bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful Deployment of Large Diameter Hybrid Drill Bit with Optimized Drilling System in Exploration Well Leads to Breakthrough in Days Savings
Authors: Omar Marwa , Touny Shrief El , Taha Mohammed , Lee Roger , Holliday Alan , Al-Foudari Saud J , Al-Sarraf Adel , Abdullah Meshal , Mahalanobis Partha
Published: October 2015

In Kuwait's largest reservoir, the Burgan Field, exploration wells have large potential for drilling optimization and savings; specifically a 22 inch hole, that is drilled conventionally using multiple roller cone bits in multiple trips through challenging inter-bedded formations. Hybrid drill bit technology, roller cone combined with Polycrystalline Diamond Compact, was introduced in search for an economically viable solution to deliver wells faster and achieve yearly operator targets. This paper analyzes the breakthrough drilling performance achieved by a 22 inch hybrid bit in comparison to conventional roller cones offsets and provides conclusions on economic viability.

The main challenges drilling the 22 inch section are drill bit durability and drilling vibrations through 2,000 ft. of inter-bedded limestone, shale and sandstone. In addition to curing fluid losses in certain porous formation layers that negatively affect Rate Of Penetration (ROP). Typically two roller cone bits are used on rotary drive to drill this section at 15 feet per hour, consuming seven drilling days. Using Polycrystalline Diamond Compact (PDC) bit with a performance motor to increase ROP performance is not an economically viable solution. Using hybrid drill bit on rotary drive combines the benefits of PDC blades’ durability and higher cutting efficiency with the cones’ stability by grinding and gouging into the formation.

The deployment of the hybrid technology was a collaboration project between a national oil company and a major oil services company. The teams focused on optimizing the complete drilling system including the bottom hole assembly, hydraulics, drilling parameters and geological factors to match the hybrid drill bit mechanism.

The hybrid design selection and drilling optimization resulted in a 142-percent ROP improvement from offsets average performance. The hybrid design drilled the 22 inch hole after casing shoe to section total depth at 31 feet per hour, using one bit, in three drilling days in comparison to seven days average performance. The total operator savings from this section was approximately USD 175,000 in the first deployment. Such remarkable economical savings and technical optimization proved that the hybrid technology is the viable solution for Burgan 22 inch application.
An Empirical Correlation to Predict the SAGD Recovery Performance
Authors: Dong Xiaohu , Liu Huiqing , Hou Jirui , Chen Zhangxin , Zhang Tianlin
Published: October 2015

The prediction of the recovery performance for Steam-Assisted-Gravity-Drainage (SAGD) process is becoming increasingly important as the SAGD projects all over the world continue to increase. The prediction of SAGD recovery performance should go back to the theory basis developed by Butler (1978). Afterwards, based on his model, many modified models are proposed. But most of these models are analytical or semi-analytical methods, and the predicting process is much complicated. In particular for the SAGD projects in some irregular thick heavy oil reservoir, it will be a hard work. Thus, a quick and easy method is needed to screen the heavy oil reservoirs for potential SAGD project.

In this study, based on the grey system theory, we developed a weighted grey correlation model firstly. Through this model, aiming at a typical thick heavy oil reservoir from Bohai offshore oilfield, China, the influences of reservoir/fluid parameters and operation parameters on SAGD recovery performance were comprehensively evaluated. And a sensitive sequence of each parameter was derived to reflect the sensitive degree. Thus a static multi-parameter nonlinear correlation is proposed to predict the oil recovery, recovery rate and cumulative oil-steam ratio (COSR) of SAGD process. Then, this correlation is used to predict the SAGD recovery performance in some potential thick heavy oil reservoirs of Bohai oilfield and the results is compared against the numerical simulation model. During this process, we also make a survey on the successful SAGD projects around the world and analyze the development features. Through the modification to the proposed correlation above, it is validated.

From the simulation results, it is indicated that the SAGD recovery performance is more sensitive to the parameters of reservoir thickness, permeability (including horizontal and vertical), net-to-gross value and steam chamber pressure. Based on the gray related degrees and the sensitivity results, we proposed a six parameters nonlinear correlation to predict the recovery indicators of SAGD process. Thus, using this correlations, the recovery performance of several SAGD projects are predicted, and the correlation results are in good agreement with those obtained from numerical simulation. The prediction error of recovery factor and COSR is controlled within 10%. Furthermore, from the validation results, we found after a modification process, our correlation could be used. Our correlation is a static method to predict the recovery performance of SAGD process in heavy oil reservoir, and it could be used to successfully predict the recovery performance of SAGD projects in heavy oil reservoirs. Through the utilization of this correlation, the SAGD recovery performance in candidate oil reservoirs could be rapidly obtained.
Utilization of Modern Technology Yields Potential Recovery of 936 Million BOE from Mature Fields Portfolio
Authors: Gibson M.
Published: October 2015

This paper portrays the methodologies utilized to yield potential "barrier reserves" of 936 million BOE from an Operator’s mature fields’ portfolio.

