy Magazine │November 2013 • December 2013
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AWARENESS
Wilm’s tumor is one of the types of embryonal tumors which account for 14% (in South Africa) of all childhood cancers. Wilm’s tumor affects the kidney and accounts for 6% of all embryonal tumors. It is quite different from the cancers that affect the kidneys of adults. Most patients are under 5 years old and usually only one kidney is affected; it is very rare that both kidneys are affected.
Neuroblastoma This tumor grows from nerve cells which run in a chain down the back of the child’s neck, chest and abdomen. The most common site for this tumor is the abdomen. The second most common site is the chest (about 30%). In about 25% of patients the tumor starts in the adrenal gland, which sits on top of the kidney and in about 10% of patients the tumor starts in the neck. Most patients are younger than 5 years and it is very rare in children older than 10 years.
Retinoblastoma The light sensitive lining of the eye is known as the retina. A malignant tumor of the retina is called Retinoblastoma. In about two-thirds of cases, only one eye (unilateral disease) is affected. Sometimes a tumor develops in the other eye some months after the first diagnosis. This is most common in children less than one year old and is not usually hereditary. One-third of children develop tumors in both eyes (bilateral disease) but they usually have a genetic or hereditary form of retinoblastoma, which tends to develop during the first year of life.
Rhabdomyosarcoma Rhabdomyosarcoma is the most common of a group of tumors known as ‘Soft Tissue Sarcomas’. There are several slightly different types of these tumors, which grow in muscles or sinews, or in the fibrous tissues around the muscles. They are most common in children between birth and five years of age, but it can occur at any age.
Osteosarcoma This is the most common type of bone cancer in children. Most patients are between 10 and 20 years old. It is more common in boys and mostly affects
the long bones. The most common site is the leg, with the femur (upper leg) the most commonly affected. The next most common sites are the tibia (lower leg) and the humerus (upper arm). The growth plates (sites of bone growth) at the ends of the long bones are often affected. Osteosarcoma can also be a complication of radiation therapy for another type of cancer, such as retinoblastoma and can occur between 7 and 15 years after radiation treatment.
Ewing’s sarcoma This is the second most common type of bone cancer in children and young adults. The Ewing’s sarcoma family of tumors is part of a group of tumors that share certain characteristics. There are two separate types: • Ewing’s sarcoma, which involves the bones; • Primitive neuroectodermal tumor (PNET) and Peripheral neuroepithelioma, which involves bone and soft tissue. These tumors can occur in any part of the body, but the most common sites are the pelvis, arms and legs and the ribs.
Hepatoblastoma Cancer of the liver is quite rare in children, accounting for only 1-2% of childhood cancers. Many other childhood cancers can spread to the liver, but these are very different from primary liver cancer. Hepatoblastoma is the most common type of liver cancer in children younger than three years. Another type of liver cancer, hepatocellular carcinoma, is more common in children aged 12 to 15 years and may be associated with Hepatitis B infection.
Germ cell tumors Germ cells are the cells that develop into an embryo and then continue growing into a baby in the womb. Some of these cells remain in the child’s body and may grow into malignant or benign tumors. The most common places these types of tumor appear are the testes, ovaries, at the bottom of the spine (sacrococcygeal area) and the middle of the brain, chest and abdomen. The different names of these tumors usually refer to the place where they start. This type of cancer is very rare.
Whilst cancer in children is a treatable disease and up to 70% of children can be cured, it remains a complex disease. Treating childhood cancer can be an extremely difficult and trying process, both for the child and the parents. The major portion of your child’s treatment will take place in the hospital. Your child’s treatment plan (protocol) will be explained to you in more detail by your doctor. Please ask if there is anything that you do not understand. We believe that knowledge of both the disease and its treatment is crucial. By learning all you can, fear is eased, hope is heightened and you can play an active role in your child’s treatment. The most important decision you as a parent must make in regard to your child’s treatment, is to ensure that your child is treated by a qualified and registered Pediatric Oncologist at a specialised Pediatric Oncology Unit. The treatment of childhood cancers is significantly different from those in adults and requires specialist knowledge. The Pediatric Oncologist specialises in the diagnosis and treatment of children’s cancers. Your child should be looked after by a multidisciplinary team headed by the Pediatrician and treatment should only be practiced in a unit attached to or affiliated with an Academic Hospital.
