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Background: The treatment of esophageal carcinoma may demand multiple approaches including combination of radiotherapy and chemotherapy, particularly cases which are considered unresectable, such as upper third esophageal cancers, locally advanced middle and lower third cancers. Methods: This was a prospective, randomized, open-label, single-center study conducted between December 2014 and July 2016. Patients of either sex aged more than 18 years with the confirmed diagnosis of previously untreated advanced esophageal carcinoma were included in the study. Eligible patients were randomized to receive one of the treatments (chemo-radiotherapy [cisplatin] or radiotherapy alone). Response criteria included dysphasia free survival (DySF), disease free survival (DFS), and overall survival (OS). Tolerability was also assessed. Results: A total of 31 patients (chemo-radiotherapy, n=13; radiotherapy alone, n=18) were enrolled in this study. At one year, the probability of remaining dysphagia free was 40% and 20%, respectively for chemo-radiotherapy and radiotherapy alone groups; and the probability of OS was 64% versus 21%, respectively. The median DFS was 12 months and 5 months for chemo-radiotherapy and radiotherapy alone group, respectively. There were no significant differences in both the groups in EBRT, total treatment duration and duration of EBRT. No patient reported thrombocytopenia or nephrotoxicity. Conclusions: Concurrent chemo-radiotherapy with cisplatin can improve dysphasia and OS in patients with esophageal carcinoma.

– Aim: The aim of this study was to assess the knowledge of Mangalore mothers regarding dental trauma. Methods: A questionnaire inquiring about mother’s knowledge on dental trauma was distributed to 500 working and non-working mothers via their children attending two primary schools in the Mangalore city. Results: Around 68.5% of the mothers were aware of the management of dental trauma. Of the working mothers, 72% were aware of the management of dental trauma while 65% of the non-working mothers were aware. When asked about saving the avulsed tooth, 36% of mothers said that the avulsed tooth can be saved. Regarding mouth guards, 54.5% of the mothers said that they aware of the use of mouth guards to prevent traumatic injuries to the teeth. Of the working mothers 72% knew that mouth guards are useful in the prevention of dental trauma while 37% of the non-working mothers have this knowledge; 68% of the mothers would take the child to the dentist following tooth injury whereas 17% of the mothers would use an emergency kit. Chi-square test and logistic regression analysis indicated a significant difference between the responses of working and the non-working mothers with regard to mouth guard knowledge and recommendation (P-value 0.001). Conclusion: Most of the mothers were graduates and were aware of the emergency management of dental trauma. The working mothers had better knowledge and awareness regarding mouth guards (72%) when compared with non-working mothers (37%).

The aim of this study was to assess the knowledge of Mangalore mothers regarding dental trauma.A questionnaire inquiring about mother's knowledge on dental trauma was distributed to 500 working and non-working mothers via their children attending two primary schools in the Mangalore city.Around 68.5% of the mothers were aware of the management of dental trauma. Of the working mothers, 72% were aware of the management of dental trauma while 65% of the non-working mothers were aware. When asked about saving the avulsed tooth, 36% of mothers said that the avulsed tooth can be saved. Regarding mouth guards, 54.5% of the mothers said that they aware of the use of mouth guards to prevent traumatic injuries to the teeth. Of the working mothers 72% knew that mouth guards are useful in the prevention of dental trauma while 37% of the non-working mothers have this knowledge; 68% of the mothers would take the child to the dentist following tooth injury whereas 17% of the mothers would use an emergency kit. Chi-square test and logistic regression analysis indicated a significant difference between the responses of working and the non-working mothers with regard to mouth guard knowledge and recommendation (P-value 0.001).Most of the mothers were graduates and were aware of the emergency management of dental trauma. The working mothers had better knowledge and awareness regarding mouth guards (72%) when compared with non-working mothers (37%).

