End-to-end well planning strategies for Alaska north slope directional wells

Master's Project (M.S.) University of Alaska Fairbanks, 2018Directional well planning has gained special attention in the Alaska North Slope (ANS) as operators are being compelled to drill increasing numbers of wells from already congested pads because of low oil prices, Capex restrictions, and environmental regulations. This research focuses on two major components of directional well planning: anti-collision and torque and drag analysis in Schrader Bluff, Milne Point. The drilling pattern at the ANS implies very high wellbore collision risk, especially at the shallower section, which affects the safety of drilling operations. However, satisfying anti-collision norms is not the solitary step towards successful well planning. Integration of anti-collision results with torque and drag analysis is essential in evaluating the safety and feasibility of drilling a particular well path and avoiding drill string failures. In the first part of the study, three well profiles (horizontal, slant, and s-shaped) were planned for each of the two new targets selected in the Schrader Bluff OA sand. Initially, this part of the research compared the performance of the newly developed Operator Wellbore Survey Group (OWSG) error model and the industry-standard Industry Steering Committee for Wellbore Surveying Accuracy (ISCWSA) error model. To provide effective guidelines, the results of error model comparison were used to carry out sensitivity analyses based on four parameters: surface location, well profiles, survey tools, and different target locations in the same sand. The results of this study aid in proposing an improved anti-collision risk management workflow for effective well planning in Arctic areas. The second part of the study investigates the drillability of the well paths planned using the improved anti-collision risk management workflow. Furthermore, this part of the research aims at defining the end point limits for critical well planning parameters, including inclination and dogleg, such that within these limits, the well path satisfies anticollision as well as torque and drag considerations. These limits were generated using a drill string optimized in terms of steerable tool, drill pipe size, mud rheology, trip speed, rotational speed, and weight on bit (WOB) during drilling and tripping out operations. The results of this study would help reduce the cumbersome iterative steps and narrow down the design domain for any well to be drilled on the North Slope of Alaska

End-to-end well planning strategies for Alaska north slope directional wells

Master's Project (M.S.) University of Alaska Fairbanks, 2018Directional well planning has gained special attention in the Alaska North Slope (ANS) as operators are being compelled to drill increasing numbers of wells from already congested pads because of low oil prices, Capex restrictions, and environmental regulations. This research focuses on two major components of directional well planning: anti-collision and torque and drag analysis in Schrader Bluff, Milne Point. The drilling pattern at the ANS implies very high wellbore collision risk, especially at the shallower section, which affects the safety of drilling operations. However, satisfying anti-collision norms is not the solitary step towards successful well planning. Integration of anti-collision results with torque and drag analysis is essential in evaluating the safety and feasibility of drilling a particular well path and avoiding drill string failures. In the first part of the study, three well profiles (horizontal, slant, and s-shaped) were planned for each of the two new targets selected in the Schrader Bluff OA sand. Initially, this part of the research compared the performance of the newly developed Operator Wellbore Survey Group (OWSG) error model and the industry-standard Industry Steering Committee for Wellbore Surveying Accuracy (ISCWSA) error model. To provide effective guidelines, the results of error model comparison were used to carry out sensitivity analyses based on four parameters: surface location, well profiles, survey tools, and different target locations in the same sand. The results of this study aid in proposing an improved anti-collision risk management workflow for effective well planning in Arctic areas. The second part of the study investigates the drillability of the well paths planned using the improved anti-collision risk management workflow. Furthermore, this part of the research aims at defining the end point limits for critical well planning parameters, including inclination and dogleg, such that within these limits, the well path satisfies anticollision as well as torque and drag considerations. These limits were generated using a drill string optimized in terms of steerable tool, drill pipe size, mud rheology, trip speed, rotational speed, and weight on bit (WOB) during drilling and tripping out operations. The results of this study would help reduce the cumbersome iterative steps and narrow down the design domain for any well to be drilled on the North Slope of Alaska

Study to compare the effectiveness of intravaginal misoprostol alone with combined use of intravaginal misoprostol and intracervical foley’s catheter for termination of mid trimester pregnancy

