RESUMEN
Objective: To determine the effect of two dimensional echocardiography on time of surgery, post-operative ambulation and hospital stay among patients with lower limb fractures. Study Design: Descriptive cross sectional study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Sep 2015 to Dec 2015
Patients and Methods: A total of 123 patients were included in study based on non-probability convenient sampling who presented with lower limb fractures. The patients were divided into two groups, group A included those who underwent only electrocardiogram [ECG] for assessment and group B included those patients who were further assessed by echocardiography
Results: There was significant delay in group B patients from time of admission to surgery [p=0.0001] as well as post-operative ambulation [p=0.0001] and mean hospital stay was also longer [p=0.0005]. However the postoperative complications were similar in two groups
Conclusion: Pre-operative cardiac evaluation by echocardiography is associated with delay in surgery and increases overall hospital stay. The implementation of the American College of Cardiology/American Heart Association guidelines may prevent unnecessary cardiac consultations which can minimize use of preoperative resources, delay in time of surgery and early post-operative recovery
RESUMEN
Primary neuroendocrine tumors of the liver are seldom seen. This is the case report of 45 years old woman who presented with right upper quadrant vague abdominal pain and low grade fever. On examination a firm mass about 6 × 4 cm was palpable in left hypochondrium and epigastrium. Ultrasound and CT-scan showed mass of left lobe [segment II and III] of liver. There was no evidence of cirrhosis and hepatitis B and C status was negative. The tumor markers were also within normal values. Core biopsy confirmed a tumor of neuroendocrine origin. Octreotide scan was done which confirmed that liver was the primary site of neuroendocrine tumor. Left lobectomy [Segment II and III] was done. The diagnosis was confirmed on histopathology and immune histochemistry of specimen