Search

This study aims to evaluate Kharita gas reservoir to enhance the production. The increase in water-cut ratio reduces the left hydrocarbons’ amount behind pipe. Accurate determination of pore throats, pores connectivity and fluid distribution are central elements in improved reservoir description. The integration of core and logging data responses is often used to draw inferences about lithology, depositional sequences, facies, and fluid content. These inferences are based on petrophysical models utilizing correlations among tools’ responses as well as rocks and fluids properties. Upper Kharita Formation produces gas and condensate from the clastic sandstone in Badr-3 field, western desert of Egypt. It consists mainly of sandstone with shale intercalations. It is subdivided into three sub-units Kharita A, Kharita B and Kharita C that are in pressure communication. Hence, a new further investigation and review for the previously calculated GIIP (gas initially in place) was initiated. The results of this study yielded that the main uncertainty in the volumetric calculations was the petrophysical evaluation; subsequently, a new unconventional petrophysical evaluation approach was performed. The sands thickness in Upper Kharita Formation varies between more than 9 up and more than 61 m with average porosity values range between 0.08 and 0.17 PU while the average permeability values range between 1.89 and 696.66 mD. The average hydrocarbon saturation values range between 46 and 97%. The sands thickness in Upper Kharita Formation varies between more than 9 up and more than 61 m with average porosity values range between 0.08 and 0.17 PU while the average permeability values range between 1.89 and 696.66 mD. The average hydrocarbon saturation values range between 46 and 97%. Reservoir shale cutoff of 55% by using cross-plot between shale volume and porosity (Toby Darling concept) was utilized to discriminate the reservoir from non-reservoir sections. The porosity model was used to calculate reservoir porosity, using the density log. The Archie and saturation/height function models were used to calculate the water saturation and used to calibrate the water saturation in the transition zone. The porosity–permeability (POR-PERM) transform equation was used to estimate the reservoir connectivity (absolute permeability) for the four petrophysical facies (High Quality Reservoir, Moderate Quality Reservoir, Low Quality Reservoir and Highly Shale Reservoir). Core data have shown variations in reservoir quality parameters (porosity and permeability) from one well to the other. Integration of all the reservoir pressures indicated that there are different fluid types (oil, gas and water) in the Upper Kharita Formation level. The saturation/height function model was used to calibrate the saturation in the transition zone. The integration of geological core and geophysical log data helped to conduct a comprehensive petrophysical assessment of Upper Kharita Formation for a better estimation of the reservoir and to achieve a better understanding of the water encroachment in the Upper Kharita reservoir. The big challenge is the determination of the most correct model for calculating porosity, permeability and water saturation in this reservoir of different quality sand. The new petrophysical evaluation resulted in doubling the volumes in Upper Kharita reservoir and so a perforation campaign was performed to confirm the new volumetric calculations, which showed a good match with the model results. Hence, a new well was drilled targeting the low quality sand and found them with high pressure almost near virgin pressure.

Background: Dysfunction of the coronary microcirculation may be one of the factors responsible for persistent anginal symptoms. Noninvasive as well as invasive modes for assessing microcirculation have yielded inconsistent results. Aim of work: To determine the usefulness of coronary sinus filling time (CSFT) for assessment of microcirculatory transit time in the coronary circulation. Subjects and methods: A case-control study carried out in the Cardiology Department, Zagazig University Hospital on 57 patients divided into three groups: Group A included diabetics with angina, Group B included non-diabetics with angina, and Group C included control group. All patients were subjected to complete history taking, general examination and local cardiac examination. 12 Lead ECG, stress ECG (treadmill test), transthoracic echocardiography and coronary angiography were done. Results: regarding CSFT in group A the mean was 5.247 ± 0.562, in group B the mean was 4.635 ± 0.224 sec and in group C the mean was 3.295 ± 0.525 sec. There were significant difference between group A and control group (P < 0.001), between group B and control group (P < 0.001) and between group A and group B (P < 0.001). There were statistically significant relation between prolongation of coronary sinus filling time and presence of comorbid hypertension (P < 0.001), dyslipidemia (P < 0.05), Family History of CAD (P < 0.001) and obesity (P < 0.05). Conclusion: The coronary sinus filling time is a useful method for assessment of microcirculatory transit time in the coronary circulation. The prolongation of coronary sinus filling time is significantly associated with the presence of diabetes mellitus.

