THE ONLY PPI WITH A 2ND RELEASE FOR MAINTAINED RELIEF2,3
• the MOST POWERFUL inhibitory effect on the proton pump of ALL available PPIs.4
• TRUE once-daily dosing.5
References: 1. South African Medicine Price Registry. Database of Medicine Prices, 01 November 2023 [online]. [cited November 2023]; Available from URL: http://www.mpr.gov.za/. 2. Monthly Index of Medical Specialities. September 2023;63(No. 8):185-191. 3. Metz DC, Howden CW, Perez MC, et al. Clinical trial: dexlansoprazole MR, a proton pump inhibitor with dual delayed-release technology, effectively controls symptoms and prevents relapse in patients with healed erosive oesophagitis. Aliment Pharmacol Ther 2009;29(7):742-54. doi: 10.1111/j.1365-2036.2009.03954.x. 4. Gąsiorowska A. The role of pH in symptomatic relief and effective treatment of gastroesophageal reflux disease. Prz Gastroenterol. 2017;12(4):244249. doi: 10.5114/pg.2017.72097. 5. Frye JW, Peura DA. Managing gastroesophageal reflux disease - comparative efficacy and outcomes of dexlansoprazole MR. Ther Clin Risk Manag 2015;11:1649-56. doi: 10.2147/TCRM.S66680. 6. Dexilant Professional Information. Takeda (Pty) Ltd, South Africa; August 2021. 7. Sharma P, Shaheen NJ, Perez MC, et al. Clinical trials: healing of erosive oesophagitis with dexlansoprazole MR, a proton pump inhibitor with a novel dual delayed-release formulation--results from two randomized controlled studies. Aliment Pharmacol Ther. 2009;29(7):731-41. doi: 10.1111/j.1365-2036.2009.03933.x. 8. Fass R, Chey WD, Zakko SF, et al. Clinical trial: the effects of the proton pump inhibitor dexlansoprazole MR on daytime and nighttime heartburn in patients with non-erosive reflux disease. Aliment Pharmacol Ther. 2009;29(12):1261-72. doi: 10.1111/j.1365-2036.2009.04013.x.
NOTE
New report affirms Covid-19 vaccine safety 4 7
Signing of NHI Bill has no effect yet
11 Acetylcysteine’s role in cough, cold, & sinusitis
By enhancing mucus clearance, acetylcysteine improves airway function and alleviates congestion, a common symptom in respiratory infections.
13 Osteoarthritis: role of joint supplements
Characterised by progressive degeneration of joint cartilage and underlying bone changes, osteoarthritis is a leading cause of disability among the elderly.
19 The power of moist wound healing
By understanding the principles, mechanisms, and appropriate applications of moist wound healing, you can enhance patient outcomes and promote quicker, more comfortable healing.
20 Menopause can impact mental well-being
A reality for most women around the age of 51, menopause can increase their risk of depression and anxiety.
21 Unlocking the importance of magnesium for children's health
Magnesium plays a pivotal role in supporting children's overall health and well-being, influencing various physiologicalprocesses crucial for growth and development.
23 Decoding glaucoma
A complex group of eye conditions characterised by damage to the optic nerve, glaucoma is a leading cause of irreversible blindness worldwide, affecting an estimated 60 million people.
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The COVID-19 vaccines made by PfizerBioNTech and Moderna do not cause such conditions as female infertility, myocardial infarction, Bell palsy, or Guillain-Barré syndrome in adults, according to a report by the National Academies of Sciences, Engineering, and Medicine that reviewed evidence for potential harms for 19 conditions associated with these vaccines. There was not enough evidence involving children to draw conclusions about possible harms.
The committee did conclude that there is evidence that these vaccines can cause myocarditis, although the group emphasised cases linked with vaccines are rare. The report follows a recent study published by the US Centers for Disease Control and Prevention showing no association between Covid-19 vaccination and sudden cardiac death among healthy young people.
The committee's evidence also suggests that the Janssen vaccine may cause GuillainBarré syndrome and thrombosis with thrombocytopenia syndrome. More broadly, the committee concluded that vaccinations in general might cause certain shoulder injuries from the injection itself.
The results of the report, which analysed studies conducted soon after vaccines were available, represent a ‘snapshot in time’ and might not fully reflect the real-world use of the
vaccines, author Dr George Isham said in a statement.
With SA now firmly in winter’s icy grip we look at Beyond summer: SA's battle against skin cancer (page 8), Acetylcysteine's role in cough, cold, & sinusitis (page 11), Xerosis 101 (page 15), and Winter skincare solutions (page 17).
