Background: Extubation and emergence from general anesthesia is a stressful event which is a less addressed clinical entity. Problems associated with extubation, recovery, and emergences are more common than problems at intubation. Reports from the UK suggest that respiratory complications are common at extubation and during recovery. Death or brain injury was more common in claims associated with extubation and recovery than those occurring at the time of induction of anesthesia. Subjects and Methods: The Consolidated Standards of Reporting Trials (CONSORT) recommendations for reporting randomized, control clinical trials were followed. After obtaining hospital ethics committee approval, a prospective randomized controlled study was done to compare fentanyl, dexmedetomidine and placebo in attenuating of hemodynamic stress response during extubation and emergence from general anaesthesia; in 150 patients with 50 patients in each of 3 groups. Results: Sedation score at 15 min in group A was 1.64±0.56, in group B sedation score was 2.36±0.53. Among group A & B, there was statistically significant difference at 15, 20 and at 120 minutes following extubation (p<0.050). At remaining interval of observation there was no statistically significant difference (p>0.050). Recovery score at 15 min following extubation in group A, B, C were 13.28±0.50, 13.78±0.46, 13.78±0.42 respectively. Conclusion: There was statistically significant difference in recovery score among the groups (p<0.001) at 15, 20, 25 minutes of study period. But clinically recovery score were nearly similar in all 3 groups.

Urinary tract infection is one of the most frequently seen medical complication in pregnancy. Related to it further a number of complications like acute and chronic pyelonephritis, HT, intrauterine growth retardation are seen. Early detection and treatment of bacteria allows an approach to be made for the prevention of chronic urinary disease in the community and to avoid complications in pregnancy at an early stage. In view of the above an attempt was made to isolate and identify the pathogens from urine in suspected cases of UTI in pregnant women. The objective was to: 1 Isolate various pathogens from urine in suspected cases of UTI in pregnant women, 2 Identify the pathogens by biochemical reactions. A total of 500 samples were investigated. The samples were collected from women attending the antenatal clinic at the Khaja Banda Nawaz Hospital, Gulbarga. A proforma was used to collect the data from the subjects of varying ages from 18 years to 25 years, from varying gravida and all three trimesters were included. Sterilized urine container was used to collect urine with all aseptic precautions. Macroscopic and microscopic examination was done. Culture and biochemical reactions were done and the strains were isolated and identified. The prevalence rate of UTI in pregnancy was (10.4%). The incidence of organisms isolated in bacteriuric cases showed Klebsiella as the major isolate constituting 25%. Urinary tract infection the most commonly seen complication in pregnancy. Prevalence rate of 10.4% (52/500) was seen. Both Gram-negative and Gram-positive bacteria were isolated, coliform isolates being comparatively higher.

Dexmedetomidine does not appear to have any direct effects on the heart. A biphasic cardiovascular response has been described after the application of dexmedetomidine. The administration of a bolus of 1μg/kg dexmedetomidine initially results in a transient increase of the blood pressure and a reflex decrease in heart rate, especially in younger, healthy patients. The initial reaction can be explained by the peripheral α2B-adrenoceptor stimulation of vascular smooth muscle and can be attenuated by a slow infusion over 10 or more minutes. Patients were randomly allotted to each of study group, based on a computer generated random number table using Microsoft excel. 150 patients with 50 in each group of ASA (American Society of Anaesthesiologists) physical status I & II patients aged between 18-55 years undergoing elective surgical procedures, lasting between 1 and ½ hour to 4 hour, under general anesthesia requiring endotracheal intubation were enrolled for study. There was statistically significant (p<0.001) differences among group A, B & C with respect to extubation quality scale and also there was clinically significant difference among the three groups. Extubation quality was superior in decreasing order in group C (Dexmedetomidine); group B (Fentanyl) and group a (control group). Group C had best extubation quality, while group A had relatively poor extubation quality.