Impact of Information Technology on innovation in determining firm performance.

Masters Degree. University of KwaZulu-Natal, Durban.The aim of this study was to investigate if IT Capability played a moderating role on the relationship between Innovation Capability and the Firm Performance. The study used resource-based theory to test if IT was a competitive resource, by examining the role it played between the constructs of innovation capability and firm performance. A cross-sectional study was conducted amongst two hundred and ninety two (292) employees at the Hillside Aluminium Smelter in Richards Bay, South Africa. The results showed a strong, positive and statistically significant relationship between innovation and firm performance (r-value of 0.616, p-value <0.01, and R2 value of 0.375). The results also support the model in showing a moderate and statistically significant relationship between IT Capability and Innovation Capability (r-value of 0.563, p-value <0.01, and R2 value of 0.32). The conceptual model tested the moderation role of IT Capability between Innovation Capability and Firm Performance. These results showed a favorable result for the moderator variable (p-value <0.01), however the Innovation Capability as the independent variable showed an unfavorable results (p-value=0.579 > 0.05), albeit with a good R2 value of 0.45. Consequently, a multiple regression analysis was conducted using IT Capability and Innovation Capability as independent variables. This model proved to be statistically significant with both p-values of <0.01 and a R2 value of 0.4573. This result fitted well with the research analysis. For practice, the drive for innovation as a key determinant of future firm competitive advantage must factor in the technological capability, specifically information technology. Through the careful selection of IT resources and skills, IT capabilities the are valuable, rare, imperfectly imitable, and non-substitutable can be achieved, resulting in IT as a strategic resource

Massive Pulmonary Thromboembolism and Stroke

A 38-year-old HIV-positive female, recently started on antiretroviral therapy, presented in extremis. She had features suggestive of an HIV-associated cardiomyopathy complicated by the following problems: a four-day-old stroke, extensive deep venous thrombosis, and massive pulmonary embolism. She received intravenous streptokinase with rapid improvement, both haemodynamically and, unexpectedly, neurologically. Our case illustrates that a positive outcome is potentially possible where the two conditions coincide

Marfan syndrome : a case report and pictorial essay

We report a case of Marfan syndrome (MFS) in a South African patient, which is extraordinary because of the large constellation of clinical, radiological and vascular anomalies in a single patient. A literature search from 1950 to date did not show a similar report of such extensive clinical characteristics of MFS.http://www.panafrican-med-journal.comam2019Cardiolog

Does the use of adjunct urine lipopolysaccharide lipoarabinomannan in HIV-infected hospitalized patients reduce the utilization of healthcare resources? A post hoc analysis of the LAM multi-country randomized controlled trial.

BACKGROUND: The World Health Organization (WHO) recommends the use of adjunctive urine lipopolysaccharide lipoarabinomannan (LAM) testing in hospitalized HIV-infected persons with suspected tuberculosis (TB) and a CD4 count <100cells/ml. However, the recommendation is conditional, and uptake by individual treatment programmes depends on perceived additional benefit. The aim of this study was to determine whether adjunctive LAM testing has additional clinical benefits including a reduction in healthcare-related use of resources. METHODS: A post hoc analysis was performed of a published multicentre, multi-country, randomized controlled trial that showed an approximate 20% mortality benefit in HIV-infected hospitalized patients who underwent adjunctive LAM testing as part of their diagnostic workup. In that parent study, adult HIV-infected hospitalized patients with suspected TB (n=2528) were randomly allocated to either routine diagnostics (smear microscopy, Xpert MTB/RIF, and culture; n=1271), or routine diagnostics plus adjunctive urine LAM testing (n=1257). Data were further analyzed to determine whether there were other potential benefits of LAM usage based on CD4 count and illness severity. Aspects evaluated included: (1) the reduction in number of diagnostic sputum samples tested, (2) the utilization of additional imaging, (3) disease resolution based on follow-up signs and symptoms of illness severity, and (4) the reduction in hospital readmission. RESULTS: Adjuvant LAM did not reduce the number of diagnostic sputum samples requested, the need for additional imaging, or the hospital readmission rate. However, adjunctive LAM was associated with a more rapid rate of disease resolution (dyspnoea) in the severely ill subgroup. Higher LAM grade (grades 4 and 5), compared to lower grade positivity (≤3), was associated with lower use of ultrasound, lower Karnofsky performance score, lower CD4 cell count, and shorter time to culture positivity. CONCLUSIONS: Although, adjunct LAM was associated with a mortality benefit in the parent study, no benefit could be demonstrated in the secondary analysis with respect to the number of diagnostic sputum samples requested, the use of additional imaging, or hospital readmission rates. However, given the limitations of the present study, further appropriately designed studies are required to determine the effect of adjunct urine LAM on the utilization of healthcare resources