• Signing of NHI Bill has no effect yet (page 7)
• Osteoarthritis: role of joint supplements (page 13)
• Menopause can impact mental well-being (page 20)
• The power of moist wound healing (page 19)
• Unlocking the importance of magnesium for children's health (page 21)
Congratulations to the winner of Crossword #62 Benson Bongobi. For your chance to win a R500 Woolworths voucher don’t miss this month’s crossword puzzle on page 25
“Laughter is the sun that drives winter from the human face.” – Victor Hugo
Join Pharmacy Magazine in partnership with Eucerin for a one-hour webinar.
Dr Zandile Spengane recently relocated from Knysna in the Southern Cape, where she ran her private practice for five years. She trained at Groote Schuur Hospital and UCT completing her fellowship in 2019. Dr Spengane won the Strauss and Katz World Congress Fund Scholarship. This is a scholarship aimed at young dermatologists from third world countries to attend the AAD’s (American Academy of Dermatology) Annual Meeting for educational and networking opportunities. Her research titled “Blood and virus detection on barber clippers" was selected for presentation at the prestigious congress. She has published work in peer reviewed journals. She treats various skin conditions ranging from usual acne, eczema to autoimmune skin conditions, drug reactions and skin cancer. She is passionate about sharing her knowledge through teaching and making skin care accessible.
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Wednesday, 10 July 2024
Wednesday, 24 July 2024
Teresa Hagens and Muriel Bartsch 19h00
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As the global medical training manager for Hansaplast, Elastoplast, and Curitas, Teresa Hagens has developed a deep expertise in training healthcare professionals. Over the years she has conducted multiple digital and inpharmacy training programmes for the pharmaceutical industry and various healthcare brands. In her current role in medical management at Beiersdorf, Hagens is responsible for creating communication materials and training programmes for pharmacists. Hagen's passion for the healthcare industry is evident in her work, and she is committed to staying up to date with the latest trends and developments in the field.
A licensed pharmacist with extensive practical experience in consulting customers in a community pharmacy, Muriel Bartsch has gained years of valuable experience as a medical expert at Beiersdorf. She currently holds the position of junior scientific advisor for Hansaplast, Elastoplast, and Curitas in the Medical and Clinical Affairs Team, where she imparts her pharmaceutical expertise to internal employees and specialist target groups. A recognised expert in the field of wound care, Bartsch’s knowledge and skills are highly valued in the industry.
The process towards fulfilling the promises of the National Health Insurance will be a complex and unprecedented process that will necessitate extensive reorganisation of the healthcare sector. As such the experience for most South Africans will not meaningfully change for years to come with hopes having been raised of achieving Universal Health Coverage through the NHI Act, writes Craig Comrie
- Chairpersonof the Health Funders Association
There are various paths towards Universal Health Coverage (UHC), and collaboration with private healthcare funders can bring the benefits of more equitable access to quality healthcare to millions more South Africans.
The signing of the National Health Insurance (NHI) Bill into law by President Cyril Ramaphosa will shape SA's healthcare future, yet at present there is no threat to medical scheme members’ benefits as the implementation of the NHI Act will be constrained by significant financial and structural constraints and complexities, not to mention legal challenges.
Until the NHI Fund and public healthcare system are ready to support quality, dignityaffirming healthcare, private health cover could offer an effective means of elevating the standards of care and extending access to millions more South Africans. With the finalisation of long-awaited regulations such as those pertaining to Low-Cost Benefit Options (LCBOs) and regular Prescribed Minimum Benefit reviews, real and lasting progress towards the goals of UHC could be made.
The
NHI Act in its current form
will not achieve equity in healthcare and there are better ways to achieve the genuine objectives of UHC
We remain concerned about the longterm implications of certain sections of the NHI Act and its ramifications for the quality of healthcare for all South Africans, the sustainability of the healthcare system, and by extension, the rights of patients to quality care.
What is needed is for all in the healthcare sector to unite our efforts to build a workable integrated funding system incorporating multiple funding streams and collaborative engagement to benefit everyone in SA. There are workable alternative approaches which can achieve universal healthcare without compromising the freedom of individuals to choose how to fund their healthcare needs.
Where constitutional and other legal issues exist, we will take the necessary action to protect the constitutional rights of individuals and their medical scheme benefits.
