Preliminary investigations into the energy efficiency of manufacturing firms operating in South Africa have shown that no previous study of the barriers to energy efficiency has been conducted. This paper sets out to investigate whether there is an energy efficiency gap in medium to large manufacturing firms operating in the eThekwini municipal area. It goes on further to analyse the barriers to energy efficiency in such firms. These barriers are analysed by firm characteristics and across manufacturing sectors. The findings of this research indicate that more can be done to improve the energy efficiency profile within South African manufacturing subsectors. Policy-makers should take these findings into consideration when drafting new policy on energy efficiency. OPSOMMINGVoorlopige ondersoeke oor energiedoeltreffendheid in vervaardigingsaktiwiteite van maatskappye in Suid-Afrika toon dat daar geen vorige studies bestaan wat fokus op die struikelblokke van toepassing op bestaande energiedoeltreffendheid nie. Hierdie artikel ondersoek 'n energiedoeltreffendheidsgaping wat bestaan binne medium tot groot vervaardigingsmaatskappye binne die eThekwini munisipale gebied. Die ondersoek identifiseer en analiseer gepaardgaande beperkinge wat bestuurders binne sulke maatskappye verhinder om energie doeltreffendheid te implementeer. Die ondersoek en analise strek oor 'n aantal vervaardigingsektore. Die bevindinge van hierdie navorsing dui daarop dat heelwat meer bereik kan word in terme van energiedoeltreffendheid binne die verskeie vervaardigingsubsektore in Suid-Afrika. Hierdie gevolgtrekkings behoort in ag geneem te word deur beleidmakers tydens die opstel van 'n nuwe beleid oor energiedoeltreffendheid.

This study includes a series of 5 cases demonstrating cardiovascular manifestations of findings of IgG4-related disease. Two cases demonstrate peri-aortic soft tissue thickening in the infrarenal abdominal aorta and bilateral ostio--proximal common iliac artery. In 2 cases there were circumferential soft tissue lesions around the arch of the aorta. One of the cases showed coexistent, biopsy-proven Riedel’s thyroiditis and infiltrative soft tissue along the right atrial wall and interatrial septum. In one case there was a partly calcified mass in the left hemi-thorax consistent with a diagnosis of IgG4-related fibrosing mediastinitis.

No abstract

Background: Delays in diagnosis of tuberculosis (TB) is still a problem at all levels of health care. Understanding the etiology of these delays is essential for all stakeholders involved in TB control. This study was done to find the delays related to health-care seeking behavior, diagnosis, and major contributors to such delays among newly diagnosed patients of TB. Methods: This cross-sectional study was conducted from August 1, 2018, to July 2019 among the patients of TB diagnosed at Indira Gandhi Medical College, Shimla. A consecutive sample of 105 patients was enrolled for the study. Newly diagnosed cases aged 18 years and above were included in the study. Prevalence ratio with 95% confidence interval was calculated for risk factors associated with the identified delays. Results: At the patient level around 55% reported a delay of more than 14 days in seeking care with a median delay of 45 days (interquartile range [IQR] of 30–60 days). Nearly 67% patients were found to have a diagnostic delay of more than 7 days at the health-care provider level (Median 30 days; IQR 12.5–54.7 days). Delayed initiation of treatment after 7 days of diagnosis was found in 6.6% cases (Median 10 days; IQR 8–15 days) and all of these were patients of extra pulmonary TB. Delay was significantly associated (P = 0.01) with patients who travelled <5 km to reach the health facility. Conclusion: Inter-sectoral coordination, refresher trainings of health-care providers, patient education and capacity building for diagnostics at peripheral institutions can reduce delay in diagnosis and treatment of TB.

We hereby present a case of intrapulmonary invagination of the left internal mammary artery detected on CT angiography. We aim to highlight the role of CT angiography in identifying these course anomalies and their clinical implications.