The paper reviews the whole project in overview and will also go into detail for one particular asset to appraise readers of the pertinent details associated with how each particular methodology yielded the "barrier reserves" it did, including the economic value and risks associated with each mature field.
Precise Well Integrity Diagnostic Delivers Production Sustainability, Cost Reduction and Regulatory Compliance
Authors: Leong Chua Hing , Khairul Anuar Khairina Bt , Batumelai Sathish Kumar , Bin Mahmud Ahmad Fitri
Published: October 2015

This paper is a case study of a well intervention performed by PETRONAS Carigali Sdn Bhd (PCSB) in Sarawak region to investigate and rectify a breach in well integrity. The review and discussion demonstrate that the intervention not only ensured compliance with existing well bore risk management guidelines but also reduced operational rig cost and enabled increase in production.

The paper identifies the aspects of what appears on first view to be a straightforward well integrity diagnostic process, but which on deeper evaluation exposes the wider and acute impact of the outcomes of such a diagnosis.

The nature of the diagnostic technique is examined, and the interrelated impact on PCSB HSE requirements, platform operating efficiency, and field-wide production.

The well intervention and the subsequent targeted rectification made possible by the precise nature of the diagnosis, enabled PCSB to bring this well back online and restore its gas production. This gas production is vital for several of the gas lifted wells in the field. Restoration enabled PCSB to increase field production significantly.

The study concludes that accurate, reliable and rapid integrity diagnostics should not be evaluated as only relevant as a means of HSE management but also a means of cost management and in sustaining or increasing overall production.
Estimation of Fracture Characteristic within Stimulated Rock Volume using Finite Element and Semi-Analytical Approaches
Authors: Maulianda B. T. , Wong R. C. , Gates I. D. , Eaton D.
Published: October 2015

Hydraulic fracturing increases the drainage area and effective permeability of unconventional oil and gas reservoirs by creating a fracture network or stimulated rock volume (SRV) within the reservoir rock. The dimensions of the SRV and its permeability are the key parameters that enhance the unconventional reservoirs' performance after the hydraulic fracture operation. Simulation of the SRV to obtain its dimension and permeability can be used to determine the optimum hydraulic fracture treatment parameters and production. In this study, finite element analysis is employed to determine the SRV characteristics based on field data from a hydraulic fracturing job in a horizontal well penetrating the Glauconite formation in Hoadley field, Alberta, Canada. The dimensions of the SRV are calibrated from the microseismic data. The fracture propagation pressure of the finite element model is matched to the field value by altering the permeability of the SRV. The matched model is used to obtain the in-situ stress changes and the pressure drop within the SRV. The SRV permeability and the pressure drop are used to calculate the aperture, the number, and the spacing of the fractures within the SRV using a semi-analytical approach. The final outputs can be used to optimize the future hydraulic fracture design at the Hoadley field or at other fields that have similar geomechanical properties. It could also be used to predict the reservoir production after the hydraulic fracturing and to provide estimates of changes in the in-situ stresses around the stimulated horizontal wellbore.
Inter-Well Sandstone Prediction and Facies Evolution by Multidisciplinary Integration: An Example from G Gas Field in Jabung Block in South Sumatra Basin
Authors: Mu Longxin , Zhang Ming , Ren Bin , Xia Zhaohui , Zhang Xiaoling , Zhang Wenqi , Li Chunlei , Zheng Yabin
Published: October 2015

In the development of conventional oil and gas projects, inter-well sandstone prediction and facies evolution provide benefit by reducing the number of wells drilled, optimizing well location and maximizing the performance of the wells. However, several particularly thorny issues were encountered in our study. Multi-bedded thin sandstone reservoirs were vertically stacked with thin coal seams. The main sedimentary facies of sandstones in areal and vertical directions varied quickly. This paper summarizes one multidisciplinary integration methodology to predict the distribution of inter- well sandstone and sedimentary facies in the South Sumatra Basin in Indonesia.

To overcome the aforementioned disadvantages, this method included the following steps. First, it made use of multidisciplinary knowledge including mineralogy, sedimentology, lithology, geology, petrophysics and geophysics based on cores, well logs, and seismic data of various source data. Second, sequence strata division and correlation were studied with eleven target layers in order to describe this multi-stack reservoir. Then sedimentary facies system including braided channel and braided delta were identified based on reliable data from sedimentary structure of lithology, facies sequence, Formation Micro scanner Image data (FMI), and sedimentary characteristics of core samples such as: rock color, lithological features, mineral composition, and rock sedimentary structure. Fourth, a sandstone identification assessment standard was established to improve the precision of the reservoir prediction. Fifth, logging data and sedimentary facies were used to establish the facies log patterns. Favorable reservoir facies in strata were outlined based on the study of properties of sedimentary facies. Sixth, a four step procedure including seismic data partitioning, seismic attribute analysis, normalized seismic attributes of three compartments and sandstone thickness calculation was used to identify sandstone inter-well distribution. Seventh, multidisciplinary integration was used to understand facies and facies evolution to arrive at favourable facies and properties distribution which could then be used for geomodel building.