The NHI Act in its current form will not achieve equity in healthcare and there are better ways to achieve the genuine objectives of UHC. We take the duty to protect access to quality healthcare in line with citizens' constitutional rights very seriously and will not be deterred. PM
CANSA makes an urgent call for year-round vigilance as South Africans face rising risk
While May marked the end of Autumn for South Africans, with winter fast approaching the Cancer Association of South Africa (CANSA) stressed the importance to continue to be sunsmart throughout the year, no matter the weather conditions.
“SA could become the skin cancer capital of the world,” says general medical practitioner Dr Donny Fick.
According to CANSA, figures in the 2022 National Cancer Registry prove that South Africans are at a higher risk of skin cancer, with melanoma, the most serious type of skin cancer, one of the top five cancers
in the country among men and women. CANSA stressed the importance of cancer risk reduction and early detection which applies to most types of cancer. It means adjusting lifestyle choices if necessary to lower the risk of cancer and to keep a watchful eye for warning signs that need to be checked by a medical professional.
Melanomas develop in the cells (melanocytes) that produce melanin, the pigment that gives skin its colour. Melanomas can develop on any skin colour and anywhere on the body, including the head, neck, eyes, under the fingernails, the genitals and the soles of the feet or palms of the hands. They can be similar in colour
All ethnic and racial groups are susceptible to melanoma; however, the typical patient has a fair complexion and a tendency to burn in the sun
to a mole, have no colour at all or be slightly red. While melanomas most often develop in areas that have had exposure to the sun, such as the back, legs, arms, and face, they can also occur in areas that don’t receive much sun exposure and can show up inside the body too.
All ethnic and racial groups are susceptible to melanoma; however, the typical patient has a fair complexion and a tendency to burn in the sun, even after a brief exposure to sunlight. Although there is no conclusive evidence that exposure to sunlight results in the development of melanoma, lesions are most commonly found on sun-exposed areas of the body. Other risk factors include the occurrence of a previous melanoma in the patient and in a close family member, that is, a parent or a sibling.
According to Lorraine Govender, CANSA national manager of Health Programmes, “We advocate to check your spots, it’s a highly presentable cancer, you can easily detect it on your skin.”
CANSA also advises companies whose employees work outside in the sun, such as in the agricultural or building industries, for example, to ensure they have adequate protection against the sun. Look out for sunscreens, clothing, hats, and summer accessories that bear the CANSA Seal of Recognition.
“Even when you are driving, you need to protect yourself,” she explained. “Certain UV rays penetrate windows.” She added that they also penetrate clouds, so you still need to wear sunscreen on overcast days.
Dr Ficks cautioned that the sooner people start using sunscreen the better. “Protecting yourself from the sun slows down the aging process,” he said. Govender agreed.
“Sunscreen should be a mandatory part of any beauty regime for both men and
women. Apply a broad-spectrum sunscreen with a sun protection factor (SPF) of 20 or higher, according to skin type.
“Men can be really bad at remembering to use sunscreen,” said Dr Fick. “Just do it,” he said, “You will thank me later.”
In SA, the risk of melanoma seems to be increasing in people under 40, especially women.
To help identify characteristics of unusual moles that may indicate melanomas or other skin cancers, think of the letters A, B, C, D, and E (pictured right):
• Asymmetry: Halves might not match when you draw a line through the mole.
• Border irregularities: Edges may be scalloped or notched.
• Colour variations: Different shades or unconventional colours may appear.
• Diameter: Moles that are wider than a pencil eraser.
• Evolving characteristics: Encompasses any change in size, shape, colour, elevation, or new symptoms like bleeding or itching.
Malignant moles vary in appearance, with some showing all the changes listed above, and others having only one or two unusual characteristics. The first sign of a melanoma is usually a new spot or an existing mole or freckle that changes in appearance. Some changes can include growing in size or evolving; edges that are irregular rather than smooth and even; a range of colours such as brown, black, blue, red, white, or light grey, and moles becoming itchy or bleeding. PM
*For more information on how to reduce the risk of skin cancer, go to cansa.org.za for fact sheets on melanoma, and ways to be sunsmart.