You may want to visit some of the websites listed below. • CHOC’s website: www.choc.org.za • Campaigning for Cancer: this SA site gives general information related to cancer (not specifically childhood cancer) and has relevant information, especially related to personal advocacy www.cancerhelp.co.za. • International Confederation of Childhood Cancer Parent Organisations: www.icccpo.org • International Society of Paediatric Oncology (SIOP): www.siop.nl • Families of Children with Cancer: www.fcco.org • Children’s Cancer Web: www.cancerindex.org • Paediatric Oncology Resource Centre: www.acor.org • United Kingdom Children’s Cancer Study Group: www.cancerbacup.org.uk Written by Leandra Visser for CHOC
The Script Pharmacy Magazine │November 2013 • December 2013
35
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WHERE CREATIVE THINKING MEETS QUALITY TRAINING
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
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PARTICIPATION
The future of
Independence
Survey Participation Belinda Botha – October 2013 The Independent Pharmacy Sector in South Africa is experiencing numerous challenges, ranging from government legislation and changes to resource challenges. In addition; skills shortages also add to a challenging and dynamic environment. A recent study conducted by (The Professional Provident Society of South Africa, 2013) (PPS) noted that in line with many skilled professionals in South Africa, the shortage of qualified people in pharmacies remains a huge problem. Joubert (2013) indicates a key challenge still remaining for pharmacists is the regulation of the sector. Impacting on the resource challenges, and further complicating the issues, comes the historical composition of the pharmacy sector. This is a sector where leaders and owners are predominantly from the Traditionalist and Baby Boomer generation and find themselves needing to manage Generation X, Y and even Z employees. In other words, the employee compliment in a typical pharmacy is literally made up of five generations. How do we overcome these challenges to help secure a bright future for Independent and Community 42
pharmacy? Life, and therefore business is about constant change and as we approach the future; the only constant will be our attitude and feelings towards continuous learning and managing change. Let us unpack some interesting and relevant concepts.
What about this “Generation” thing? Although much debated, discussed, theorised, ignored, jargoned and speculated, the construct of generations received little research attention since the concept was first formed and defined. Online definitions range from (Merriam-Webster.com, n.d.) “a group of individuals born and living contemporaneously”; (Oxford Dictionaries, n.d.) “all of the people born and living at about the same time, regarded collectively; a group of people of similar age involved in a particular activity” and (Collins Dictionary, n.d.) as “all the people of approximately the same age, especially when considered as sharing certain attitudes....” . (Meister & Willyerd, 2010) explains that in the 2020 workplace three forces will shape the future; globalisation, social web and generations (demographics). Therefore the understanding and study of the different generations will become
The Script Pharmacy Magazine │November 2013 • December 2013
increasingly important in today’s day and world. What is known from research conducted in the business world, is what one generation sees as a positive move might appear threatening to another generation because upbringing varies by age bracket, shaping not only personality but also job performance, relations to co-workers and dealings with superiors (CFO Publications, 2013). This also applies to the pharmacy environment. Furthermore, an employees’ perceived level of support they get from management, including different generation leadership, has an impact on general self efficacy (Burgess, n.d.); (du Plessis, 2010). This in turn may impact on the overall productivity in the business, indicated as seen through lower organisational energy.
Perceived Organisational WHAT? Perceived organisational support, as explained by (du Plessis, 2010: 44) “suggests that employees pay attention to the manner in which the organisation treats them in order to discern the extent to which the organisation is supportive and values their contribution”. Therefore high organisational support should
PARTICIPATION
strengthen employees’ beliefs that the organisation recognises and rewards increased performance and therefore should have favourable outcomes both for employees and for the organisation (Rhoades & Eisenberger, 2002). Perceived organisational support has been found to have important consequences for employee performance and well-being.
So what do we make of Self efficacy? Self efficacy appears from studies as a constructive self-belief related to positive motivation and behaviour (Bandura A. , 2005). “General selfefficacy can be defined as one’s belief in one’s overall competence to effect requisite performance across a wide variety of achievement situations” (Eden, 2001: 75). Early literature reviews indicates a potential relationship between (general) self-efficacy and productive organisational energy.