Background: Accurate diagnosis, characterization, and quantification of myocardial infarction (MI) are essential to assess the impact of therapy and to aid in predicting prognosis of patients with ischaemic heart disease.Objective: This study aimed to define different parameters regarding prediction of myocardial functional recovery following successful reperfusion of acute ST segment elevation myocardial infarction (STEMI).Patients and methods: This prospective study was carried out in Zagazig University and National Heart Institute (NHI) of Egypt during the period from June 2020 to June 2021. The study included 48 patients admitted with first acute STEMI. All patients were subjected to demographic data taking, electrocardiography and echocardiography examination (two examinations were done, the first was immediately after reperfusion and the second was 3 months from primary percutaneous coronary intervention (PCI).Results: There was no statistically significant difference between demographic data and risk factors except smoking habit. Regarding laboratory findings there were significant lower troponin value, peak CKMB value compared to patients had remolding (p=0.0001, p=0.027 respectively). Regarding ECG parameters, there was no statistical significant difference between the study groups regarding sum ST elevation and MI territory (p value > 0.05), but there was highly statistically significant difference between the study groups regarding 90 min ST resolution among contractile recovery (group I) p=0.0001.Conclusions: In this study patients affected by AMI with ST segment elevation and treated by primary PCI showed contractile recovery in 60.4% of the patients, while the remodeling of the LV has been observed in 39.6%.

Background and study aim: Cardiac dysfunction in cirrhotic patients presented by imperfect cardiac contractility in response to stress and/or change in the diastolic relaxation of the heart with electrophysiological changes in lack of other recognized cardiac disease. The study aimed to assess the cardiac changes in cirrhotic patients. Patients and Methods: our study was conducted on 100 adult cirrhotic patients who were divided according to the Child Pugh score into 3 groups: G1: comprised 30 Child A patients. G2: comprised 30 Child B patients. G3: comprised 40 Child C patients. Full history, clinical examination, laboratory (CBC, liver and kidney function tests, viral markers and FBS), ECG and cardiac echo-doppler were done for all patients. Results: Out of 100 cirrhotic patients, QTC interval was found to be prolonged in 70 cirrhotic patients. Echo-cardiographic abnormalities were found in Child B and C group patients more than in Child A patients. There was significant increase in Echo parameters as (IVRT and PAP) with liver disease deterioration from Child A to Child C. There was no significant difference regarding left and right ventricular end diastolic diameter among the studied groups. Conclusion: 70% of cirrhotic patients had cardiac changes and there is positive correlation between severity of liver cirrhosis and cardiac changes.

Background Conducted studies showed that the ADC (apparent diffusion coefficient) values of malignant mediastinal lesions are significantly lower than those of benign lesions. Investigators determined cut-off ADC values to differentiate the two; concluding that ADC value is a promising noninvasive, imaging parameter that helps assess and characterize mediastinal tumors. Taking this a step forward, the primary objective of our prospective study was to investigate the potential of DW-MRI (diffusion-weighted magnetic resonance imaging) to characterize malignant mediastinal lesions using their ADC values. Thirty-three patients that underwent MRI of the chest with DWI and latter pathologically diagnosed with a malignant mediastinal lesion were included in this study. Lesions’ ADC values were measured and correlated with the histopathological results. The statistical significance of differences between measurements was tested using the one-way ANOVA (analysis of variance) test; p values equal to or less than 0.05 were considered significant. Results There was no statistically significant difference between the ADCmean values of the histopathological groups of lesions assessed with the overlap of their ADCmean values. The average ADCmean value of NHL (non-Hodgkin lymphoma) was evidently lower than that of HD (Hodgkin disease) with no overlap between their ADCmean values. DWI failed at characterizing one lesion in this study as a malignant tumor, namely an immature teratoma (germ-cell tumor). Again DWI could not be used to evaluate a mass, latter pathologically diagnosed as an angiosarcoma, because of its overall hemorrhagic nature showing no definite non-hemorrhagic soft tissue components. The aforementioned results did not differ considerably when minimum ADC was used instead of mean ADC. Conclusion There was no statistically significant difference between the ADC values of the malignant mediastinal lesions evaluated. However, regarding lymphoma subtypes, our limited sample study of lymphoma suggested a considerable difference between the ADC values of Hodgkin disease and non-Hodgkin lymphoma.