The Starting up and Shutting down of a closed cycle gas turbine power plant needs special attention due to the inter-dependable nature of the components. Achieving self-sustainability in a fast and efficient way within the mechanical constraints is the challenge in the start-up of a closed cycle. The Nuclear reactor as the heat source will add more complexity to the system. The paper looks into the various options available for the start up and shutdown of a closed cycle Helium turbine using a gas cooled reactor as the heat source. A comparative analysis of these options is carried out by simulating various operating scenarios using a Transient Simulation Computer Programme especially prepared for an HTGR Project called PBMR (Pebble Bed Modular Reactor), which is being carried out in South Africa. The simulation was focused on the power conversion side of the plant, which includes all the Turbocompressors, Turbogenerator, Heat exchangers, Valves etc. Based on the analysis and its findings, an outline of a start up and shutdown procedure for a 3-shaft Closed Cycle Turbine Power Plant using hot gas injection is proposed in the paper.

This paper analyses the operational aspects of a temperature Gas Reactor using direct Helium Cycle for power conversion. As an engineering project, the complexity in the operational aspects of HTGR’s is more severe than that of its design and installation. Its transient stability is achieved in a different manner compared to conventional power plants. An efficient and steady operation is a must for its successful realization. The paper looks into the start-up, shutdown and part load performance of helium power conversion system. The study is based on an ongoing developmental project in South Africa called Pebble Bed Modular Reactor (PBMR).Copyright © 2002 by ASME

This paper describes the steady state performance analysis of a 3-shaft closed cycle helium turbine using nuclear heat source. The analysis is carried out using a computer program, which is specifically made for this cycle. The computer model was tested for various Turbine Entry Temperatures (TET) and absolute pressures. The analysis of the change was focused on the compressors, as these are relatively more critical than the rest of the equipments. The change in TET triggered changes in shaft speed, mass flow rate, power output, absolute pressure etc. Adjustable guide vanes were used to study the operation with constant surge margin. The closed cycle was tested for various absolute pressures and it was established that the efficiency will not be affected in using the inventory control for the load variation.

Context Glucose-insulin-potassium (GIK) infusion is a widely applicable, low-cost therapy that has been postulated to improve mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Given the potential global importance of GIK infusion, a large, adequately powered randomized trial is required to determine the effect of GIK on mortality in patients with STEMI. Objective To determine the effect of high-dose GIK infusion on mortality in patients with STEMI. Design, setting, and participants Randomized controlled trial conducted in 470 centers worldwide among 20,201 patients with STEMI who presented within 12 hours of symptom onset. The mean age of patients was 58.6 years, and evidence-based therapies were commonly used. Intervention Patients were randomly assigned to receive GIK intravenous infusion for 24 hours plus usual care (n = 10,091) or to receive usual care alone (controls; n = 10,110). Main outcome measures Mortality, cardiac arrest, cardiogenic shock, and reinfarction at 30 days after randomization. Results At 30 days, 976 control patients (9.7%) and 1004 GIK infusion patients (10.0%) died (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.95-1.13; P = .45). There were no significant differences in the rates of cardiac arrest (1.5% [151/10 107] in control and 1.4% [139/10,088] in GIK infusion; HR, 0.93; 95% CI, 0.74-1.17; P = .51), cardiogenic shock (6.3% [640/10 107] vs 6.6% [667/10 088]; HR, 1.05; 95% CI, 0.94-1.17; P = .38), or reinfarction (2.4% [246/10,107] vs 2.3% [236/10,088]; HR, 0.98; 95% CI, 0.82-1.17; P = .81). The rates of heart failure at 7 days after randomization were also similar between the groups (16.9% [1711/10,107] vs 17.1% [1721/10,088]; HR, 1.01; 95% CI, 0.95-1.08; P = .72). The lack of benefit of GIK infusion on mortality was consistent in prespecified subgroups, including in those with and without diabetes, in those presenting with and without heart failure, in those presenting early and later after symptom onset, and in those receiving and not receiving reperfusion therapy (thrombolysis or primary percutaneous coronary intervention). Conclusion In this large, international randomized trial, high-dose GIK infusion had a neutral effect on mortality, cardiac arrest, and cardiogenic shock in patients with acute STEMI.