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Objective/Scope Accurate well production rate measurement is critical for reservoir management. The production rate measurement is carried out using surface devices, such as orifice flow meter and venturi flow meter. For large offshore fields development with a high number of wells, the installation and maintenance costs of these flowmeters can be significant. Therefore, an alternative solution needs to be developed. This paper described the successful implementation of Artificial Intelligence in predicting the production rate of big-bore gas wells in an offshore field. Methods, Procedures, Process Successful application of AI depends on capitalizing on a large set of data. Therefore, flowing parameters data were collected for more than 30 gas wells and totaling over 100,000 data points. These wells are producing gas with slight solid production from a high-pressure high-temperature field. In addition, these wells are equipped with a multistage choke that reduces the noise and vibration levels. An Artificial Neural Network is trained on the data using Gradient Descent method as the optimization algorithm. The network takes as an input the upstream and downstream pressure and temperature, and the choke size. The output is the gas rate measured in MMscf/day. Results, Observations, Conclusions The data set was divided into 70% for training the neural network and 30% for validation. Artificial Neural Network (ANN) was used and the developed model compared exceptionally well with the gas rates measured from the calibrated venturi meters. The gas rate estimation was within a 5% error. The model was developed for two types of completions: 7" and 9-5/8" production tubing. One of the challenges was how to estimate the choke wear which plays a major role in the quality of the choke size data. A linear choke wear deterioration is applied in this case, while work in progress is taking place for acquiring acoustic data that can significantly improve the choke wear modeling. Novel/Additive Information The novel approach presented in this paper capitalizes on Al analytics for estimating accurate gas flow rate values. This approach has improved the reservoir data management by providing accurate production rate values which has drastically improved the reservoir simulation. Moreover, the robustness of the AI model has forced us to rethink the conventional design of installing a flow meter for every well. As shown in this paper, the AI model served as an alternative to conventional venturi meters. We believe that the application of AI models to other aspects of production surveillance will lead to a shift into how operators design production facilities.

Introduction Endometrial cancer (ECa) usually presents as early stage disease when primary surgery is the recommended management. Patients with advanced disease pose a more challenging problem if disease is locally advanced, when primary surgery may be difficult and potentially morbid. Limited data exists regarding neoadjuvant chemotherapy (NACT) and surgery in this setting. We present our initial experiences with NACT and surgery in patients with endometrial cancer >stage 2. Methodology Data were collected retrospectively from patients with ECa treated between January 2015-June 2020. Outcome measures include response; survival; and treatment-related morbidity. Results We identified 12 patients aged 39–70 yrs. Data is complete for 11 as one patient had surgery overseas. Histological type was: endometrioid (75%), serous (25%). 50% were stage IV; 42%stage III; 8% stage II. All patients received combination Carboplatin/Paclitaxel chemotherapy. One patient received radiotherapy in addition prior to surgery. 67% had 3 cycles of chemotherapy; 17% had 4 cycles. One patient is recently diagnosed and still receiving treatment. 90% had optimal debulking surgery, 10% sub-optimal debulking and one patient has unknown operative findings. Data regarding survival is available for 11 patients. Two have died. Nine are alive without recurrence with survival ranging 2–40 mth. Overall median survival is 18 mth. 70% had no complications post-treatment; 20% had wound infection; 10% had neuropathy. Conclusions NACT and surgery can deliver high rates of optimal debulking in patients presenting with advanced stage ECa. There were acceptable levels of treatment-related morbidity. It is too early to assess the survival of patients with this strategy although our initial experience shows promising results.

This paper presents a new insight into the factors that affect the initial productivity of Acid Fracturing (AF) treatments in a sour gas carbonate reservoir. Acid Fracturing is a stimulation technique used to improve the productivity or injectivity of wells. It involves pumping acid into a formation at above fracture pressure, and can treat deep into the formation. Despite the benefits of acid fracturing, conditions are not always favourable for acid fracturing. This could be due to reservoir or well limitations for example, very low formation permeability, formation temperature especially in dolomite formations, and/or well completion integrity. In this application, a total of 12 wells were stimulated after initial completion by acid fracturing. The treatment design is a single stage Pad-Acid treatment which involves pumping 1) pre-acid, 2) gelled water, 3) main acid, 4) diverter, 5) repeat of steps 2 to 4 as required, then followed by 6) a post-acid flush and 7) over-flush. Optimisations made on the treatment design as the campaign progressed include use of specially formulated diversion system, ramp up of acid injection rates and volumes. The analysis of pre and post stimulation productivity performance show the following: An average productivity improvement of 9 times the pre stimulation productivity,A direct relationship between productivity improvement and increasing the rates/volumes of acid injection during the treatment,That treatment volume did not always result to productivity increase but the manner and sequence of fluid injection were of greater effect on productivity.Fluid diversion system blended with particulates show greater increase in productivity than wells treated with diversion systems with no particulates. Based on the results, it can be concluded that, an optimized method of ramping up acid injection rate/volume as well as careful selection of diversion system can lead to productivity improvement of up to 9 times the pretreatment productivity in Carbonate reservoir stimulation.