Long-term safety and efficacy of alirocumab in South African patients with heterozygous familial hypercholesterolaemia : the ODYSSEY open-label extension study

BACKGROUND : Alirocumab reduces low-density lipoprotein cholesterol (LDL-C) levels by up to 61%. The ODYSSEY Open-Label Extension study investigated the effect of alirocumab in patients with heterozygous familial hypercholesterolaemia (HeFH) over 144 weeks. METHODS : Eligible patients with HeFH had completed an earlier double-blind, randomised, placebo-controlled parent study. Patients were initiated on 75 mg alirocumab Q2W subcutaneous (SC) unless baseline LDL-C was > 8.9 mmol/l, in which case they received 150 mg alirocumab Q2W. Dose titration to 150 mg Q2W was at the investigator’s discretion. RESULTS : The study enrolled 167 patients and the parent study mean (± SD) baseline LDL-C level was 3.65 ± 1.9 mmol/l. Mean LDL-C level was reduced by 48.7% at week 144; mean on-treatment LDL-C was 2.30 ± 1.24 mmol/l. Eight patients reported injection-site reactions, with one treatment discontinuation. Treatment emergent anti-drug antibodies were identified in five patients but these did not affect the efficacy. CONCLUSION : Alirocumab effectively and safely reduced LDL-C in these patients.http://www.cvja.co.zahj2020Physiolog

Status asthmaticus with pseudo-dextrocardia, complicated by iatrogenic tension pneumothorax

A 25-year old female, with a background of asthma, presented with acute shortness of breath. On examination the patient was in severe respiratory distress with expiratory wheezes. She was nebulized with ipratropium and fenoterol. A chest x-ray revealed pseudo-dextrocardia and air trapping (A). She did not respond to inhaled bronchodilator therapy. Intravenous hydrocortisone and magnesium sulphate were administered. The patient deteriorated and was subsequently ventilated and intravenous aminophylline initiated. After intubation and ventilation, a central venous line was inserted. The patient deteriorated immediately after central line placement and an arterial blood gas showed type 2 respiratory failure with respiratory acidosis. The repeat x-ray revealed a right sided tension pneumothorax with displacement of the mediastinum to the left, incorrect placement of the central line, endotracheal tube and nasogastric tube (B). The central line and nasogastric tube were removed and an intercostal drain was inserted. The endotracheal tube was adjusted. The pneumothorax resolved and the patient made an uneventful recovery. The patient was mechanically ventilated, had severe airway obstruction with air retention and had central venous line insertion, all of which are risk factors for development of tension pneumothorax Tension pneumothroax requires immediate intercostal chest drain insertion.The Pan African Medical Journal 2016;2

Access to novel anti-diabetic agents in resource limited settings : A brief commentary

The prevalence of diabetes mellitus is increasing in resource limited settings. Simultaneously, there has been an increase in the number of novel therapies for the management of diabetes mellitus. However, use of novel antidiabetic therapies is limited because of major market access challenges in resource limited settings. Niching products to those patients with the highest absolute risk for major adverse cardiovascular outcomes, and thus most likely to benefit from the therapy, are less likely to have negative budget impact for funders. To improve access, and reduce morbidity and mortality, requires alignment amongst key stakeholders including patient advocacy groups, health care professional councils, national departments of health, the pharmaceutical industry, treasury and finance departments