This methodology constitutes a systematic and effective way to delineate the distribution of sandstones and sedimentary evolution for future well planning.
Grassroots Ideas for Sustainable CSR Programs for the Oil & Gas Industry in Indonesia, Lessons Learned From Other Sectors
Authors: Setiadi M. I. , Hoffman M. , Lemain S. , de Groot E. , de Waard P. , Elings C. , Jansen D.
Published: October 2015

Objectives/Scope

In this paper, we present our review on best practices Corporate Social Responsibility (CSR) for the Oil & Gas industry gathering our experiences from industrial sectors such as dairy industry, food & beverages, mining, using worldwide information and experiences but emphasizing on Indonesia.

Methods, Procedures, Process

Large or small, many unintended side effects of human activities continue to have impacts on society and the environment, whether reversible or irreversible, sort term or long term. There are guidelines and safeguards in the oil and gas industry with the objective to manage the impacts. These safeguards and guidelines help to mitigate negative effects and optimize the positive effects of industrial activities in general and oil and gas industry specifically. We will present a review of our international experiences and adding our pilot study in Indonesia such as the Dairy Industry, Food & Beverages, and Mining.

Results, Observations, Conclusions

Traditional Health Safety and Environment (HSE) aspects of oil and gas organizations have been put into place but more often now, this is not enough. Deeper societal engagement includes ‘giving back’ to society as a form environmental and social responsibility. In Indonesia, and probably in most developing nations, politics and reputation plays a significant role in the industry, for example its development strategy, its product placement and how the company maintains its relation with the community. To stay on top of the game, organizations in the Oil & Gas Industry can manage social, environmental and reputational risks by a well-implemented CSR program. Unfortunately, we find that often CSR programs are a short term one-time deal and do not reach the targets with the involved stakeholders. CSR programs may sometimes lack a meaningful stakeholder engagement. Taking experience from industries outside the Oil & Gas sector, our approach is more bottom-up, where we work together with primary stakeholders to determine a more strategic and sustainable CSR approach

Novel/Additive Information

Our bottom-up approach lets us work together with primary stakeholders to determine a more strategic and sustainable CSR program. The central way of thinking is that when the stakeholders (may it be local communities, farmers, educators, industry etc.) are meaningfully involved, full ownership of CSR programs is ensured and long term CSR programs are sustained
Introduction and Field Test of a Neutron Porosity While Drilling Tool Using Non-Chemical Source
Authors: Gao Wenkai , Sheng Limin , Lin Yushui , Gao Xuesheng , Ai Weiping , Song Yanchun , Mao Weimin , Jia Hengtian , Fan Jinhui , Cao Chong , Wang Peng
Published: October 2015

Combined with other measurements, neutron porosity tool provide basic and important parameters for real-time formation evaluation and geosteering. In earlier neutron porosity LWD systems, the porosity instruments containe an isotopic chemical source which emit fast neutrons.

Using the chemical neutron source, it should be meeting the problem of handing, shipment, and storage. For radiation safety consideration, non-chemical source based neutron instruments will be the best choice for measurement while-drilling. A new type of non-chemical source based neutron porosity instrument has been developed and prototyped.

The instrument was designed for porosity measurement while-drilling. it consists basically of an accelerator neutron source and several neutron detectors. The accelerator based neutron generator source can be switched on and off by electronic circuit and software control.

The development of new porosity instrument includes two parts - method study and tool design. In method studies, computer modeling was use to tool structure designs and detector parameter choices. Both computer modeling and experimental measurements made in standard formation were used to determine the tool responses. The field test has been made with two prototype tools.

Comparing the measured porosity data with wire-line neutron logging data, they are in good agreement. The preliminary test and data analysis show that the designed tools have many new features over chemical source based neutron porosity tools. This paper will highlight the technical development and present helpful case histories and recommendations.
Corrosion Assessment of Different Production Casings and Material Selection in Sour Gas Wells
Authors: Dezhi Zeng , Naiyan Zhang , Feng Wang , Rui Chen , Tianlei LI , Chengqiang Ren , Junying Hu , Taihe Shi
Published: October 2015

In order to assess the applicability of three steel specimens (T95, 110SS-2Cr and 825 steel) in sour gas well, corrosion tests were conducted in a simulated gas field solution containing both 0.55MPa H2S and 0.75MPa CO2 at 55 °C-100 °C for 72h in an autoclave. Then the corresponding corrosion products were analyzed and compared through EDS and SEM technologies. The stress corrosion cracking (SCC) behavior of three steel specimens had been tested using four point bending (FPB) technique and constant-load test. The results showed that the 825 steel had lowest corrosion rate among all those steels. The corrosion rate of T95 steel was higher than 110SS-2Cr steel for its looser corrosion products. With the increase of temperature, T95 steel and 110SS-2Cr steel corrosion product film thickened, and the trends of crystallization and agglomeration were clear. The main components of the film were FexSy, FeCO3 and compounds containing a small amount of Cr. It could also be found that the Cr content of 110SS-2Cr steel corrosion products was higher than that of T95 steel, which may contribute to its lower corrosion rate. According to the FPB results, all of those three steels did not get broken under 85% stress state in the simulated field condition. The constant load tests also showed that under 72% stress state, the T95 steel and 110SS-2Cr steel were not broken, indicating a good resistance to environmental cracking with low stress corrosion sensitivity. As a result, the 825 steel could be used below the packer of production casing; the 110SS-2Cr steel is appropriate to be used in the middle of production casing; the T95 steel is suitable for the wellhead of production casing.
Formation Damage from Fine Particulate Invasion: An Example from the Lost Soldier Tensleep Formation
Authors: Rickford R. L. , Finney T. P.
Published: October 2015