Introduction Tres peu d’etudes en dermatologie sont dediees aux caracteristiques des ongles chez les nouveau-nes en bonne sante a terme. De ce fait, l’appareil ungueal a cet âge demeure une entite encore mal elucidee qui laisse le dermatologue parfois perplexe face aux questions des parents. L’objectif de cette etude est d’evaluer la prevalence des differents aspects physiologiques des ongles des nouveau-nes a terme. Materiel et methodes Ce travail est descriptif et analytique transversal portant sur des nouveau-nes a terme sains aucun antecedent pathologique maternel, gravidique ou neonatal du centre de maternite du CHU Mohammed VI de Marrakech. L’histoire medicale de la mere et du nouveau-ne ainsi que l’examen general et l’examen specifique des ongles ont ete notes en utilisant un questionnaire standardise. Les ongles etaient systematiquement pris en photo. Resultats Au total 200 nouveau-nes etaient inclus dans l’etude soit 4000 ongles. Le sex-ratio etait de 1,2 et 57,5 % avaient un phototype IV. Sur les mains, les caracteristiques predominantes etaient la forme ovale (70 %) et la courbure convexe (67 %). La lunule n’etait presente que dans 9,75 % des ongles des mains, une hypertrophie des replis lateraux etait notee dans 20 % des cas, une hyperpigmentation du repli proximal dans 32,45 % des ongles et 6,25 % avaient des ongles en chevron. La partie distale de l’ongle etait longue (33,5 %) et une eversion etait constatee dans 1 % des cas. Sur les orteils, la forme des ongles etait ronde (70,3 %) ou triangulaire (21,1 %) avec une courbure plate (76,9 %). Nous avons note une koilonychie chez 4 % des nouveau-nes et une lunule chez 1 %. Nous avons trouve une micronychie chez 32 % des cas. La surface du plateau ungueal a presente des lignes de beau (4,95 %), des stries horizontales (2,35 %), et des ongles en chevron (3,3 %). Les parties distales ont montre une eversion (10 %) et aussi une onychoschisie (1,95 %). Notre etude a monte une correlation significative entre la longueur de l’ongle et le poids, la taille et le terme, ainsi qu’une correlation significative entre le phototype et l’hyperpigmentation des replis proximaux. Discussion Les aspects trouves dans cette etude semblent etre des variations physiologiques des ongles a la naissance et non pas des aspects pathologiques, qui peuvent etre expliques par les donnees sociodemographiques ainsi que plusieurs phenomenes lors de la vie intra- ou extra-uterine. Conclusion Pour conclure, ce travail nous a permis d’avoir un apercu sur les caracteristiques physiologiques des ongles de nouveaux nes marocains mais un recueil des donnees des ongles des nouveaux nes avec un suivi devrait etre propose sur le plan national afin d’etablir le profil de notre population, et de ce fait pouvoir rassurer les parents devant certains aspects particuliers.

A combined system using the microalgae from South Africa and the sewage sludge from Algeria has been tested, in order to study the efficiency of wastewater treatment by mixtures of microalgae / activated sludge, five bioreactors were installed with different inoculation rates (microalgae / activated sludge) B1: 100% algae, B2: 90.90%: 9.1%, B3: 83.33%: 16.67%, B4: 50%: 50% and B5: 16.67: 83.33. The best removal percentages were measured as: 76.36% for PO4-P, 94.90% for NO3-N, 90.42% for NH4-N and 65.73% for COD, in the combined system. Except in the case of COD, there were highly significant effects of different inoculations rates on yield. The best results are those of the bioreactor B5. These results suggest that the nutrients in the wastewater can be effectively eliminated by co-cultivation of micro-algae with bacteria (activated sludge).Keywords: Wastewater; phosphates; nitrates; ammonium; COD; microalgae / activated sludge; bioreactor