Background: The main concern of obstetrician is to provide the most effective and safest regimen for mid trimester termination of pregnancy which combines the shortest expulsion interval with least side effects. The combination of intravaginal misoprostol and intracervical Foley catheter for second trimester pregnancy termination has been described in previous studies with conflicting results. Hence gap exists in literature and not adequate evidence available so this study is undertaken.Methods: A prospective and interventional randomized comparative study was conducted in the department of obstetrics and gynecology, tertiary care centre, New Delhi. A total 60 pregnant female of 14 to 20 weeks of gestation who were admitted for termination of pregnancy due to any indication included in the study. Patients were divided into two groups (30 patients in each group). Group A (misoprostol and foleys combination group) and Group B (misoprostol group). Quantitative variables were compared with unpaired t-test/Mann-whitney test (when the data sets were not normally distributed) between the two groups and qualitative variables were compared by using chi-square test/Fisher’s exact test.Results: The mean induction to abortion interval was 18.31±1.95 hours in the female where misoprostol and foleys combination was used and 21.90±2.62 hours in the women where misoprostol alone used group. Authors found a significant reduction in induction to expulsion time in misoprostol and foleys combination group as compared to misoprostol alone group for mid-trimester termination of pregnancy. Total required dose of misoprostol use for termination of pregnancy was significantly less (p 0.008) in the women where both misoprostol and foleys was used than misoprostol alone.Conclusions: With the use of intracervical Foley’s catheter, the duration from induction to expulsion of abortus gets shortened and required dose of misoprostol is also reduced without any significant increase of side effects

Paediatric lateral humeral condyle fractures managed by k-wire fixation, should the wires be buried or left exposed: a dilemma

Background: Fractures of the lateral condyle of the humerus in children are common injuries. If displaced or unstable they may require surgical reduction and fixation with Kirschner wires (K-wires). These may be passed through the skin and left exposed or buried subcutaneously.Methods: A prospective study was carried out in department of orthopaedics at my college from January 2019 to March 2020.  A total number of 37 subjects were included in the study.Results: Patients were followed for a period of 3 months and results were drawn on basis of union, infection, carrying angle at the elbow, and range of motion (ROM) which was assessed by clinico-radiological means.Conclusions: Buried wire group has shown better union rate than exposed group, wires could be removed under local anaesthesia thereby avoiding any major procedure and also the risk of infection is low making this a better option than the exposed cohort

Functional results of AO 13C fractures managed with bicolumnar plating in a tertiary care centre of North India

Background: Distal humerus fractures are associated with many problems like fracture comminution and complex fracture anatomy. Achieving a good functional range of motion at the elbow with stability are the primary objectives in managing a comminuted distal humerus fracture.Methods: 25 consecutive patients were operated with bicolumnar plating for fracture distal humerus AO type 13C. The patients were kept in follow up for at least six months. Mayo elbow performance (MEP) score and flexion extension arc was calculated to study the outcome.Results: All patients achieved fracture union with mean MEP score of 73.2 and mean flexion extension arc of 93º. This was within the functional range of elbow. Stiffness was observed to be most common complication.Conclusions: Our study concluded that internal fixation with bicolumnar plating offers good functional results in comminuted intra-articular fractures even in osteoporotic bone with negligible complications

Introducing and assessment of FAIR principles of education in teaching biochemistry to I year MBBS students

Background: Recent curriculum is theory based where students just mug up and reproduce in exam with less understanding. It is Exam and marks oriented education. Students show less interest in classes. Presently FAIR (Feedback, Active learning, Individual learning and Relevance) principles of application are practically missing, according to this model students will be naturally motivated to learn. Students will take more responsibility for their own learning. By applying these principles we will improve the effectiveness and efficiency of learning and enhancing learning among students. The objective was to design an effective educational strategy using certain principles of education such as FAIR.Methods: The first batch of the Integrated Curriculum students of the I MBBS program formed the study population. Certain principles of education such as Feedback, Active learning, Individualization of learning and relevance that have been advocated for use to enhance learning, were applied in educational strategies for the implementation of the Integrated Curriculum.Results: By Implementing the FAIR model of integrated curriculum the scores obtained during evaluation and the positive student response validated the enhancement of learning objectively and subjectively.Conclusions: Our collective experience convinced us that designing a curriculum with FAIR model was well worth. 95% students felt it is advantageous with negative perception 35% of students, they felt lengthy and time consuming