The Tensleep Formation in the Lost Soldier Field has been pattern waterflooded since 1976. Injection wells have historically exhibited large declines in injectivity which required frequent workovers. Since those declines were originally attributed to near-well damage from poor injection water quality, a cleanup program was initiated that significantly reduced the amount and size of suspended particles in the injection water. Despite the improvements, injectivity continued to decline in many of the wells. Subsequent analysis of well histories, PFOTs, and reservoir petrophysical properties suggest the reservoir damage in many instances was not only a sandface phenomena, but also caused by deep particle invasion. Workover procedures were altered to treat the formation beyond the near wellbore area resulting in increased injectivities when compared to the historical norm.
A Mechanical Diversion Method for Ultradeep and HP-HT Wells
Authors: Giacon P. , Toffolo G.
Published: October 2015

In the HP-HT field of Villafortuna Trecate, located in northern Italy, five horizontal drain holes have been drilled in the last few years. Existing wells have been sidetracked to access trapped reserves and to enhance production. Since the field is the deepest onshore European field, these wells are amongst the deepest horizontal wells ever drilled.

Final measured depths are over 6300 m with an average true Vertical Depth of about 6000 m.

Several technical problems related to the extremely severe HP-HT environment were met, both in drilling, completion and stimulation phase.

This paper briefly describes the Trecate 9 drain hole drilling and completion execution, with emphasis on the stimulation technique adopted to obtain an effective acid diversion along 250 meters of open hole section, the longest in the field.

Without getting into complicated analysis involving fluodynamics, kinetic of chemical reactions, effects of bridging and chemical diverting agents that would necessitate separate studies, the description of this technique is focused on basic design concepts and how operations have been carried out on this field application. Nevertheless we believe that this simple and cost effective technique represents a real opportunity in all the cases when diversion of treating fluids is a concern, and hope that in the future, more work done following this basic guideline will lead to many other successful field applications.
16+1 cooperation framework: Genesis, characteristics and prospect
Authors: Tianping Kong
Published: October 2015

The relations between China and Central and Eastern European countries (CEEC)
have experienced different phases in the last 25 years. China?s new strategy
toward CEE emerged in the last three years. It can be called the regional
approach. The so-called regional approach to deal with Central and Eastern
European countries can be regarded as a breakthrough in China?s policy
towards Central and Eastern European countries. 16+1 cooperation framework
has taken shape in the last three years. As China rediscovered different
CEEC, CEEC rediscovered different China, common interests have drawn China
and CEEC closer. The 16+1 cooperation framework is quite special, neither
group nor international organization can encapsulate its characteristics.
Equal partnership, loose institutionalization, comprehensive cooperation,
multi-functional arrangement and well-planned framework are main
characteristics. The 16+1 cooperation framework is a real novelty in
international relations. The emergence of 16+1 framework arises from both
common political will to cooperation and mutual demand for closer economic
links. The 16+1 framework has to face several challenges.
Can Serbian and Chinese managers have a successful cooperation: A critical analysis
Authors: Zakic Katarina
Published: October 2015

The paper examines to what extent the Chinese and Serbian approaches in doing
business differ, with focus on structural features of the management system
and ownership. The paper is aimed at overcoming possible difficulties that
stem from the differences in the business practices with a view to the
statement of the Serbian Government that the People?s Republic of China will
play important role in the transformation of our economy as well as the
conclusions of the 2014 Belgrade summit of prime ministers of China and
Central and Eastern Europe countries. Since Serbian and Chinese business
people have been doing business for many years, some difficulties in mutual
cooperation are being already experienced. The author focuses her analysis on
the phase dynamics of the management process and takes into consideration the
business practice that is upon direct influence of culture. Hofstede?s model
of cultural differences is employed. The author concludes that although the
management practice in China and Serbia has lots of similarities, there are
structural differences in business practices as an outcome of national
cultural diversity.
Macroeconomic Uncertainty and Management Earnings Forecasts
Authors: Kim Kyonghee , Pandit Shailendra (Shail) , Wasley Charles E.
Published: October 2015

SYNOPSIS

To provide evidence on the role macroeconomic uncertainty plays in managers' decision to issue management earnings forecasts (MFs), this study develops and tests hypotheses about how such uncertainty affects the issuance and characteristics of MFs. Macroeconomic uncertainty is measured using the dispersion in GDP forecasts and the CBOE's Volatility Index (VIX). We find that during periods of high macroeconomic uncertainty there is a decrease in the likelihood of MF issuance, consistent with managers assigning a higher cost to releasing forward-looking information as macroeconomic uncertainty increases. We also find that managers issue fewer good and bad news MFs, but more neutral MFs, during periods of high macroeconomic uncertainty. Macroeconomic uncertainty also affects the characteristics of the MFs that managers do issue; for example, managers shift to more earnings preannouncements and to shorter-horizon, but more precise, MFs. Further analysis indicates that the regulatory changes imbedded in the Sarbanes-Oxley Act increased the costs of providing MFs, thereby increasing the sensitivity of MF issuance to macroeconomic uncertainty. The findings provide insight into the role macroeconomic uncertainty plays in managers' decision to issue MFs and the characteristics of the MFs they choose to issue.
When 14C Dates Fall Beyond the Limits of Uncertainty: An Assessment of Anomalies in Western Mediterranean Bronze Age 14C Series
Authors: Lull Vicente , Micó Rafael , Rihuete-Herrada Cristina , Risch Roberto
Published: October 2015