Introduction Le xeroderma pigmentosum (XP) reste relativement frequent dans certaines regions a fort taux de consanguinite et dans des familles relativement nombreuses, comme au Moyen-Orient et au Maghreb. Si les mesures pour une photoprotection appropriee ne sont pas prises, les patients XP developperont des symptomes graves et plusieurs cancers de la peau, quel que soit leur âge. Le but de ce travail est de montrer le defi que represente la gestion de cette pathologie lorsque les patients ne peuvent pas payer le cout d’une protection solaire stricte et d’un suivi medical etroit. Nous abordons egalement les aspects epidemiologiques et aspects cliniques de l’XP, en mettant l’accent sur les tumeurs, leur traitement et leur evolution. Materiel et methodes Il s’agit d’une etude retrospective monocentrique portant sur 52 cas de xeroderma pigmentosum collectes dans les departements de dermatologie et de chirurgie plastique et reconstructive entre 2011 et fevrier 2019 a l’hopital universitaire Mohammed VI de Marrakech, au Maroc. Resultats Cinquante-deux xeroderma pigmentosum etaient admis en 8 ans. 57 % des cas etaient des hommes. Les patients etaient issus d’un mariage consanguin dans 68 % des cas et leur niveau socioeconomique etait tres bas dans 72 % des cas. Le diagnostic de XP avait ete pose en moyenne a 3 ans. Les principaux symptomes cutanes etaient des lesions pigmentees, des lentigines. L’âge moyen de la premiere tumeur etait de 5,9 ans, allant de 2 a 13 ans. Seulement 22 % des patients utilisaient la photoprotection, mais avec une faible compliance. Quarante-trois de nos patients presentaient une transformation maligne (83 %) et 152 tumeurs de la peau etaient diagnostiquees avec une moyenne de 3,5 tumeurs par patient. Ces tumeurs etaient de type carcinome epidermoide dans 50 % des cas, de type carcinome basocellulaire chez 16 % des patients et de type melanome dans 4 cas. Une excision des tumeurs etait realisee pour tous les patients, 2 patients avaient une exenteration oculaire, 40 % avaient une greffe de peau et un patient avait recu une greffe faciale totale. Les rechutes cutanees apres la chirurgie etaient notees dans 56 % des cas. Discussion Notre serie se caracterise par une grande frequence de tumeurs cutanees (83 %) par rapport a la plus grande revue de litterature (45 %). Ces tumeurs etaient principalement representees par des carcinomes spinocellulaires et basocellulaires apparus tot (5,9 ans). Notre serie se caracterise egalement par une frequence elevee de rechutes cutanees apres chirurgie (56 %). Conclusion Le cout eleve de la photoprotection stricte, en particulier pour les patients pauvres, et l’absence de depistage dermatologique regulier conduisent a la proliferation de tumeurs de grande taille, rendant les strategies therapeutiques difficiles et assombrissant le pronostic.

Drug-eluting stents have greatly reduced the risk of in-stent restenosis compared to bare metal stents by inhibiting neointimal growth. However, they may carry some long-term risks, especially the risk of late stent thrombosis. Recently, several cases of drug-eluting stent fracture have been also reported. The mechanisms, the diagnosis, the clinical implications and the management of this new complication are not well-known. We report the observation of a new case of displaced, sirolimus drug-eluting stent fracture. To our knowledge, this is the first reported case in France.

The present authors report the case of an adult with chronic granulomatous disease who developed an unusual lung fibrosis associated with severe pulmonary hypertension. Histological analysis of a lung biopsy showed a diffuse infiltration with pigmented macrophages without granulomas, which particularly involved the pulmonary arterial and venular walls. Clinical and histological findings were suggestive of pulmonary veno-occlusive disease. Such a clinical association has not been previously described in the literature and might be due to the persistent expression of gp91phox at a very low level. In conclusion, the present case report illustrates a novel manifestation of chronic granulomatous disease.