Where does Productive Organisational Energy fit into all of this? “Most leaders have experienced the ebb and flow of different states of energy in their own organisations. This energy belongs to the intangible but very powerful, so-called soft factors of human potential that lie at the core of all companies. We call this phenomenon organisational energy....” (Bruch & Vogel, 2011: 9) Energy is the ability to do work, in whatever format it is presented. Originating in the mid 16th century (denoting force or vigour of expression) from French “energie”, or via late Latin from Greek “energeia” combined as “en”- in and ergon – “work”. As defined in (Oxford Dictionaries, n.d.) “energy is the strength and vitality for sustained physical or mental activity”. Organisational energy as explained by Schiuma et al. states that energy is dynamic and changing, and managing energy encompasses managing energy dynamics that are related to both structural and contingent factors (organisational infrastructure, social interaction and individual behaviour). It can therefore be construed that organisational performance is founded in energy.
Further, (Cole, Bruch, & Vogel, 2005) explain that organisational energy is “the fuel tank that makes organisations run”.
Where to from here then with Independence? It seems like more needs to be done to secure a bright future for the Independent and Community Pharmacy Sector in South Africa to combat the numerous challenges facing the sector. It appears as if limited local research has been done combining different generations with perceived organisational support, self efficacy and productive organisational energy. One such study, titled “The impact of Perceived Organisational Support on Self-Efficacy and Productive Organisational Energy across different Generations in the Independent Pharmacy Sector of South Africa” aims to investigate the impact of the above and contribute not only to the existing body of knowledge on the above constructs in a South African context but also combine them in a unique way. You can participate in this study by accessing the link below: https://www.surveymonkey.com/s/ G9X5RFZ The value of this study on a theoretical and practical level will aim to contribute additional information with regards to different generations in the workplace. Perceived organisational support and self efficacy have been researched to some extent; whereas productive organisational energy in the South African environment has not been widely researched. The study is also expected to provide insights into the generational composition of the Independent Pharmacy Sector of South Africa that could potentially assist in cross-generational understandings and addressing critical skills shortages and training gaps within the Independent Pharmacy Sector of South Africa. For more information, to get the results of this study or to get personally involved, contact our Group Human Resources Manager, Belinda Botha on belinda.b@cjpharm.co.za or call her on 076 373 2964.
References Bandura, A. (2005). Evolution of Social Cognitive Theory. In K. Smith, & M. (. Hitt, Great Minds in Management (pp. 9-35). Oxford University Press. Burgess, J. (n.d.). Managing the new workforce, Generation Y (Millenials). Career Development International, 8. du Plessis, L. (2010). The relationship between perceived talent management practices, Perceived Organizational Support (POS), Perceived Supervisor Support (PSS), and Intention to quit amongst Generation Y employees in the recruitment Sector. Dissertation, University of Pretoria. The Professional Provident Society of South Africa. (2013). SA Pharmacist concerneed about he impact of retail chains. PPS. CFO Publications. (2013, June 21). www. youtube.com. (CEO, Ed.) Retrieved from YouTube: http://www.youtube.com/watch?v=OI 0UcwNzLMs&list=TLiBVFdJf94fs Cole, M. S., Bruch, H., & Vogel, B. (2005). Development and Validation of a measure of Organisational Energy. Academy of Management Best Conference Paper, OB: V1 V6. DOI 10.5465/AMBPP.2005.18781081 Cole, M., Bruch, H., & Vogel, B. (2011, May 27). Energy at work: A measurement validation and linkage to unit effectiveness. Journal of Organizational Behavior(33), 445-467. DOI: 10.1002/job.759 Collins Dictionary. (n.d.). Collins English Dictionary. Retrieved August 13, 2013, from http://www.collinsdictionary.com Eden, D. (2001). Means efficacy: External sources of general and specific subjective efficacy. In M. Erez, U. Kleinbeck, & T. H, Work motivation in the context of a globalizing economy (pp. 73-85). Hillsdale: Lawrence Erlbaum. Joubert D. (2013, August 7). COVER. Retrieved from COVER: http://www.cover.co.za/news/ sa-pharmacists-concerned-about-the-impactof-retail-chains?utm_source=rss&utm_ medium=rss&utm_campaign=sa-pharmacistsconcerned-about-the-impact-of-retail-chains Meister, J. C., & Willyerd, K. (2010). The 2020 Workplace: How innovative companies attract, develop and keep tomorrow's emloyees today (Vol. 1). Harper Business. Merriam-Webster.com. (n.d.). Merriam-Webster. Retrieved August 12, 2013, from http://www. merriam-webster.com/dictionary/generation Oxford Dictionaries. (n.d.). energy. (Oxford University Press) Retrieved August 12, 2013, from Oxford Dictionaries: http:// oxforddictionaries.com/definition/english/ energy Oxford Dictionaries. (n.d.). Oxford University Press. Retrieved August 13, 2013, from http:// oxforddictionaries.com/definition/english/ generation?q=generation Rhoades, L., & Eisenberger, R. (2002). Perceived Organizational Support: A Review of the Literature. Journal of Applied Psychology, 87(4), 698-714. DOI: 10.1037/00219010.87.4.698 Schiuma, G., Mason, S., & Kennerley, M. (2007). Assessing energy within organisations. Measuring Business Excellence, 11(3), 69-78. DOI: 10.1108/13683040710820764
The Script Pharmacy Magazine │November 2013 • December 2013
43
R 25.57 incl VAT
R 49.58 incl VAT
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 – 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) to collect the stock • 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
FUN
mindmovers Sudoku
Solve the maze. Begin at the starting point and find an uninterrupted route that leads to the end point.