ROLE OF PLATELET-RICH PLASMA INJECTIONS IN TENNIS ELBOW; A PROSPECTIVE STUDY

Aims and Objectives: The aim of this study is to evaluate the efficacy of platelet-rich plasma (PRP) injections in chronic/recalcitrant cases of lateral epicondylitis in comparison to steroid injections and their role in averting surgical procedures. Methods: A prospective study was carried out in the Post Graduate Department of Orthopaedics, Government Medical College and Hospital, Jammu, from July 21 to June 22. Results: The patients managed with PRP injections tend to have a better outcome in long-term follow-up than the steroid group and the results in our study have been found to be statistically significant (p<0.05). Conclusion: We consider PRP injection for intractable lateral epicondylitis of the elbow, not only a safe but also very effective tool in reducing symptoms as well as averting the need for surgical intervention in this difficult cohort of patients

Open reduction for neglected traumatic hip dislocation in children and adolescents

Background: Neglected traumatic dislocation of the hip is extremely rare in children, and the preferred treatment remains unclear. In this study we studied the role of open reduction in neglected traumatic hip dislocation in children and adolescents as a modality of treatment.Methods: Eight patients with a neglected, traumatic dislocation of the hip received in the emergency department of GMC, Jammu were managed by open reduction. Types of dislocations, associated lesions, treatment methods, complications, and clinical and radiological outcomes were reviewed in the study.Results: All patients presented with limp and pain. Six patients had minimal difficulty in squatting while two had marked difficulty. Leg lengths were within 2 cm in 7 of 8 cases at follow-up, and only 1 patient had a discrepancy greater than 2 cm.Conclusions: Open reduction is a satisfactory treatment for neglected hip dislocation. It restores joint stability, range of motion and limb length

Effect of prenap coffee on daytime sleepiness in university students

Background: Daytime sleepiness impairs academic performance in college students. Napping is a counter to daytime sleepiness, but often causes sleep inertia on waking up. Caffeine absorption from beverages peaks 30 minutes after their ingestion presenting a window of opportunity to have a short nap such that the time of waking up is in synchrony with onset of action of caffeine; thereby abolishing post-nap inertia and achieving synergistic mitigation of fatigue.Objective of this study to assess effect of nap, coffee, ‘coffee and nap’ and ‘wakeful break without coffee’ on daytime sleepiness using Psychomotor Vigilance Tests (PVTs) and Karolinska Sleepiness Scale (KSS) score.Methods: After Institutional Review Board clearance, 10 subjects (aged 19-21 years) were selected using their Epworth Sleepiness Scale score (ESS >5) and called to the study site 8 times on different days to be exposed to these four conditions twice - only coffee (standardized), only nap (30min), coffee immediately followed by 30min nap, wakeful break (30min) without coffee or nap. Pre and post scores were recorded for electronic PVT (Reaction Time and Motor Responsiveness) and KSS for each attempt.Results: Test outcome was associated with intervention used (p=0.00001). ‘Nap only’ group was associated with deterioration in outcomes (p=0.00001), accounting for highest percentage (41%) of all deteriorated test outcomes. ‘Coffee only’ group was associated with improvement in test scores (p=0.00001), responsible for highest share (38.8%) of all improved test outcomes. ‘Nap only’ and ‘Coffee-nap’ group showed improvement in 11.67% and 21.67% of outcomes respectively. Conclusions: Pre-nap coffee is a proactive counter-measure to post nap sleep inertia

Functional outcome of galeazzi fracture dislocation treated by open reduction and internal fixation with dynamic compression plate

Background: Galeazzi fracture involves fracture of the distal 1/3rd of   radius shaft associated with dislocation of distal radioulnar joint. Open reduction and rigid internal fixation of radius is goal standard treatment. The aim of this study was done to evaluate the functional outcome of Galeazzi fracture dislocation managed by open reduction and internal fixation of radius.Methods: The study was conducted in department of orthopaedics Government Medical college Jammu from December 2018 to February 2021. 30 patients of Galeazzi fracture dislocation were managed with Open reduction and internal fixation of Radius with plating and were followed up to evaluate the results.Results: Age of the patients ranged between 23 years to 60 years with a mean range of 42 years. 22 cases were male (73.3%), 8 cases were females (26.6%). In 19 cases injury was in right side and in 11 cases injury was in left side. In most of the cases injury was due to due to RTA (80%) and in rest of cases injury was due to fall from height (20%).Conclusions: Anatomic restoration of length of the radius with rigid internal fixation is key to satisfactory results in Galeazzi fracture dislocations and K-wire fixation of distal radio ulnar joint is not necessary if anatomic reduction of the joint is obtained by indirect means such as open reduction and internal fixation of the radius and immobilization.