Melanomas can develop on any skin colour and anywhere on the body, including the head, neck, eyes, under the fingernails, the genitals and the soles of the feet or palms of the hands
CHARACTERISTICS OF UNUSUAL MOLES
A B C D E
Acetylcysteine is a versatile active ingredient used primarily for its mucolytic properties.1,2 Initially developed as a treatment for acetaminophen overdose, acetylcysteine has found applications in respiratory conditions, particularly in managing symptoms associated with cough, cold, and sinusitis. 2,3
Acetylcysteine works by breaking down disulfide bonds in mucoproteins, which are a component of mucus. This action reduces the viscosity of mucus, making it easier to expectorate. By enhancing mucus clearance, acetylcysteine improves airway function and alleviates congestion, a common symptom in respiratory infections.4
Additionally, acetylcysteine acts as an antioxidant. It replenishes intracellular levels of glutathione, a critical antioxidant that protects cells from oxidative damage. This property is particularly beneficial in respiratory conditions where oxidative stress can exacerbate inflammation and tissue damage.3
Coughing is a reflex that helps clear the airways of mucus and irritants.5 In conditions like chronic bronchitis or acute respiratory infections, excessive mucus production can lead to persistent and productive coughs.6 Acetylcysteine’s mucolytic action aids in liquefying thick mucus, facilitating its removal through coughing and improving respiratory function.4
Clinical studies have shown that acetylcysteine can reduce the frequency and severity of cough in patients with chronic obstructive pulmonary disease (COPD) and bronchitis. Its ability to modulate mucus production and enhance clearance makes it an effective adjunct therapy in managing chronic coughs associated with these conditions.1,7
The common colds, often caused by viral infections, leads to symptoms such as nasal congestion, runny nose, and cough.8 Sinusitis, the inflammation of the sinuses, can result from viral, bacterial, or fungal infections and often presents with similar symptoms, including facial pain and pressure.9
In these conditions, acetylcysteine's mucolytic properties help reduce nasal and sinus congestion by breaking down thick mucus, facilitating its drainage.1,2,9 This not only relieves congestion but also helps prevent secondary bacterial infections by promoting the clearance of mucus that can serve as a breeding ground for pathogens.9 Furthermore, acetylcysteine's antioxidant properties can mitigate the inflammatory response associated with viral infections,10 potentially reducing the duration and severity of cold and sinusitis symptoms.
AND DOSAGE
Acetylcysteine is available in various forms, including oral tablets, effervescent granules, and inhalation solutions. The appropriate form and dosage depend on the specific condition being treated and the patient's overall health status.1,10
Acetylcysteine is generally well-tolerated, with a favourable safety profile. Common side effects include gastrointestinal disturbances such as nausea, vomiting, and diarrhoea. Rarely, allergic reactions and bronchospasm may occur, particularly in individuals with asthma.1,2,3 With its dual action as a mucolytic and antioxidant makes it effective in reducing mucus viscosity, improving clearance, and mitigating inflammation, acetylcysteine is a valuable agent in the management of cough, cold, and sinusitis. PM
*References available on request
Acetylcysteine can relieve symptoms of respiratory conditions by acting as an antioxidant and mucolytic, loosening mucus in air passageways
Once a day dosage
Osteoarthritis (OA) stands as one of the most prevalent musculoskeletal disorders worldwide, affecting millions of individuals and posing a significant burden on patients' quality of life.1,2
Characterised by progressive degeneration of joint cartilage and underlying bone changes, osteoarthritis is a leading cause of disability among the elderly. However, it also affects individuals across all age groups, with risk factors including aging, obesity, joint injury, and genetic predisposition.1,2,3,4 According to the World Health Organization (WHO), OA affects around 10% of men and 18% of women aged over 60 globally, making it a significant public health concern.1,2,4
Joint supplements have emerged as an integral component of OA management, offering symptomatic relief, modifying disease progression, and improving joint function. Among these supplements, Avocado Soybean Unsaponifiables (ASU) and Boswellia have garnered considerable attention due to their promising clinical evidence.
