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Background: This review evaluates the possible cardiac side effects of general anesthetic agents upon usage. Cardiac as well as non-cardiac surgery may precipitate adverse events including ischaemia, diverse arrhythmias and reperfusion injury. Volatile and non-volatile anesthetic agents possess cardiovascular effects that can lead to depression of cardiac contractility, arterial pressure, ventricular resistance and reflex tachycardia. However, as not all studies have demonstrated improved outcomes, the risk for undesirable haemodynamic effects must be weighed against the possible benefits of using anaesthetic agents either pre-operatively, intra-operatively or post-operatively during both cardiac and non-cardiac surgeries as well as in patients with coronary artery disease. The halogenated agents all have similar circulatory effects as seen in young, healthy volunteers during maintenance anesthesia (Cahalan MK et al., 1991; Eis S & Kramer J, 2022). The effects of anesthetics on the cardiovascular system have a complicated character, and almost all the anesthetic agents have a dose-related myocardial depression and decreases in heart rate and arterial pressure. During anesthesia, individual responses of patients against procedures such as induction, intubation, and surgical stimulation are influenced by many factors, including preoperatively used drugs, anesthesia type, preferred anesthetic agents, and the autonomic nervous system (Fee JPH et al., 1997, Pagel PS et al., 1991; Smith G et al., 2022).

Infection with HIV is independently associated with an increased risk of cardiovascular disease, while therapeutic use of HAART has been shown to increase the risk of metabolic derangements which may have potentially damaging effects on the cardiovascular system. The study was carried out to assess the pattern of electrocardiographic (ECG) and echocardiographic (ECHO) abnormalities among HAART experienced and HAART naive HIV patients. This was a cross-sectional study of one hundred (100) HIV seropositive subjects and 100 age and sex matched controls to assess cardiovascular risk among HIV seropositive persons in Port-Harcourt, Rivers State, Nigeria. The results showed that the prevalence of ECG abnormalities among the cases was 49 (49%) compared to 42 (42%) of the controls (c2=0.020, p=0.886). Sinus tachycardia was the most common ECG abnormality in all study participants and was present in 37 (37%) of the control subjects when compared to 21 (21%) of the cases and this was statistically significant. T-wave inversion and prolonged QT interval were the next two most prevalent findings seen in 23% and 18% of the cases compared with 8% and 5% of the controls respectively and these were also statistically significant (p=0.004 and 0.003 respectively). Among the cases 10% had grade 1-2 diastolic dysfunctions compared with 23% of the controls and this was statistically significant (p=0.013). Ninety percent (90%) however had normal diastolic function compared with 77% of the controls. Systolic dysfunction was found in only 2% of the HAART experienced cases compared to 10 (10%) of the HAART naive controls and this was also statistically significant (p=0.017). The study showed that electrocardiographic and echocardiographic abnormalities are common in HIV seropositive patients with ECG abnormalities being more common among the HAART treated subjects. These ECG & ECHO abnormalities generally increase the cardiovascular risk profile of PLWHIV/AIDS and are independent predictors of CV mortality hence the need for prompt diagnosis and interventions.

Background: Meningioma is a common intracranial tumor that accounts for 14 to 19% of all primary intracranial neoplasms. Over 90% are benign and confirmed by either histology or radiological studies. We report a case of meningioma mimicking a stroke with adult onset tonic clonic seizures.Methods: The case records of a 47-year-old female at the University of Port Harcourt Teaching Hospital and a review of the literature utilizing Google and Pub Med search was utilized.Results: A 47 year old housewife presented to the emergency room with a 17 hour history of repeated generalized seizures and a 6 hour history of left sided limb weakness. She had a 10-year history of recurrent adult onset seizures and had a transient ischaemic attack 2 years prior to presentation A clinical diagnosis of right hemispheric stroke with left hemiparesis and left facial nerve palsy was made. A brain computerized tomography (CT) scan revealed a meningioma and the patient was referred for surgery.Conclusion: Strokes in developing countries like ours are sometimes managed without radiological evaluation due to financial constraints. There is however, the possibility of missing out treatable causes and stroke mimics like meningioma. Stroke misdiagnosis due to meningioma is a rare clinical occurrence but the presence of adult onset seizures should raise the suspicion and prompt further evaluation.Keywords: Meningiomas; Stroke Mimic; Seizures

Echocardiography is a noninvasive technique for the investigation of cardiac disease with reliable levels of accuracy. Echocardiographic services commenced in the cardiac unit of the University of Port-Harcourt teaching hospital in southern Nigeria in April 2000. This study aims to report our experience with the procedure over a 12 month period as well as the spectrum of clinical cases diagnosed at our center.This is a cross-sectional study carried out at the cardiology unit of the department of internal medicine of the University of Port-Harcourt teaching hospital in southern Nigeria between May 2009 and April 2010. This was performed with the ALOKA- 400R machine using two dimensional, M-mode, color flow and tissue Doppler protocols.Two hundred and thirty-four consecutive patients, 119 males and 115 females, were examined during the study period. Their ages ranged from 10 to 96 years with a mean of 49.69 +/- 16.5 years. One hundred and twenty-four patients (53%) had hypertensive heart disease, 20 (9%) had rheumatic heart disease while 13 (6%) had dilated cardiomyopathy. Hypertrophic cardiomyopathy, pericardial effusion, intracardiac tumors, cor pulmonale, arrhythmogenic right ventricular dysplasia, infective endocarditis, prosthetic heart valve, aortic arch aneurysm were present in less than 5% of the participants. The echocardiography was inconclusive in 3 (1%) while 49 (21%) had a normal study.Hypertensive heart disease was the largest echocardiographic diagnosis at our center and is one of the most important noncommunicable diseases responsible for increased morbidity and mortality among our patients in Nigeria. More work needs to be done to increase awareness about, and treatement for, hypertension in order to prevent its complications.