Acute chest syndrome is a frequent complication of sickle cell disease. This syndrome is characterized by recent infiltrate on chest X-ray with chest pain or fever or dyspnea. We report the case of a 26-year-old man in whom an acute chest syndrome with fat embolism was the inaugural sign of sickle cell disease. This report illustrates the frequency of potentially serious fat embolism in the acute chest syndrome and the importance of bronchoscopy and bronchoalveolar lavage (fatty macrophages) for determining the etiology of acute chest syndrome.

Intramural hematoma (IMH) of the aorta is an uncommon entity. This disease shares many characteristics with acute aortic dissection. Treatment of IMH remains controversial. We report the case of a 58 years old man with hypertension disease who was admitted in emergency department with suspicion of acute aortic dissection. Transoesophageal echocardiography showed IMH involving the descending aorta which spread afterwards to the ascending aorta. Patient was treated medically and echocardiographic follow-up showed that aortic hematoma remains stable. Two years later, patient is alive and the last TEE reveals disappearance of hematoma in ascending aorta and decrease of it in descending aorta.

Resume L’hypereosinophilie majeure isolee a la streptomycine n’a jamais ete rapportee. Nous rapportons l’observation d’un patient âge de 39 ans mis sous traitement antituberculeux aux doses usuelles pour une tuberculose pulmonaire bacillifere du sommet droit. Sa numeration formule sanguine avant sa mise sous traitement montrait 80 eosinophiles/ml. Au 15e jour, ce taux etait de 1980 eosinophiles/ml, sans aucune autre manifestation allergique ou generale. L’arret de la streptomycine, a entraine un retour a la normale du taux d’eosinophiles et sa reintroduction controlee a ete a l’origine de la reascension du taux d’eosinophiles, ce qui nous a permis d’imputer la streptomycine.

PURPOSE:: To evaluate the effect of autologous platelet-rich plasma (PRP) on the early phases of osteoinduction by allogenic demineralized bone matrix (DBM) in rabbit intramuscular positions. MATERIALS AND METHODS:: Allogenic DBM was produced from bones of 3 healthy rabbits. In each of 6 experimental animals, 0.3 mL autologous PRP was prepared and 2 muscle pouches were created, where 250 mg DBM + PRP (experimental sites) and 250 mg DBM without PRP (control sites) were randomly implanted. Animals were euthanized 3 weeks postoperatively. RESULTS:: Histologic examination revealed uneventful healing in all cases, whereas remineralization of the periphery of the bone graft particles was a constant finding. In both control and experimental sites, fibroblasts and other mesenchymal cells (probably osteoprogenitor cells and preosteoblasts) were observed. The main histological difference was the recolonization of the empty lacunae of the bone graft particles by osteocytes at the control sites. The degradation of the graft at the control sites was statistically significantly quicker, although a statistically significant difference regarding the amount of the newly formed fibrous connective tissue was not observed. CONCLUSION:: The present study demonstrated that in this experimental model, the addition of PRP to DBM had a negative effect on the early phases of osteoinduction at 3 weeks of observation. Copyright © 2012 by Lippincott Williams & Wilkins.

Drug-eluting stents have greatly reduced the risk of in-stent restenosis compared to bare metal stents by inhibiting neointimal growth. However, they may carry some long-term risks, especially the risk of late stent thrombosis. Recently, several cases of drug-eluting stent fracture have been also reported. The mechanisms, the diagnosis, the clinical implications and the management of this new complication are not well-known. We report the observation of a new case of displaced, sirolimus drug-eluting stent fracture. To our knowledge, this is the first reported case in France.

Geochemical analysis of 254 core and cuttings samples from three petroleum exploration and development wells (Well 1, 2, and 3) in the Sfax area of eastern Tunisia, has successfully characterised the Cenomanian Fahdene Formation, and the Turonian Annaba, Bireno and Douleb members of the Aleg Formation. The cored mid-Turonian Bireno Member in the Well 3 is subdivided into two lithostratigraphic units: (i) Unit 1, attributed to a shallow subtidal environment; (ii) Unit 2, believed to represent an intertidal to supratidal sabkha environment. Vertical geochemical profiles were established for each well for 11 major elements and 7 trace elements. Chemostratigraphic correlation based on marker geochemical shifts that reflect member boundaries and the two Bireno Member sub-units has been successfully established between the three wells. Porosity seems to be strongly correlated with Ca and Mg, reflecting the importance of peri-reefal limestones and sabkha dolostones as important reservoir horizons, while clay minerals provide the main source of gamma ray response, and clay-rich beds typically represent relatively tight intervals. Chemostratigraphic studies of shallow-marine sediments such as the Bireno Member, offer considerable potential for the characterisation, subdivision and correlation of strata in petroleum basins.