Avocado Soybean Unsaponifiables (ASU): A natural vegetable extract derived from avocado and soybean oils, ASU has demonstrated anti-inflammatory, chondroprotective, anabolic, and anticatabolic properties. Clinical studies have shown that ASUs reduce pain and stiffness while improving joint function. Moreover, ASUs are a natural, slow-acting agent that do not merely address acute pain but actively prevent progression of OA symptoms.5
Boswellia: Extracted from the resin of the Boswellia serrata tree, Boswellia has been traditionally used in Ayurvedic medicine for its anti-inflammatory properties. Clinical research supports its efficacy in reducing
pain and improving joint function in OA patients.6 Furthermore, Boswellia has shown synergistic effects when combined with other joint supplements, enhancing overall therapeutic outcomes.7
Promoting patient-centred care and optimising treatment outcomes in OA management is important.2 Recommending joint supplements is crucial for several reasons:
• Early intervention: Osteoarthritis is a progressive disease with irreversible joint damage.1,2 Recommending joint supplements at the onset of symptoms or diagnosis can potentially halt disease progression, preserve joint integrity, and mitigate long-term disability.5,6,7
• Symptomatic relief: Joint supplements offer symptomatic relief by alleviating pain, reducing inflammation, and improving joint mobility, thereby enhancing patients' quality of life and functional capacity.5,6,7
• Complementary to conventional therapy: Joint supplements complement conventional pharmacological and non-pharmacological therapies, providing a holistic approach to OA management.8 Their favourable safety profiles and minimal adverse effects make them suitable for long-term use, either as monotherapy or adjunctive therapy.5,6,7
Integrated models of patientcentred multidisciplinary care have been shown to reduce pain and improve function and quality of life among individuals with OA2
• Patient empowerment: Recommending joint supplements empowers patients to actively participate in their treatment journey, fostering self-management skills and adherence to therapy. Educating patients about the benefits of joint supplements instils confidence and encourages proactive healthseeking behaviours.
By recommending joint supplements early, pharmacists contribute to optimising patient outcomes, alleviating symptom burden, and improving overall quality of life in individuals living with osteoarthritis. PM
*References available on request
+92% more moisture
Moisturising relief for skin prone to psoriasis and eczema.
Also referred to as xeroderma, or xerosis (extremely dry skin), dry skin is among the most common dermatological diagnoses and a fundamental symptom of many dermatological, internal, and neurological diseases1,2
Moisturises containing humectants are helpful in decreasing skin dryness, reducing pruritus, and improving skin barrier function.4
Due to weakening of the skin barrier function, sensitivity to external irritants is increased, and there is an increased risk of secondary infection. This may also facilitate the development of inflammatory skin disorders like eczema or contact dermatitis.4
2
Dry, itchy skin can lower quality of life and aggravate skin diseases.3
Dry skin is a particularly common phenomenon among senior citizens affecting as many as 60% of the population, and up to 99% of those residing in long-term care.4
Xerosis is represented by dry skin surface with rough and scaly appearance.4
Dryness related itching or pruritus may cause sleep and emotional distress and affects patients’ wellbeing.4 Scratching can lead to further damage of the skin as well as painful wounds.4 1 3 4 5 6 7
Moisturisers work effectively to overcome dry skin underlying dermatoses, interrupting dry skin cycle while maintaining skin smoothness. Possible functions of moisturisers:
• Anti-inflammation • Antipruritic
• Antimitotic
• Wound healing.
External factors: cold environment, low humidity, intense sunlight, hot water exposure, etc.
Endogenous causes: aging, dermatological diseases, internal health conditions, psychiatric conditions, diet, drugs, etc.
*References available on request
E45 gets to work instantly to help repair dry skin
As winter sets in, the drop in temperature and humidity levels can wreak havoc on the skin.1 Pharmacists have a crucial role in educating patients on adapting their skincare routine to combat the harsh effects of winter.
• Dryness: Cold air outside and heated indoor environments lead to decreased humidity levels, causing the skin to lose moisture rapidly resulting in dryness, flakiness, and tightness.1,2,3
• Increased sensitivity: Exposure to cold winds and sudden temperature changes can exacerbate skin sensitivity and irritation.4
• Flare-ups of skin conditions: Conditions like eczema, psoriasis, and rosacea may worsen during winter due to dryness and irritation.3,5
• Barrier disruption: The skin's protective barrier weakens, making it more susceptible to irritation and infection.6
Hydrate, hydrate, hydrate
• Emphasise the importance of using a hydrating cleanser and body wash that doesn't strip the skin of its natural oils. Recommend gentle, non-foaming cleansers with creamier formulas and hydrating ingredients like hyaluronic acid or glycerin.3,7,8,9
• Encourage the use of a rich, nourishing ointment or cream containing humectants, emollients, and occlusives to lock in moisture and prevent dryness. Suggest applying moisturiser immediately after washing while the skin is still damp to maximise hydration.1,3,7,8