6
START
5
1
3
7
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5
8
1 2
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1 8
3
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6 8
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4 7
There is only one rule: Every row, column and box of 3x3 cells must contain the numbers 1 through 9 exactly once (Solution Next Edition)
3
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9
8
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6
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Puzzle
1
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A
2 1
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Which triangle continues this series? 3
2
£
END
Boggler 1
£
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F
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a
6
b
12
c
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4 The Script Pharmacy Magazine │November 2013 • December 2013
2
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47
Solution IS.39
Maze Madness
DIRECTORY
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VALID 1 SEP 2013 - 24 OCT VALIDFROM FROM 1 September - 242013 October 2011
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Product Product
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Everysun Aquasport Sunscreen Aerosol Spray SpfSpf 4040 Everysun Aquasport Sunscreen Aerosol Spray
125ml 58.60 66.21
Everysun Aquasport Lip Balm SpfUV 30Protection Spf 30 Everysun Anti Ageing Face Cream Everysun Anti Ageing Face Cream Protection Everysun Anti Ageing Face Cream UVUV Protection SpfSpf 4030
15.12 53.26 50ml 42.80 60.88 50ml
Everysun Anti Ageing Face Cream UV Protection Spf 40 Everysun Kids Sunscreen Lotion Spf 40 Everysun Kids Sunscreen Lotion Spf 40 Everysun Kids Milk Spray Spf 40 Everysun Kids Milk Spray Spf 40 Everysun Kids Grape Milk Spray Spf 40 Everysun Kids Grape Milk Spray Spf 40 Everysun Cool Cooling Everysun KidsAftersun Sunscreen StickGel Spf 50+
125ml
55.55
125ml
63.15
Everysun Cool Aftersun Lotion Everysun Cool Aftersun Cooling Gel
125ml 27.00 28.91
Everysun Cool Aftersun Lotion Everysun Waterbabies Lotion Spf50
24.00 55.55 125ml
Everysun Waterbabies Milk Pump Spray Spf50
125ml
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48.45 59.60 61.30
125ml 63.15 61.30 150ml 41.20 30.43
64.68
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For above please contact Estelle 013 665 1011 Forany anyfurther furtherenquiries enquiriesregarding regardingthe the above please contact Estelle 013 665 1011 The Script Pharmacy Magazine │June 2012 • July 2012
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Tabard Citronella candle 120g
R22.05
6+1
R18.90
Tabard insect repel aero 150g
R39.41
6+1
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Tabard insect repel aero 70g
R26.40
6+1
R22.63
Tabard insect repel lotion 150ml
R37.35
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Tabard insect repel stick 30ml
R21.15
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R15.35
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The Script Pharmacy Magazine │June 2012 • July 2012
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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
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PROFILES
Top, from left: Christine, Maritsa, Liza, Corné Bottom, from left: Anje, Vicky, Caron
ACCOUNTS Profiles>>
52
The Script Pharmacy Magazine │November 2013 • December 2013
PROFILES
Here’s your opportunity to get to know our very own Accounts Department. Each lady took the time to complete our survey in which we asked a few “non-accounting” questions. Read through these Q&A’s to get a better idea of whom these ladies are when they’re in the office.