The aim of this article is to bring to light a serious problem affecting radiocarbon dates produced at least from 2009 onwards by the AMS Leibniz laboratory at the Christian-Albrechts-Universität (Kiel, Germany). Archaeological observations and cross-checkings between several laboratories confirm that in a significant number of dates, clear deviations of the results from chronological schemes based on stratigraphical sequences and hundreds of measurements have occurred, which usually implies an aging of the 14C values.
14C and Marine Reservoir Effect in Archaeological Samples from the Northeast Gulf of California
Authors: Dettman David L , Mitchell Douglas R , Huckleberry Gary , Foster Michael S
Published: October 2015

Previous studies of live-collected pre-weapons testing mollusk shells in the northern Gulf of California have demonstrated that the local radiocarbon reservoir effect (ΔR) is large and highly variable. To test the validity of this observation for paired charcoal and shell samples from archaeological contexts, we dated samples from four shell midden locations and six midden layers from the eastern shoreline of the Gulf of California near Puerto Peñasco, Sonora, Mexico. Dated charcoal samples were small twigs or brushy plants used to cook shellfish and the shells dated within each midden showed signs of burning. Ages range from approximately 5700 to 1900 cal BP. The offset between the modeled marine14C age for calibrated ages of the middens and measured shell14C age (ΔR) averaged 425 yr with a standard deviation of 115 yr.
The Marine Radiocarbon Reservoir Effect on Adak Island (Central Aleutian Islands), Alaska
Authors: Khasanov Bulat F , Nakamura Toshio , Okuno Mitsuru , Gorlova Ekaterina N , Krylovich Olga A , West Dixie L , Hatfield Virginia , Savinetsky Arkady B
Published: October 2015

Radiocarbon dates (n= 18) from three archaeological sites on Adak Island, Alaska, were analyzed to understand the marine reservoir offset. Samples of marine and terrestrial origins recovered from the same archaeological context were compiled in nine pairs. The mean ΔR value calculated for them totaled 545 ± 10 yr. This value can be regarded as a sound estimate of the marine reservoir offset in the central Aleutians.
AMS Dating of the Late Pleistocene Mammals at the Colorado Creek Site, Interior Western Alaska
Authors: Reuther Joshua D , Rogers Jason S , Rousseau Julie , Druckenmiller Patrick S
Published: October 2015

The Colorado Creek section of Alaska is an important paleontological site first excavated and reported on in the early 1980s and 1990s. The remains of two individual mammoths (the “Upper” and “Lower”), and elements of horse, bison, and caribou make this a unique faunal assemblage for a region in interior western Alaska, and the western edge of eastern Beringia. The mammoth remains were the only portions of the faunal assemblage radiocarbon dated in the 1980s. The Upper mammoth ages were widespread between 13,000 and 16,200 BP with the older dates being more accepted for the death of the individual. A single age on the Lower mammoth was produced at 22,880 14C yr BP. New accelerator mass spectrometry (AMS) dates generally confirm the accepted ages for the two mammoths and provide more precise ages of 16,200 ± 50 and 22,710 ± 90 14C yr BP for the Upper and Lower mammoths, respectively. AMS dates on caribou and horse are similar to ages on the Upper mammoth and show an overlap in their ecological ranges in interior western Alaska between 16,000 and 17,000 14C yr BP during the Late Glacial, similar to other areas of the state. The sole AMS date on bison produced an infinite 14C age (>43,500 14C yr BP), considerably older than the Upper and Lower mammoths’ remains, and indicates that older deposits are present at the site. A dearth of dated Quaternary paleontological specimens from western Alaska hinders our understanding of this region's paleoecology. This study enhances our conception of the geographic and chronological spread of late Pleistocene large terrestrial mammals in Alaska and Beringia.
Efficacy of endotracheal tube disinfection strategies for elimination of Streptococcus zooepidemicus and Bordetella bronchiseptica
Authors: Crawford Sarah , Weese J. Scott
Published: October 2015

Objective—To evaluate the efficacy of various endotracheal tube disinfection strategies for elimination of Streptococcus zooepidemicus and Bordetella bronchiseptica.

Design—Experimental in vitro study.

Sample—12 sterile endotracheal tubes.