• Stress the importance of using a broad-spectrum sunscreen with SPF 30 or higher, even in winter. UV rays can still penetrate through clouds leading to sunburn and premature aging.5,7
• Recommend the use of a barrier repair cream or ointment containing ingredients like ceramides, fatty acids, and cholesterol to strengthen the skin barrier and protect against environmental aggressors.5,10,11
• Encourage customers to avoid harsh exfoliants and alcohol-based skincare products that can further compromise the skin barrier. Even gentle exfoliation with a mild chemical exfoliant containing alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) can be irritating on the skin during winter months.1,3,5
• Advise customers to switch to fragrance-free and hypoallergenic skincare products to minimise the risk of irritation and allergic reactions.1,5
• Recommend the use of a soothing serum or cream containing antiinflammatory ingredients like niacinamide, panthenol, or colloidal oatmeal to calm irritated skin and reduce redness.5,12
By emphasising hydration, barrier protection, and sensitivity management, you can help patients maintain healthy, glowing skin throughout the cold winter months. Encourage customers to consult with a dermatologist if they experience severe skin issues or persistent symptoms despite following a winter skincare regimen. PM
*References available on request
Moisturisation is a cornerstone of any good skincare routine and even more important during cold winter months
ADVANCED WOUND PAD
For faster healing
REDUCES THE RISK OF SCARRING DURABLE
For several days *Compared
Moist wound healing is an advanced wound care technique that emphasises maintaining an optimal moisture balance in the wound environment. This method accelerates healing, reduces pain, and minimises scarring compared to traditional dry wound healing methods.1,2,3
The concept of moist wound healing was first introduced by Dr George D Winter in the 1960s. His research demonstrated that wounds kept in a moist environment healed more quickly than those exposed to air.3,4,5 The key principles of moist wound healing include:
• Optimal hydration: Maintaining moisture helps preserve the physiological function of the wound bed.5,6
• Temperature regulation: A moist wound environment retains the warmth necessary for cellular activities involved in healing. 3
• Protection from infection: Moist wound dressings act as a barrier to external contaminants while also managing exudate. 3,4
• Reduced pain and scarring: Keeping nerve endings moist minimises pain and leads to less scab formation and scar tissue development. 3,4
MECHANISMS OF MOIST WOUND HEALING
• Cell proliferation and migration: Moisture facilitates the migration of epithelial cells across the wound surface, enhancing re-epithelialisation.1,3,6
• Autolytic debridement: Moisture aids in the body’s natural process of shedding dead tissue. 3,4
• Collagen synthesis: A hydrated environment supports fibroblast activity and collagen production, crucial for tissue repair. 3,4
• Reduced inflammation: Moisture helps control the inflammatory response, reducing the likelihood of chronic inflammation and associated complications.1,3
Pharmacists should be knowledgeable about the various clinical scenarios where moist wound healing is beneficial:
• Acute wounds: Surgical incisions, lacerations, and abrasions.7
• Chronic wounds: Diabetic foot ulcers, pressure ulcers, and venous leg ulcers.7,8
• Burns: Partial thickness burns where moisture can accelerate healing and reduce pain.9
Pharmacists can offer valuable guidance on the application and maintenance of moist wound healing:
• Wound assessment: Educate patients on recognising signs of infection and the importance of regular wound monitoring.
• Dressing selection and application: Provide instructions on selecting the appropriate dressing and how to apply and change it correctly.
• Moisture balance: Emphasise the importance of maintaining the right moisture level – not too wet and not too dry.
• Pain management: Discuss pain management strategies, including the use of appropriate analgesics and the painreducing benefits of moist wound healing.
• Signs of complications: Instruct patients on when to seek medical advice if signs of complications, such as increased redness, swelling, or unusual discharge, appear. Moist wound healing represents a significant advancement in wound care, offering numerous benefits over traditional methods. PM
*References available on request
Moist wound healing is 3-5 times quicker than the healing of wounds that are allowed to dry out
Menopause, a reality for most women around the age of 51, on average, can increase their risk of depression and anxiety. The mental health impacts of menopause rank in the top five challenges that women encounter along with the more well-known physical symptoms such as weight gain and hot flushes.
Menopause can also start early, any time from the age of 30, or only in the mid-50s or even later.
About 4 in 10 women have mood changes during perimenopause when the reproductive years end and the body naturally transitions to menopause, causing women to experience irritability, low energy, trouble concentrating and being tearful and moody.
However, according to a recent study, only 59% of South Africans consider themselves knowledgeable about menopause.
Dr Joanna Taylor, specialist psychiatrist and member of SASOP (South African Society of Psychiatrists), said the most widely spoken about symptoms are the physical, such as hot flushes, night sweats, low libido and weight gain. The mental health symptoms of menopause are rarely discussed, yet they are as common as the physical symptoms and are among the top five complaints raised by menopausal women.