Objective: To assess the relationship between serum endostatin (ES) and coronary artery calcification (CAC) in type 2 diabetic (T2DM) patients. Methods: The study included 110 participants with coronary artery disease (CAD); 55 with T2DM, for serum ES levels by enzyme-linked immunosorbent assay and CAC by contrast-enhanced spiral computed tomography (CT). Results: Mean serum ES value was 66.54 ng/mL [95% confidence interval (CI), 61.77–71.32 ng/mL]. Serum ES levels positively correlated with Agatston score index [ASI; r = 0.701, p

Background The dramatic increase in the use of cardiovascular implantable electronic devices (CIED) was associated with an increased rate of CIED infection, which has a high management cost. Aim of the study To test the safety and efficacy of a single-session protocol, aiming to reuse the infected pocket side and the same device and leads in patients with CIED pocket infection. Patients and methods We included patients with isolated pocket infection between January 2015 and November 2019. The Patient was prepared by taking a swab for culture and sensitivity before the procedure. The pocket was debrided and the capsule was removed, the pocket was rinsed with povidone-iodine and hydrogen peroxide mixture, then packed with gauze sponge soaked with povidone-iodine. The device was debrided using ultrasonic irrigation and sterilized using gas plasma. The device was reimplanted and the wound was closed in layers. Results During the period of the study, we had 12 patients with isolated pocket infection. Nine presented with erosion, two with impending erosion, and one with a chronic sinus. Patient's age was 61.5 ± 7.64 years. The infection was diagnosed 14.2 ± 8.22 weeks post device implantation. They were admitted for 7.6 ± 1.54 days postprocedure. The follow-up duration was 26.5 ± 15 (1.7-52) months. Only one patient (8%) had a recurrence of the infection after 50 days of the procedure. Conclusion Our protocol was successful in treating 92% of device-related pocket infection without the need to replace the device or the pocket side.

Background: Permanent pacemaker implantation (PPI) and heart conduction disturbances are the most common complications of TAVR. Several predictors of PPI after TAVR have been consistently identified.Objective: This study was aimed to estimate occurrence and detect predictors of permanent pacemaker implantation after trans-catheter aortic valve implantation versus surgical aortic valve replacement.Methods: Prospective cohort study from November 2014 to April 2017 in National Heart Institute and Zagazig University Hospitals in elderly severe symptomatic aortic valve stenosis patients who were candidates for aortic valve replacement.Results: The incidence of AV conduction disorders was significant high in TAVI group compared to SAVR group 50% vs. 20% (p value =0.03) derived mainly by significant increased incidence of LBBB and complete heart block. Permanent pacemaker implantation was done post procedure to three cases in TAVI group and to one case in surgical aortic valve replacement group. After one-month pacemaker implantation was done to another one patient in the TAVI group. Conclusion: Transcatheter aortic valve implantation is significantly followed by incidence of atrio-ventricular conduction disorders mainly the third-degree atrio-ventricular block demanding for permanent pacemaker implantation and left bundle branch block in comparison to surgical aortic valve replacement.

BACKGROUND: It is important to diagnose right ventricular (RV) infarction in the setting of acute inferior myocardial infarction (MI). We aimed to improve the diagnostic accuracy of RV infarction and identify a high‐risk subset of inferior MI patients with proximal RCA lesions. HYPOTHESIS: We tried to find the link between speckle tracking and coronaries in high risk inferior infarction METHODS: This study included 68 patients within 24 hours of first acute inferior MI. Group 1 (n = 49) isolated inferior MI; group 2 (n = 19) inferior and RV MI. echocardiography for RV free wall longitudinal strain (FWLS), RV fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (MPI) and peak systolic velocity (S′). RESULTS: Group 2 had higher MPI by tissue Doppler and 2D‐RV average FWLS, whereas RV FAC, S′, and TAPSE were lower (P