About 1. I consider myself to be... happy 2. I am currently reading... This email 3. I recently watched... the 70’s Show 4. Top of my current playlist is... See you on the other side – Ozzy Osbourn 5. Every day... I’m shuffling 6. On Saturdays I... relax and have fun 7. Sometimes when no-ones’ looking I... laugh at myself
Designation: Bookkeeper
when… I make a customer and all of my colleges happy 12. I am proud that I... am a strong, independent woman 13. I love people who... can make me laugh and are honest 14. I am happiest when... I succeed and when I have down time to listen to music and I can draw what is in my heart
8. The best part of my work day is when… everything works out
15. The wisest thing I’ve ever… for
9. I am proud that I’m... alive
me the wisest thing is to love with all
10. I love people who... have a sense of humor
no matter how much it hurts
11. I am happiest when... everyone else is happy
Christine Randall >> Anje de Rouwe >>
11. The best part of my work day is
Designation: Accounting Assistant Department: Finance
your heart and to be honest at all times
Corne Lessing >> Designation: Bookkeeper Department: Finance
About
Department: Finance
About
1. I consider myself to be... a reliable
About
1. I consider myself to be… fun, hardworking, playful, sometimes silly, honest, “artsy”
2. I am inspired by… People
1. I consider myself to be… a family person 2. I am inspired by… people who persevere
2. I am inspired by… nature
person and always willing to help
3. I am currently reading... Sylvia Day 4. I recently watched... Barbie:
3. I am currently reading... Twilight, Percy Jackson, 50 Shades of Grey, Silvia Days
Princess and the Popstar
Carika en Goempie
4. I recently watched... Smurfs 2
4. I recently watched... Futurerama, The Mentalist
5. Top of my current playlist is... Storieman
5. Top of my current playlist is... Justin Timberlake – Mirrors / Katy Perry – Roar
6. I love people who... don’t pretend to be what they’re not.
6. Every day I... am grateful for a new day to start all over
7. I am happiest when... my family is happy.
7. On Saturdays I... Play computer games with my boyfriend
3. I am currently reading... “Middernagfees”
8. The wisest thing I’ve ever…heard: “Keep on walking.”
8. Sometimes when no-ones’ looking I... make silly faces and sing aloud 9. I am terrified by… SPIDERS!!!!!!!!!!!!
Caron Potgieter >> Designation: Bookkeeper Department: Finance
10. The craziest thing that has ever happened to me was... on my 21 Birthday I rode the anaconda at Gold Reef City. Was very scary but I’ll do it all again!!!
5. Top of my current playlist is...
6. Every day I... Live to the best I can 7. On Saturdays I... love spending time with my family 8. The best part of my work day is when… I achieve a goal 9. I am proud that I... have the ability to work and do the best I can 10. I love people who... love’s me and are there for me 11. I am happiest when... I am spending quality time with my Family
The Script Pharmacy Magazine │November 2013 • December 2013
53
PROFILES
Liza Burger >> Designation: Financial Clerk
6. Every day I... wake up and face my challenges one at a time.
Department: Finance
7. On Saturdays I... do as much as possible with my family.
About
8. The craziest thing that has ever happened to me was... I became a mother over night.
1. I consider myself to be... an introvert 2. I am inspired by… support 3. I am currently reading... no reading
9. The best part of my work day is when … i can solve a problem and can find solutions for future problems.
4. I recently watched... horror movies
10. I am proud that I... am a mother and loving it.
5. Top of my current playlist is... “God se bedelaar” – Steve Hofmeyer
11. I love people who... are honest, true and positive about life.
6. Every day I... thank God for forgiveness
13. I am happiest when... people around me are happy and positive.
7. On Saturdays I... do gardening and washing
14. The wisest thing I’ve ever heard… “Nurture your minds with great thoughts, the tongue can paint what the eye can’t see.”
8. Sometimes when no-ones’ looking I... rest 9. I am terrified by… criminals 10. The best part of my work day is when… I drive home 11. I am proud that I... obtained Springbok Colours and qualifications.
Sonja Van der Merwe >> Designation: Senior Creditors Controller
14. The wisest thing I’ve ever done is... to accept life as is.
1. I consider myself to be… outgoing 2. I am inspired by… successful people
4. I recently watched... Brave
Department: Finance
6. Every day I... brush my teeth 7. On Saturdays I... relax
2. I am inspired by… my family and my faith. 3. I am currently reading... Suster Lilian Says (Guide) 4. I recently watched... Walk the Line 5. Top of my current playlist is ... Journey, Don’t Stop Believin’
54
Vicky De Vries >> Designation: Accountant Department: Finance
About 1. I consider myself to be… dependable 2. I am inspired by… people who rise above their circumstances 3. I am currently reading... XO – Jeffrey Deaver 4. I recently watched... Here comes the Boom!