“The risk of depression and anxiety increases during menopause due to hormonal changes, leading to feelings of hopelessness, lack of interest in life, being tearful, and increased worry, which can impact one’s day-to-day life, concentration, sleep patterns, and ability to take care of oneself.
“Women with a history of depression
and anxiety are more prone to depressive symptoms during menopause,” Dr Taylor said.
“It’s important to recognise that menopause is universal for all women and should never feel disabling. The symptoms of menopause will eventually ease, however most women find them difficult to manage and require treatments to offer relief.
“Some might go through menopause with little disruption whilst others experience the prolonged agony of dwindling libido, hair loss, and headaches. But there is no need to suffer in silence. There are treatment options that can support this new phase of life.”
Dr Taylor said that one’s age, genetics, and type of menopause play a significant role in determining the best course of treatment.
For women to support their mental well-being during menopause
Dr Taylor recommends:
Exercise :Daily movement of at least 30 minutes will release endorphins which reduce stress and promote positive emotions.
Diet: A Mediterranean-style diet can assist in decreasing inflammation, hot flushes, and night sweats. Avoid foods high in sugar and fat, and rather increase the intake of fruit, vegetables, whole grains and lean protein.
Sleep: Make sure to get 7-9 hours of sleep to better deal with challenges, improve decision-making, and overall mood.
Socialise: Isolation increases the symptoms of depression and anxiety. Spend time with friends and family, and talk to other menopausal women to share struggles and solutions. PM
Apharmacist’s role in promoting children's health extends beyond simply dispensing medications. You are pivotal in educating parents and caregivers about the essential nutrients crucial for children's growth and development. Magnesium plays a pivotal role in supporting children's overall health and well-being, influencing various physiological processes crucial for growth and development.1,2
Magnesium is a mineral that plays a crucial role in over 300 biochemical reactions in the body, ranging from energy production to muscle function and nerve signalling.1 While it's essential for individuals of all ages, its significance is particularly pronounced during childhood, a period of rapid growth and development.
MAGNESIUM FOR CHILDREN:
• Bone health: Magnesium is vital for the development and maintenance of strong bones in children. It works synergistically with calcium and vitamin D to promote bone mineralisation, making it indispensable for achieving optimal bone density during childhood and adolescence.1,2,3,4
• Muscle function: Adequate magnesium levels are essential for proper muscle function, including relaxation and contraction. This is particularly important for children engaged in physical activities and sports, as magnesium deficiency can lead to muscle cramps and impaired performance.1,2
• Energy metabolism: Magnesium plays a critical role in energy metabolism2 by activating enzymes involved in the breakdown of carbohydrates and fats.5 Ensuring sufficient magnesium intake helps support children's energy levels, allowing them to thrive in their daily activities.
• Nervous system health: The nervous system relies on magnesium for neurotransmitter
regulation and nerve signal transmission. Sustaining optimal magnesium levels promotes cognitive function and emotional well-being, contributing to overall mental health. 2 Severe magnesium deficiency can cause a generalised tonic-clonic seizure.1
• Regulation of heart rhythm: Magnesium is involved in maintaining a steady heart rhythm by regulating the movement of other electrolytes like potassium and calcium across cell membranes.1
Recognising the signs of magnesium deficiency in children is essential for early intervention. Symptoms may include muscle cramps, fatigue, irritability, poor appetite, and abnormal heart rhythms. However, since these symptoms are non-specific and can overlap with other health conditions, consulting a healthcare professional for proper diagnosis is imperative.1,2,5
Pharmacists are uniquely positioned to educate parents and caregivers on practical ways to promote magnesium intake in children:
• Encourage a balanced diet rich in magnesium-containing foods such as green leafy vegetables, nuts, seeds, whole grains, and legumes.1,2,4,5
• Recommend paediatric-friendly magnesium supplements when dietary intake is inadequate or in cases of increased magnesium requirements due to growth spurts, intense physical activity, or medical conditions.