Procedures—Endotracheal tubes were inoculated with S zooepidemicus or B bronchiseptica and subjected to 1 of 5 treatments (spraying with accelerated hydrogen peroxide solution [AHP] or soaking in one of the following: AHP, 0.5% chlorhexidine gluconate solution [CHG], 0.3% triclosan-containing soap solution, or tap water) or left untreated (controls). After 5 minutes, tubes were rinsed with water and swabbed for direct and enrichment culture. Culture results were scored semiquantitatively. Each isolate was tested separately (10 endotracheal tubes/isolate/treatment).

Results—No growth was identified by direct culture of any samples collected from CHG-treated endotracheal tubes, whereas S zooepidemicus and B bronchiseptica were each identified from 1 of 10 tubes sprayed or soaked with AHP and from all tubes (10/10 each) treated by other methods or used as controls. The CHG and AHP treatments resulted in significantly lower median growth scores after direct culture than did other treatments. After enrichment culture, samples from CHG-treated tubes had significantly lower growth scores than samples from AHP-treated tubes, which had significantly lower scores than samples from other treatment groups.

Conclusions and Clinical Relevance—High-level disinfection (ie, elimination of all vegetative bacterial growth) was not achieved with any treatment tested. Although optimal approaches are not known, processing of endotracheal tubes with CHG or AHP appears to be the best approach when sterilization is not feasible.
Assessment of Post Graduate Medical Students in Nepal: Is it time to introspect?
Authors: Shrestha D , Shrestha R
Published: October 2015

Kathmandu University Medical Journal Vol.12(4) 2014; 231-232
Clinicohistological Profile of Cutaneous Tuberculosis in Central Nepal
Authors: Mathur M , Pandey SN
Published: October 2015

Background There are few studies on cutaneous tuberculosis in Nepal.Objective To analyse the epidemiological, clinical and histological patterns of cutaneous TB over the past 5 years.Method Patients with cutaneous tuberculosis diagnosed from January 2010 to December 2014 at College of Medical Sciences, Chitwan, Nepal were included in the study. Chest radiography, routine investigations and screening for HIV was performed in all cases.Result A total of 47 clinical cases of cutaneous tuberculosis were diagnosed. The most commonly affected age group was 41-50 years. Male to female ratio was 1.5:1. Duration of cutaneous tuberculosis ranged from 1 month to 33 years. Lupus vulgaris was the most common clinical type (64%), followed by tuberculosis verrucosa cutis (19%). Two cases (4%) were diagnosed as papulonecrotic tuberculid. Overall, the most common site of involvement was extremities (55%) followed by head and neck, trunk, and perianal region. Histopathologic features of epitheloid cell granuloma with Langhans type giant cells were seen in 89% of cases, and in remaining 11% cases, chronic inflammatory dermatitis and nonspecific chronic dermatitis were observed.Conclusion M Tuberculosis is endemic in Nepal and the incidence of cutaneous tuberculosis at our centre was 0.1%. Lupus vulgaris was the most common type followed by tuberculosis verrucosa cutis in our study. Cutaneous tuberculosis can be accompanied by tuberculosis in internal organs and hence should be looked for. Clinicopathologic correlation is necessary to make a proper diagnosis.Kathmandu University Medical Journal Vol.12(4) 2014; 238-241
Histopathological Findings of Endometrial Samples and its Correlation Between the Premenopausal and Postmenopausal Women in Abnormal Uterine Bleeding
Authors: Sharma S , Makaju R , Shrestha S , Shrestha A
Published: October 2015

Background Abnormal uterine bleeding is considered as one of the most common problems among women. The therapy is incomplete without knowing the underlying pathology.Objectives To determine the types and frequency of endometrial pathologies in patients presenting with abnormal uterine bleeding at Dhulikhel Hospital Kathmandu university Hospital.Methods This is retrospective study total 100 cases were included over a period of one year of Abnormal Uterine bleeding.Results Out of 100 cases of Abnormal uterine bleeding, 61% were due to non-organic cause with a commonest histopathological findings proliferative endometrium. 27% cases were due to organic cause with pregnancy related condition as most common finding. 12% were reported as inadequate. The rate of postmenopausal bleeding declined with increasing age in the postmenopausal period and endometritis was the predominant finding.Conclusion There is an age specific association of Abnormal uterine bleeding with increased incidence in perimenopausal age group. Postmenopausal bleeding declined with increasing with endometritis the most common finding. Dilation and curettage is helpful to exclude other organic pathology. It is useful for diagnosis and to know pathological incidence of organic lesions in cases of Abnormal uterine bleeding prior to surgery.Kathmandu University Medical Journal Vol.12(4) 2014; 275-278
Acetabular Fracture: Retrospective Analysis of Thirty Three Consecutive Cases with Operative Management
Authors: Shrestha D , Dhoju D , Shrestha R , Sharma V
Published: October 2015