6. Every day I... am greatful for another day
5. Top of my current playlist is... Batman/Spiderman - Jay
1. I consider myself to be… quiet and sometimes difficult.
15. The wisest thing I’ve ever… heard: “Friends are the ones coming in when everyone else is going out”
About
Designation: Senior Debtors Control
About
14. I am happiest when... I’m surrounded by friends
5. Top of my current playlist is... Wake me up - Avicii
3. I am currently reading... The Shack
Maritsa Van Staden >>
13. I love people who... make me laugh
Department: Finance
12. I love people who... are honest. 13. I am happiest when... I am with my animals and at home
the past year
8. Sometimes when no-ones’ looking I... like to snack on chips 9. I am terrified by… things that go bump in the night 10. The craziest thing that has ever happened to me was... becoming a mom 11. The best part of my work day is when… I get to go for a smoke break 12. I am proud that I... have survived
The Script Pharmacy Magazine │November 2013 • December 2013
7. On Saturdays I... enjoy time with my kids 8. Sometimes when no-ones looking I... eat a slab of chocolate 9. I am terrified by… the idea of losing a loved one 10. The craziest thing that has ever happened to me was... both the front and back windows of my car shattered at the same time 11. The best part of my work day is when… I am so busy that I don’t realize the time 12. I am proud that I... am a mom 13. I love people who...are true 14. I am happiest when... I accomplish a goal 15. The wisest thing I’ve ever… read: “Peace begins with a smile” Mother Teresa
TREAT DIARRHOEA EFFECTIVELY: KNOW THE FACTS AND RECOMMEND (1) THE NO.1 BRAND Unfortunately there are a few old wives’ tales and myths surrounding the use of Imodium® in treating diarrhoea. For those who still think that diarrhoea is just a ‘bug’ that needs to run its course - think again. Myth 1 It’s best to let diarrhoea run its course to get ‘the bug’ out. Fact: Treating diarrhoea does not keep ‘the bug’ in. Diarrhoea is NOT always a response to get rid of an infection. Therefore treating diarrhoea early will help relieve the symptoms and allow your customers to get on with their lives. Myth 2 It is possible to become addicted to the medicine if it is used frequently. Fact: When used as directed, Imodium® products are nonhabit forming. Myth 3 Imodium® should not be taken together with other medicines because of potential interactions. Fact: When taking Imodium®, only a very small amount of the medicine is absorbed from the digestive tract. There have been no clinically significant drug interactions reported with loperamide, the active ingredient in Imodium®.
Myth 4 If a child has diarrhoea, it’s best to let the condition run its course. Fact: Diarrhoea in children can lead to dehydration. If left untreated this is particularly dangerous as children can dehydrate much faster than adults. Myth 5 An anti-diarrhoeal medicine can slow down or stop bowel movements completely. Fact: When used as directed, Imodium® is designed to help return the intestinal system to normal, as speedily as possible. It works by giving the colon more time to absorb water in the stool, and by restoring normal contractions to the muscles in the small intestine resulting in fewer bowel movements. Myth 6 Diarrhoea caused by stress should not be treated with Imodium®. Fact: Imodium® can be used for non-specific diarrhoea bouts - even those caused by stress. Imodium® has been specially formulated to work with the body to help restore its normal rhythm as rapidly as possible, even when stressed. Myth 7 Taking Imodium® is too extreme a measure in mild bouts of diarrhoea. Fact: Imodium® can be used for non-specific diarrhoea. It helps by slowing down the intestinal system to its normal pace, regardless of the intensity of the diarrhoeal bout. Reference: 1. IMS Data MAT to July 2013. S2 Imodium Melt tablets. Each tablet contains 2 mg loperamide HCl. Reg. No. 29/11.9/0213. S2 Imodium® tablets. Each tablet contains 2 mg loperamide HCl. Reg. No. H/11.9/152 S2 Imodium® syrup. Each ml contains 0.2 mg loperamide HCL. Reg. No. J/11.9/166. For full prescribing information, please refer to the package insert approved by the Medicines Control Council. ® Trademark © Johnson & Johnson (Pty) Ltd 2013. 01/IMO/02/13/D/JA ®
The No.1 Brand in Diarrhoea Treatment
(1)
Is your skin already itching? Live, work, play allergy free. For more information, refer to your healthcare professional. ZA. 13.ALG.013 09/2013. Adcock Ingram Limited. Reg. No. 1949/034385/06. Private Bag X69, Bryanston, 2021, South Africa. Tel. +27 11 635 0000 www.adcock.com
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