Intra-Cardiac Masses in Adults: A Review of Echocardiogram Records at Two Echocardiographic Laboratories in Enugu; South-East Nigeria

Background: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses; even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses; especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90 sensitivity and greater than 85 specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE; especially for apical thrombi.Aims: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart.Materials and Methods: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra-cardiac masses in adults; as well as the gender distribution and commonest location of these masses.Results: There were 2;814 echo examinations in adults over this period; comprising 1;661 males (59.1) and 1;153 females (40.9). Intra-cardiac masses were found in 20 of these patients representing 0.7 of the study population. Thrombi were the commonest masses noted in our study; and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses.Conclusion: Intra-cardiac masses are rare; and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses

Orthopaedic infuries in the elderly: Federal Medical Center, Umuahia experience

Background: The elderly constitute an important part of the general population. Worldwide the population of the elderly has increased over the years. This paper documents the pattern of orthopaedic injuries in the elderly in Umuahia; Nigeria. Methods: A retrospective study of all injuries in patients aged 60years and above seen at the Federal Medical Centre; Umuahia from 1st July; 1996 to 30th June; 1999 utilizing data from the patients' case notes; casualty and ward registers are well as the theatre registers. Extracted data was analyzed using descriptive statistics. Results: Of the 102 patients seen; only 62 patients' records were retrievable. There were 38 males and 24 females giving a male: female ratio of 1.6:1. Their average age was 68.7 years. Over 60were in the 60-69 years age bracket. Most of the injuries occurred in the rural setting. The most common aetiology was road traffic accidents(54.8) followed by falls (21.0). Most patients (69.4) presented within 7 days of injury with 27.4receiving some form of treatment before presentation. The most common body region affected was the lower limb followed by the upper limb. Fractures were the most common injury type. The most common comorbidity was hypertension followed by arthritis and diabetes mellitus. The average duration of hospital stay was 20.7 days. No mortality was recorded. While 45.2were discharged on recovery; 22.6discharged against medical advice. Conclusion: Trauma-related injuries in the elderly are not uncommon and road traffic accident was the most common aetiology. Efforts should be made to prevent these injuries