Background: Amiodarone is the only available intravenous antiarrhythmic medication in Egypt used in acute AF cardioversion. Cardioversion using IV amiodarone takes 6–8 h, and can be as late as 16 h. The aim of this study was to identify the clinical factors that are most associated with early (

BACKGROUND: Skin acts as a mirror to the internal state of the body. HYPOTHESIS: We tried to find the relation between skin aging parameters and the incidence of degenerative AV block. METHODS: This study included 97 patients divided into 2 groups; group D comprised 49 patients with advanced‐degree AV block, and group C comprised the 48 matched control group. All were subjected to full history taking, thorough clinical examination, calculation of intrinsic skin aging score, and resting 12‐lead surface electrocardiography (ECG). ECG for all patients assessed left ventricular end‐systolic diameter, left ventricular end‐diastolic diameter, ejection fraction, left atrium (LA) diameter, aortic root diameter, mitral annular calcification, aortic sclerosis. Coronary angiography was also performed when indicated for patients in group D. RESULTS: Patients in group D had a higher percentages of uneven pigmentation, fine skin wrinkles, lax appearance, seborrheic keratosis, total score > 7 (38 [77.55%] vs 10 [20.83%]), mitral annular calcification score of 33 (67.34%) vs 5 (10.41%), aortic sclerosis score of 21 (42.85%) vs 4 (8.33%), and mean LA diameter of 39.98 ± 5.52 vs 36.21 ± 3 mm (P 6 is the best cutoff value to predict advanced‐degree heart block with 89.79% sensitivity and 64.58% specificity. Seborrheic keratosis was the strongest independent predictor. CONCLUSIONS: Any population with a total intrinsic skin aging score of >6 is at high risk for developing advanced‐degree AV block and should undergo periodic ECG follow‐up for early detection of any conduction disturbance in the early asymptomatic stages to minimize sudden cardiac death.

Background: No-reflow phenomenon is the most striking example of myocardial reperfusion clinical failure. It caused by a lack of adequate blood flow in tissues after successful recanalization of infarct-related artery and was of multifactorial nature. Patients with «no-reflow» have highly

Background: Right ventricular (RV) apical pacing, induces asynchronous ventricular contraction and impairs cardiac function. Alternative sites of pacing particularly right ventricular outflow tract (RVOT) may have a more favorable hemodynamic profile, physiological left ventricular (LV) activation and normal ventricular contraction pattern. The Aim of the study was to find out the best alternative sites to RV apex for permanent pacemaker (PM) lead fixation in the RVOT, based on the width of the QRS in the surface ECG. Patients and methods: The study included 69 patients with pacemaker-dependent complete heart block; 35 with active pacemaker lead fixation in the site which achieved narrowest max. QRS duration in the RVOT (group 1) and 34 with active pacemaker lead fixation in RV apex (group 2). Results: High RVOT septum was the site which achieved the narrowest QRS duration on surface ECG (117.86 ± 8.43 ms) when compared with RV apex (140.29 ± 13.14) (p

The aim of the study was to estimate the role of ankle-brachial pressure index (ABI) in predicting severity of coronary artery disease (CAD) in patients with or without diabetes mellitus. Methods: This study included 120 patients with CAD proved by coronary angiography and ABI was measured for all of them. They were divided into 4 groups; Group (A): Non-diabetic patients without peripheral arterial disease (PAD) (ABI < or =0.9) , Group (B):diabetic patients without PAD (ABI < or =0.9), Group (C):Non-diabetic patients with PAD (ABI > 0.9) and Group (D):diabetic patients with PAD (ABI > 0.9). Results: Hypertension was more prevalent in group (D) (p value > 0.05). Group (C) had the highest mean age and the highest percentage of smokers, after normalization of the effects of the risk factors mean Gensini score, mean number of affected coronary vessels, mean number of coronary artery lesions and the percentage of coronary artery chronic total occlusions (CTO) were significantly higher in groups (C & D) (p > 0.001) (Table 1). Conclusion: ABI had a significant relationship with the degree of CAD severity. Therefore ABI seems to be a reliable independent prognostic marker of CAD severity in patients with or without diabetes mellitus.