• Emphasise the importance of moderation, as excessive magnesium intake from supplements can lead to adverse effects. Pharmacists have a unique opportunity to advocate for the importance of magnesium and empower parents and caregivers to prioritise its inclusion in children's diets and supplementation when necessary. PM *References available on request
nerves causing tunnel vision, it’s time to reduce IOP 1,2 TEST • TREAT • PRESERVE sight
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= Intraocular pressure
References: 1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014; 311(18):1901-1911. 2. South African Glaucoma Society. Glaucoma algorithm and guidelines for glaucoma, 2016. Available at https://www.sags.co.za/doctors-information. Accessed 12 December 2019. S4 TRAVATAN® Eye Drops, solution (0,004 %), 40 μg of travoprost per ml in a sterile ophthalmic solution, 36/15.4/0333, Novartis SA (Pty) Ltd. S3 SIMBRINZA® 10 mg/ml + 2 mg/ml eye drops, suspension. Reg. No.: 50/15.4/0358. Each ml contains 10 mg of brinzolamide and 2 mg of brimonidine tartrate. S4 DUOTRAV® eye drops, 1 ml of solution contains 40 μg travoprost and 6,83 mg timolol maleate equivalent to 5 mg timolol, A40/15.4/0511, Novartis SA (Pty) Ltd. S3 AZOPTIC® Eye Drops (Suspension), 10 mg brinzolamide per ml, 34/15.4/0382, Novartis SA (Pty) Ltd. S4 AZARGA® eye drops, suspension, 1 ml of suspension contains 10 mg brinzolamide and 5 mg timolol (as timolol maleate), 44 /15.4/0046, Novartis SA (Pty) Ltd. Note: Before prescribing, consult full prescribing information.
Novartis South Africa (Pty) Ltd. Magwa Crescent West, Waterfall City, Jukskei View 2090. Tel. +27 11 347 6600. Co. Reg. No. 1946/020671/07. Novartis Adverse Drug Reaction Reporting: Email: patientsafety.sacg@novartis.com. Web: https://psi.novartis.com/. Tel: 0861 929-929. Fax: 011 929-2262. Marketed and Distributed by Adcock Ingram Holdings Limited. 1 New Road, cnr 7th Road, Midrand, 1685. Tel: 0860 ADCOCK (232625) Co. Reg. No. 2007/019928/07. ZA2304173788 Exp.: 04/2025
Glaucoma is a complex group of eye conditions characterised by damage to the optic nerve, which is responsible for transmitting visual information from the eye to the brain. The damage often occurs due to elevated intraocular pressure (IOP), leading to progressive vision loss and potentially irreversible blindness.1,2,3,4 Globally, glaucoma affects an estimated 60 million individuals and stands as the leading cause of permanent vision impairment.4
Symptoms of glaucoma are typically absent in the early stages, making it a stealthy adversary to eye health. However, as the condition progresses, symptoms may manifest, including a gradual worsening of vision.1,2,3,4 Monitoring for signs of elevated intraocular pressure and variations in pressure levels are essential for early detection and management.
• Primary Open-Angle Glaucoma (POAG): Often referred to as the "thief of sight," POAG is insidious in its onset. Patients may experience no pain or discomfort, and vision loss tends to be so gradual that individuals may not even notice it until significant damage has occurred. This chronic condition arises when the drainage of aqueous fluid from the eye becomes inefficient, resulting in a buildup of intraocular fluid and increased pressure that damages the optic nerve. Regular eye exams are crucial for early detection, particularly for individuals with optic nerves sensitive to normal eye pressure.1,2,3,4
• Primary Closed-Angle Glaucoma (PCAG): Unlike POAG, PCAG involves the blockage of the angle where aqueous humour drains from the eye. This blockage typically occurs due to the iris obstructing the drainage angle, leading to a closed angle. PCAG is less common than POAG but still poses a significant risk of vision loss if left untreated. It shares the asymptomatic
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nature of POAG in its early stages, emphasising the importance of routine eye examinations for early detection.1,2,3,4
Various risk factors contribute to the development and progression of glaucoma, including age, family history, certain medical conditions like diabetes and hypertension, ocular disorders, and long-term use of corticosteroids.1,2,3,4
Treatment strategies for glaucoma aim to slow disease progression by reducing intraocular pressure, thereby preserving vision. Pharmacological interventions such as carbonic anhydrase inhibitors, prostaglandin analogues, beta-blockers, alpha-agonists, and cholinergics agonists are commonly prescribed to manage intraocular pressure. 5,6,7 When medication alone is insufficient, non-pharmacological approaches like laser trabeculoplasty or trabeculotomy may be recommended to enhance aqueous humour outflow.1,2
Understanding glaucoma involves recognising its insidious nature, identifying risk factors, and implementing timely interventions to preserve vision and mitigate the risk of irreversible blindness. Regular eye examinations and proactive management strategies play pivotal roles in combating this sight-threatening condition. PM *References available on request
Glaucoma can be challenging to diagnose because symptoms often appear at a late stage of the disease
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