Optimized Cement Slurry Design for Controlling Water Influx in a Gulf of Suez Egypt Salt Dome

The Belayim Marine field, in the Gulf of Suez Egypt, presents many challenges to drilling operators. The most challenging section of the well is the 900-m, 16-in openhole containing a 13 5/8-in casing interval. The main risks in this section are the highly reactive salt layers in combination with high potential saltwater flow zones.

This interval is frequently drilled with a heavy 2.0-sg OBM to avoid saltwater influx during the drilling operations. Due to the mobility of the salt and unstable shale formations, the casing is run without centralizers to minimize the risks of not getting the casing to the desired section depth. Initially the interval was cemented using a 2.16-sg cement system with extended thickening time, both having the same 2.16-sg density. An external casing packer is used as an additional barrier in the event the cement placement does not achieve zonal isolation across the casing due to poor standoff.

After saltwater flow was observed at surface following the installation of the BOP, a detailed review of the casing and cementing design was performed to obtain a more robust procedure to avoid similar events in the future. Cement placement, operation design, and slurry properties were reviewed and optimized. The optimization was performed using details obtained from proprietary simulators as well as by optimizing the slurry properties in the laboratory. The cement operation design called for a single slurry scheme with very critical parameters, ensuring the cement will remain in the liquid phase to maintain applied pressure on the flow zone formations until the BOP is secured. The slurry design itself was revised and optimized in the laboratory providing right angle set along with good transition time to avoid any saltwater influx from formation fluids.

The optimized cement design and slurry properties have met all challenges. Furthermore, the new cement design in conjunction with the external casing packer succeeded in stopping the water flow influx and no similar events have occurred since the new cement operations design began being used in the field.

New-onset anosmia and ageusia in adult patients diagnosed with SARS-CoV-2 infection

Objectives

We investigated the prevalence of anosmia and ageusia in adult patients with a laboratory-confirmed diagnosis of infection with severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2).

Methods

This was a retrospective observational analysis of patients infected with SARS-CoV-2 admitted to hospital or managed in the community and their household contacts across a London population during the period March 1st to April 1st, 2020. Symptomatology and duration were extracted from routinely collected clinical data and follow-up telephone consultations. Descriptive statistics were used.

Results

Of 386 patients, 141 (92 community patients, 49 discharged inpatients) were included for analysis; 77/141 (55%) reported anosmia and ageusia, nine reported only ageusia and three only anosmia. The median onset of anosmia in relation to onset of SARS-CoV-2 disease (COVID-19) symptoms (as defined by the Public Health England case definition) was 4 days (interquartile range (IQR) 5). Median duration of anosmia was 8 days (IQR 16). Median duration of COVID-19 symptoms in community patients was 10 days (IQR 8) versus 18 days (IQR 13.5) in admitted patients. As of April 1, 45 patients had ongoing COVID-19 symptoms and/or anosmia; 107/141 (76%) patients had household contacts, and of 185 non-tested household contacts 79 (43%) had COVID-19 symptoms with 46/79 (58%) reporting anosmia. Six household contacts had anosmia only.

Conclusions

Over half of the positive patients reported anosmia and ageusia, suggesting that these should be added to the case definition and used to guide self-isolation protocols. This adaptation may be integral to case findings in the absence of population-level testing. Until we have successful population-level vaccination coverage, these steps remain critical in the current and future waves of this pandemic.

Outcomes of inflammatory bowel disease surgery in obese versus non-obese patients: a meta-analysis

BACKGROUND

Obesity is considered a risk factor for many chronic diseases and obese patients are often considered higher risk surgical candidates. The aim of this meta-analysis was to evaluate the outcomes of obese (body mass index ≥ 30 kg/m²) versus non-obese patients undergoing surgery for inflammatory bowel disease (IBD).

METHODS

PubMed, Scopus, and Embase libraries were searched up to March 2019 for studies comparing outcomes of obese with non-obese patients undergoing surgery for IBD. A meta-analysis was conducted using Review Manager software to create forest plots and calculate odds ratios and mean differences.

RESULTS

Four thousand three hundred and eleven patients from five observational studies were included. Obese patients were older at the time of surgery and more likely to have diabetes. Obese patients had longer operative times (MD 23.28, 95% CI 14.63-31.93, p < 0.001), higher intra-operative blood loss (MD 45.32, 95% CI 5.89-84.76, p = 0.02), longer length of stay (MD 0.90, 95% CI 0.60-1.20, p < 0.001), higher wound infection rates (OR 1.76, 95% CI 1.39-2.23, p < 0.001), and higher total postoperative complication rates (OR 1.33, 95% CI 1.04-1.70, p = 0.02).

CONCLUSIONS

Obesity is associated with significantly worse outcomes following IBD-specific surgery, including longer operative times, greater blood loss, longer length of stay, higher wound infection rates, and higher total postoperative complication rates. Clinicians should be mindful of these increased risks when counselling patients and consider weight reduction strategies where possible.