Background With the development of better imaging modalities including 3D CT scan and availability of technical expertise, operative management is increasingly performed for acetabular fracture but many patients in developing countries like Nepal, are still being treated with prolonged skeletal traction.Objective To analyses epidemiology, types of acetabular fracture and functional and radiological outcome of patients with acetabular fracture treated with open reduction and internal fixation (ORIF).Method Inpatients hospital records of patients treated with ORIF in between June 2007 to June 2014 were evaluated. Patient’s demographic data, mode of injury, injury hospital interval, injury surgery interval, associated injuries, surgical approach, total hospital stay and peri and post-operative complications were recorded and radiological and functional outcomes were evaluated.Result Thirty three patients (Male: 24 Female: 9) with average age 39 years (range: 21 to 65 years) were operated for acetabular fracture. Twenty one patients (63%) had injury related with motor vehicle accidents and nine (24%) of them had motorbike accidents. Injury hospital interval ranges from 7 to 36 days. Average injury-surgery interval was 21 days and average hospital stay was 22 days. Bicolumnar fractures were found in 15. Nine patients had dislocation of hip and 15 had concomitant other injuries. Biculumanr fixation was performed in 15 patients, posterior column and or wall in nine with Kocher Langenbeck approach and anterior column and or wall in other nine with ilio-inguinal approach. Radiological reduction was anatomical in 18; excellent/good functional outcome was in 26 and radiological outcomes were excellent in 14. Three patients had developed Hypertopic ossification. Follow up period ranged from 6 to 48 months and 15 patients (45%) had follow up >2 years.Conclusion Acetabular fractur can be effectively managed with ORIF and have predictable and comparable functional and radiographic outcomes. Upgrading the existing facilities and training of orthopedic surgeon for acetabular fracture management is important to shorten injury-surgery interval due to lack of such facilities.Kathmandu University Medical Journal Vol.12(4) 2014; 279-287
Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey
Authors: Koju R , Manandhar K , Risal A , Steiner TJ , Holen A , Linde M
Published: October 2015

Background Hypertension (HTN), a major risk factor for cardiovascular diseases (CVDs), is a substantial global public health problem. Occasional studies indicate a high prevalence of HTN in the Nepalese population, but no nationwide population-based data exist so far. We opportunistically used a survey of major disorders of the brain in Nepal to measure blood pressure (BP) in participants selected randomly from the adult general population.Objective To establish the prevalence of elevated BP (eBP), and factors associated with it, regardless of any antihypertensive therapy being taken. We took this to be indicative of unmet health-care need.Method This was a cross-sectional study, conducted by unannounced household visits, employing multistage random cluster sampling. To achieve representativeness, 15 districts out of 75 in the country were investigated: one district from each of the three physiographic divisions in each of the five development regions of Nepal. One adult aged 18-65 years was selected from each household and interviewed by structured questionnaire. BP was recorded in a standardised manner by digital device (Microlife 3BM1-3®).Result From 2,109 eligible households, 2,100 adults (99.6%) participated. The prevalence of eBP (>140/90 mmHg on ?2 readings) was found to be 15.1%. Multivariate logistic regression showed significant and independent associations with demographic variables (higher age, male gender), with life-style factors (daily alcohol consumption, BMI ?25), and with living at high altitude (?2000 m).Conclusion In the context of the survey we could not collect data on antihypertensive therapy being taken but, clearly, whatever this might have been, it was failing to meet treatment needs. Almost one in six adults met criteria for hypertension, carrying risk implications for CVDs and their substantial public-health consequences. Two remediable associated factors were identified, although in a cross-sectional survey we could not prove causation.Kathmandu University Medical Journal Vol.13(1) 2015; 3-7
Academic Staff Perspectives Towards Adoption of E-learning at Melaka Manipal Medical College: Has E-learning Redefined our Teaching Model?
Authors: Bhardwaj A , Nagandla K , Swe KMM , Abas ABL
Published: October 2015

Background E-learning is the use of Information and Communication Technology (ICT) to provide online education and learning. E- Learning has now been integrated into the traditional teaching as the concept of ‘blended learning’ that combines digital learning with the existing traditional teaching methods to address the various challenges in the field of medical education. Structured e-learning activities were started in Melaka Manipal Medical College in 2009 via e-learning platform (MOODLE-Modular Object-Oriented Dynamic Learning Environment).Objectives The objective of the present study is to investigate the faculty opinions toward the existing e-learning activities, and to analyse the extent of adopting and integration of e-learning into their traditional teaching methods.Methods A cross sectional study was conducted among faculties of Medicine and Dentistry using pre-tested questionnaires. The data was analyzed by using the statistical package for social science, SPSS, version 16.0.Results The result of our survey indicates that majority of our faculty (65.4%) held positive opinion towards e-learning. Among the few, who demonstrated reservations, it is attributed to their average level of skills and aptitude in the use of computers that was statistically significant (p<0.05).Conclusion Our study brings to light the need for formal training as perquisite to support e-learning that enables smooth transition of the faculty from their traditional teaching methods into blended approach. Our results are anticipated to strengthen the existing e-learning activities of our college and other universities and convincingly adopt e-learning as a viable teaching and learning strategy.Kathmandu University Medical Journal Vol.13(1) 2015; 12-18
Screening for Postpartum Depression and Associated Factors among Women who Deliver at a University Hospital, Nepal.
Authors: Kunwar D , Corey EK , Sharma P , Risal A
Published: October 2015