Epithelioid haemangioendothelioma is a rare vascular tumour of slow growth and unfavourable outcome. The diagnosis of the pulmonary localisation is difficult and can mimic by clinical and radiological features other diagnosis as hypersensitivity pneumonitis. We report the case of a 28-year-old man, farmer handling with palm tree pollens, admitted to the hospital for dry cough. Clinical and thoracic computed tomography findings revealed diffuse infiltrating pneumopathy; bronchoalveolar lavage results and professional exposure were suggestive for hypersensivity pneumonitis. Surgical lung biopsy with immunochemistry study concluded to pulmonary epithelioid haemangioendothelioma. Extra pulmonary localisation research was negative. No treatment was indicated. At three years, the patient is steel asymptomatic. Epithelioid haemangioendothelioma is a tumour of intermediate malignancy, of which pulmonary localisation has a nonspecific clinical presentation mimicking diffuse infiltrating pneumonitis. Diagnosis is essentially made by surgical lung biopsy with pathological and immunohistochemical study.

Intramural hematoma (IMH) of the aorta is an uncommon entity. This disease shares many characteristics with acute aortic dissection. Treatment of IMH remains controversial. We report the case of a 58 years old man with hypertension disease who was admitted in emergency department with suspicion of acute aortic dissection. Transoesophageal echocardiography showed IMH involving the descending aorta which spread afterwards to the ascending aorta. Patient was treated medically and echocardiographic follow-up showed that aortic hematoma remains stable. Two years later, patient is alive and the last TEE reveals disappearance of hematoma in ascending aorta and decrease of it in descending aorta.

Pregnancy can precipitate or exacerbate cardiac arrhythmias. Management of those arrhythmias is not very different from that in non-pregnant women.In this review we tried to specify factors which favour arrhythmias in pregnant women and to show their specific management.We carried out a search through PubMed using as keywords: pregnancy, cardiac arrhythmias, antiarrhythmics.Hemodynamic perturbations, direct electrophysiological effects of hormones and underlying heart disease are potential factors that can promote arrhythmias in pregnancy. Usually, no drug therapy is needed for the management of supraventricular or ventricular premature beats but potential promoting factors should be eliminated. In paroxysmal supraventricular tachycardia, vagal maneuvers should be tried firstly. Adenosine could be used if vagal maneuvers are ineffective. In pregnant women with atrial fibrillation, the goal of treatment is the conversion to sinus rhythm or the control of ventricular rate. Ventricular arrhythmias are usually uncommon during pregnancy and often occur in the absence of structural heart disease and are responsive to drug therapy. Symptomatic bradycardia rarely complicates pregnancy and its management does not differ from that in non-pregnant women.

Acute chest syndrome is a frequent complication of sickle cell disease. This syndrome is characterized by recent infiltrate on chest X-ray with chest pain or fever or dyspnea. We report the case of a 26-year-old man in whom an acute chest syndrome with fat embolism was the inaugural sign of sickle cell disease. This report illustrates the frequency of potentially serious fat embolism in the acute chest syndrome and the importance of bronchoscopy and bronchoalveolar lavage (fatty macrophages) for determining the etiology of acute chest syndrome.

Resume Les carcinomes mucoepidermoides (CME) du poumon sont rares. Ils sont classes en carcinomes de bas grade qui relevent dans la mesure du possible d’un traitement chirurgical conservateur et en carcinomes de haut grade qui doivent beneficier d’une chirurgie large suivie parfois de radiotherapie. Nous rapportons une serie de 10 CME du poumon (5 de bas grade et 5 de haut grade). L’âge moyen etait de 43,9 ans avec des extremes allant de 10 a 67 ans et le sex ratio etait de 8 hommes pour 2 femmes. Seuls 5 patients etaient tabagiques. Les 10 patients ont ete operes ; 8 ont eu une lobectomie et 2 une pneumonectomie. Une radiotherapie complementaire a ete pratiquee dans 2 cas de CME de haut grade. Trois malades (2 CME de haut grade et 1 CME de bas grade) sont decedes dans un tableau de metastases diffuses alors que les 7 autres, bien suivis, sont en bon etat general.