Background Postpartum depression (PPD) is a neglected area of maternal health care in developing countries like Nepal; not only in the treatment aspect, but also, in the areas of research. However, it is important to identify and treat postpartum depression because it can have grave consequences for both the mother and her children.Objective To determine the screening prevalence and risk factors of postpartum depression, among women who deliver at university hospital Nepal.Method This is a cross-sectional study investigating the relationship between postpartum depression and various factors. A total of 100 postpartum women who presented to a Dhulikhel hospital for delivery were interviewed on days 2-3 after delivery. The mothers were administered Edinburgh Postnatal Depression Scale (EPDS) as well as a proforma that included questions about the known risk factors (sociodemographic and sociocultural factors, and mother-related, pregnancy-related, and child related factors).Result The overall screening prevalence of depressive symptoms in the postnatal period (defined as EPDS=>13) was 29 %( 95% CI 20.1%-37.8%). On univariate analysis (chi square test), postpartum depression was significantly associated with pregnancy complications (p<0.01), infant’s health problems (p <0.001) and vaginal delivery (p <0.05).Conclusion Postpartum depression is common among Nepalese women and can be detected early in the postpartum periods; and many psychosocial factors like pregnancy complications, infant’s health problems and vaginal delivery are associated with it. It is recommended that mothers with high risk should be routinely screened for postpartum depression.Kathmandu University Medical Journal Vol.13(1) 2015; 44-48
Remediation of intrusive symptoms of PTSD in fewer than five sessions: a 30-person pre-pilot study of the RTM Protocol
Authors: Gray Richard M. , Bourke Frank
Published: October 2015

Introduction: The Reconsolidation of Traumatic Memories (RTM) Protocol is a brief non-traumatizing intervention for the intrusive symptoms of post-traumatic stress disorder (PTSD). It is supported by nearly 25 years of anecdotal and clinical reports. This study reports the first scientific evaluation of the protocol. Methods: A 30-person pilot study using male Veterans with a pre-existing diagnosis of PTSD. Intake criteria included interviews and confirmatory re-diagnosis using the PTSD Checklist–Military version (PCL-M). Of 33 people who met the inclusion criteria, 26 completed treatment using the RTM protocol. A small ( n = 5) wait-list control group was included. All participants were reassessed following treatment using the PCL-M. Results: Of 26 program completers, 25 (96%) were symptom free at 6-week follow-up. Mean PCL-M score at intake was 61 points. At the 6-week follow-up, the mean PCL-M score was 28.8, with a mean reduction in scores of 33 points. Hedges’ g was computed for 6-week follow-up and showed a 2.9 SD difference from intake to follow-up. A wait-list control analysis indicated non-significant symptom changes during the 2-week wait period. Discussion: Results suggest that RTM is a promising intervention worthy of further investigation.
WatchingA Raisin in the Sunand Seeing Red
Authors: Thomas Aaron C.
Published: October 2015

“Watching A Raisin in the Sun and Seeing Red” argues that, while anti-Communism has often been discussed by historiographers of African American theatre, Communism itself and the influence of the Communist Party U.S.A. as a positive force in black theatre history have largely been ignored. As a way of exploring the Communist influence on black theatre, the article describes specific ways in which Lorraine Hansberry’s 1959 play is indebted to Communist political critiques. Following the FBI’s own surveillance of the play before it came to Broadway, “Watching A Raisin in the Sun and Seeing Red” also uses the FBI’s own internal memos about the play’s Communist content to reassess the play’s political critique of American individualism, racism, sexism, and capitalism.
“True Heart”: Reimagining Transnational Subjects through Sentimentality in Velina Hasu Houston’s Plays
Authors: Na Eunha
Published: October 2015

The article examines the political viability of empathy when we imagine interracial intimacies in women’s theatre. Borrowing Lauren Berlant’s notions of “national sentimentality” and the “intimate public,” I argue that Velina Hasu Houston’s Tea (1981) and Kokoro (1994) complicate our usual understanding of theatrical empathy. These plays restage familiar spectacles of racial suffering through the sentimental rhetoric and conventions of melodrama in order to enable cross-racial identifications between Japanese women and presumably white, female audiences. Simultaneously, they challenge the universalizing impulse of such falsely imagined affective alliances by exposing racial stereotypes and highlighting the limits of the viewers’ empathic desires. By reading these plays as creating a female cultural space – one in which affective mutuality is believed to transcend material differences – I interrogate the contingencies and pseudo-political dimensions of theatre’s feeling work.
“A Theatre of the Head”: Material Culture, Severed Heads, and the Late Drama of W.B. Yeats
Authors: Reynolds Paige
Published: October 2015

Floating (sometimes literally) throughout W.B. Yeats’s body of work is the severed human head that sings after death, an entity embodying the dynamic relationship between subject and object, being and non-being. The article traces the evolution of Yeats’s relationship to the severed head as symbol and prop to understand his ambivalence toward the object world of the stage. The symbolic severed heads of his early writing, such as the one found in The Green Helmet (1910), confirm his antipathy toward the material. However, three of his late plays feature severed heads as physical objects onstage. The King of the Great Clock Tower (1934), A Full Moon in March (1935), and The Death of Cuchulain (1939) all suggest that the unsettled and ambiguous prop of the severed head gave Yeats a unique tool to secure a human legacy and thus inspired him to recalibrate his relationship to the material world.